DFID ANIMAL HEALTH PROGRAMME

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1 DFID ANIMAL HEALTH PROGRAMME Assessment of the impact of zoonotic infections (bovine tuberculosis and brucellosis) in selected regions of The Gambia, Senegal, Guinea, and Guinea Bissau - A Scoping study - Fred Unger and Susanne Münstermann International Trypanotolerance Centre Banjul, The Gambia, May 2004

2 List of acronyms and abbreviations BTB Bovine Tuberculosis B. abortus Brucella abortus BQ Black quarter C. bovis Cysticercus bovis CIDT Comparative Intradermal Tuberculin Test Cl. botulinum Clostridia botulinum CRD Central River Division DVO District Veterinary Officer FMD Food and mouth disease GB Guinea Bissau GBA Greater Banjul Area H.S. Haemorrhagic septicaemia ILRI International Trypanotolerance Centre LIPS Low input production system MOPS Market orientated production system M. bovis Mycobacterium bovis PH Public health p.m. post mortem PRA Participatory Rural Appraisal PPR Pest de Petite Ruminants PROCORDEL Program Concerté recherche-développement sur l élevage en Afrique de l Ouest SR Small ruminants SSA Sub-Saharan Africa TB Tuberculosis VH Veterinary health WA Weighted average WAS West African shorthorn 1

3 List of contents SUMMARY BACKGROUND PURPOSE OF THE STUDY PRODUCTION SYSTEMS AND COUNTRY CHARACTERISTICS IN THE STUDY AREA Some country characteristics The Gambia Guinea Bissau Guinea Senegal MATERIALS AND METHODS Study period Study area Survey based on Participatory Rural Appraisal (PRA) Team members for PRA sessions Disease ranking Survey based on semi-structured questionnaire Survey based on serological sampling for brucellosis Data analysis RESULTS Study population Farmers perceptions of animal diseases Disease importance ranking Results presented by country Results presented by production system Chronic diseases Chronic diseases in cattle Chronic diseases in small ruminants Farmers perception on zoonoses Questionnaire results for zoonoses Results by country Results by production system Group discussion results for zoonoses Specific observations on brucellosis Symptoms of brucellosis Results by country for cattle Results by country for small ruminants

4 Results by production system Handling of aborted foetus Results by country Results by production system Handling of milk from cows with previous history of abortion or observed hygromas Results by country Results by production system Attitudes to the importance of quality of livestock products Observations on meat quality related to animal diseases Observations on milk related to animal diseases Handling of milk produced on farms Observations on zoonoses by other groups involved Butchers Butchers knowledge of zoonoses Zoonotic diseases observed during the last 12 months Knowledge of animal diseases which can influence meat quality Health status of butchers Veterinary health authorities Observations on zoonotic infections in animals Animal diseases observed during the last year Public health sector Observations of zoonotic infections during the last three years Diagnostic capacity of local health centres and hospitals with respect to brucellosis-like infections and tuberculosis Specific knowledge of brucellosis Potential direct and indirect losses due to brucellosis General herd parameters Direct and indirect losses due to brucellosis (abortions and cow sterility) Serological sampling for brucellosis B. abortus in herd bulk milk samples B. abortus in man (volunteers) Differences in local perceptions of the impact of zoonoses on livestock and man in relation to present and previous serological findings in cattle Brucellosis Tuberculosis DISCUSSION CONCLUSIONS RECOMMENDATIONS Recommendations for the control of Bovine Brucellosis in the countries of this survey Guinea Guinea Bissau Gambia and Senegal Recommendations for future research ACKNOWLEDGEMENT

5 10 REFERENCES ANNEX Results of this survey Annex 1a: Guidelines for PRA sessions Annex 1b: Tables 1-2 and Graphs Results of previous ITC studies on bovine brucellosis and BTB LIST OF TABLES Table 1: Number of questionnaires administered per region and involved group...28 Table 2: Top-five diseases or symptoms in cattle as ranked by farmers in terms of importance by country...30 Table 3: Top-five diseases or symptoms in SR as ranked by farmers in terms of importance by country...31 Table 4: Top-five diseases or symptoms in cattle as ranked by farmers in The Gambia in terms of importance by production system...32 Table 5: Top-five diseases or symptoms in cattle as ranked by farmers in Senegal in terms of importance by production system...32 Table 6: Reports by farmers during group discussions of chronic (long lasting) diseases in cattle.34 Table 7: Consumption patterns (on farm) for meat and milk from chronic sick cattle related to production system...35 Table 8: Proportion of farmers by country with knowledge of unpecified zoonotic diseases...36 Table 9: Numbers of farmers identifying diseases with perceived zoonotic character (first mentioned disease)...37 Table 10: Farmers ranking of the importance of four given zoonoses by country...38 Table 11a: Specific knowledge of rabies and clinical observations in animals during the last three years by country (% of farmers)...38 Table 11b: Specific knowledge of anthrax and clinical observations in animals during the last three years by country (% of farmers)...39 Table 11c: Specific knowledge of BTB and clinical observations in animals during the last three years by country (% of farmers)...39 Table 11d: Specific knowledge of bovine brucellosis and clinical observations in animals during the last three years by country (% of farmers)...40 Table 12: Clinical signs potentially indicative of brucellosis infection observed by farmers in their cattle (proportion of farmers by country)...44 Table 13: Clinical signs potentially indicative of brucellosis infection observed by farmers in their small ruminants (proportion of farmers by country)...45 Table 14: Abortions observed by farmers in their cattle or small ruminants (proportion of farmers by production system and country)...45 Table 15: Ways of handling aborted foetuses by country (proportion of farmers interviewed)...46 Table 16: Ways of handling aborted foetuses by production system and country (proportion of farmers interviewed)...47 Table 17 : Farmers ways of dealing with milk from cows with a history of abortion or observed hygroma by country (proportion of farmers)...48 Table 18: Farmers ways of dealing with milk from cows with a history of abortion or observed hygroma by production system and country (proportion of farmers)...48 Table 19: Processing of milk produced on-farm presented by country (% of farmers)...53 Table 20: Processing of milk produced on-farm presented by production system and country (% of farmers)...54 Table 21: General information on aspects related to slaughter and sale of cattle and small ruminants (number per butcher per week)...55 Table 22: Proportion of butchers with knowledge of unspecified zoonotic diseases by country

6 Table 23: List of suspected diseases with zoonotic importance observed by individual butchers during slaughter (last 12 months)...57 Table 24: Butchers knowledge of symptoms and associated diseases which can influence meat quality...58 Table 25: Observations on health status of butchers...59 Table 26: Information on the interviewed VH respondents...59 Table 27: Zoonotic infection in animals and humans reported by VH respondents in the study districts during the last 3 years...60 Table 28: Diseases or symptoms in cattle ranked by DVOs according to their importance over the last 12 months by country...61 Table 29: Diseases or symptoms in SR ranked by DVOs according to their importance over the last 12 months by country...61 Table 30: Numbers of interviewed public health facilities in the study districts by country...62 Table 31: Exchange of information between PH and VH authorities...63 Table 32: Reports of zoonoses in humans over the last three years in the health centres and hospitals visited...64 Table 33: Selected information on diagnostic procedures and prevalences related to flu-like infections and TB among patients that visited the health centre of this survey during the last year by country...65 Table 34: Knowledge of brucellosis symptoms in man and diagnostic procedures (number of hospitals or health centres by country)...66 Table 35: Mean herd sizes and proportion of bulls, cows, heifers and calves based on questionnaires by country...67 Table 36: Cattle breeds in the study population (number of farms)...68 Table 37: Selected herd fertility parameters...69 Table 38: Serological results for B. abortus for herd bulk milk samples...70 Table 39: Respondents perceptions of brucellosis and serological findings by country...72 Table 40: Respondents perceptions of BTB and serological findings by country

7 Summary Introduction In order to evaluate the direct and indirect impact of brucellosis and bovine tuberculosis and other zoonoses on livestock and human health a scoping study was commissioned by DFID to ITC. The study was carried out in selected areas of The Gambia, Senegal, Guinea Bissau and Guinea Conakry during the period of March to August This survey expands on work already done at ITC investigating the distribution and prevalence of both diseases in different locations in all four countries, which focussed primarily on updating the limited existing information on the animal health aspects related to these diseases in the four countries. Materials and methods The study was carried out in form of a Participatory Rural Appraisal (PRA). The PRA took place in 2 districts of The Gambia (Central River Division south, CRD and Greater Banjul Area, GBA), Senegal (Kaolack and Fatick), Guinea (Dubréka and Coyah) and in one district (Bafata) of Guinea Bissau. In each district three (GBA) up to four (all other) half-day PRA sessions in different, randomly selected locations were carried out. For each PRA session respondents (on average 14) were selected consisting of farmers, herdsmen and milk vendors from one and up to 4 surrounding villages. The study population consisted in the Gambia of 115, in Senegal of 116, in Guinea of 100 and in Guinea Bissau of 58 respondents. Overall, 73% of the respondents were males and 27% females. The respondents were composed of 47% farmers, 26% herders and 27% milk vendors. The PRA team was composed of one national expert and two enumerators. One ITC scientist and a local veterinary officer joined the sessions as observers. Besides gaining information during the PRA, a semi-structured questionnaire was applied in each district to farmers (n= 20), the Veterinary health authorities, local butchers/meat inspectors (up to five) and Public health authorities. Key issues such as observations on diseases transmissible to humans, observations after slaughter or at post mortem inspection and awareness of diseases that affect the quantity and quality of milk and meat were considered in these questionnaires. 6

8 To find correlations with results of already completed prevalence studies on brucellosis, bulk milk samples from each village/farm participating in the study were collected and tested for B. abortus. In addition serological sampling in man (farmers, veterinarians and herders) was carried out in Dubréka, a district known to have a high prevalence for brucellosis. Results Results for disease ranking Results from disease ranking for cattle differed between the countries, with high ranks for Haemorrhagic Septicaemia (H.S.) and the diarrhoea complex in all four countries. Reports on infections with zoonotic character varied widely between the four countries. Anthrax was number two in Guinea. Clinical hygromas (indicating brucellosis) were only mentioned by farmers in Guinea Bissau and Guinea and given rank number five.. In small ruminants PPR was the highest ranked disease in three of the four countries. In The Gambia, where unspecific diarrhoea and Pasteurellosis were ranked higher, PPR was number three among the top five. Anthrax was only among the top-five list in Guinea Bissau. Observations on chronic diseases With regional variations brucellosis (only reported for Guinea and Guinea Bissau) and trypanosomosis were the most frequently observed chronic diseases in cattle. Chronic specific diseases in SR (n= 9) were less frequently reported than in cattle (35). Mange (n= 3) was recorded most often. Farmers perceptions on zoonoses Farmers knowledge of zoonoses differed between the countries but was not related to the production system. Among four given zoonoses (rabies, anthrax, BTB and brucellosis) rabies was ranked highest by farmers in Guinea, Guinea Bissau and Senegal, followed by brucellosis in Guinea Bissau, Guinea and Senegal. The highest level of knowledge based on interviews and group discussions can be attested to farmers from Guinea Bissau. This includes the knowledge of symptoms and, with the exception of anthrax, also the transmission route and how to prevent transmission. Clinical cases of anthrax and brucellosis in cattle were more frequently reported by farmers in Guinea Bissau than in the other three countries. In addition, brucellosis was more often observed by farmers in Guinea than in Senegal and The Gambia, 7

9 where infections were not common. Results from group discussions on zoonoses showed that in particular the knowledge of the public health importance of anthrax was poor. The majority of participants in The Gambia, Senegal and Guinea indicated that meat from such animals is consumed after proper cooking or application of traditional treatment. Results of group discussions in Guinea indicate that cattle with hygroma are often not considered to be sick and milk is consumed without heat treatment. Observations related to abortions The number of reported cases of abortions and hygromas in cattle were significantly higher in Guinea and Guinea Bissau. Abortions in SR were not influenced by country or production systems. The ways of handling of aborted foetuses and of milk from cows with abortion history or observed hygroma differed also between countries but not between production systems. Observations related to meat and milk quality The main indicators for reduced meat quality mentioned by farmers in all four countries were bad smell, pale colour and higher water content. The handling of such meat and specific knowledge of the causing agent varies widely between the countries. Highest level of knowledge was found in Guinea Bissau followed by Guinea. Conversely, knowledge in The Gambia and Senegal was very limited. Accordingly meat of bad quality was also handled differently, i.e. usually consumed in Senegal and The Gambia while often discarded by farmers in Guinea Bissau. Observations related to milk quality and processing During all group discussions it was agreed, that milk is a good source of energy and healthy but certain animal diseases can affect the quality of the product and may even transmit diseases to man. Changes in milk quality were generally characterized by higher water content, clotting and faster fermentation. Milk of reduced quality is usually not used for home consumption. Specific knowledge of the causative agent and how to prevent transmission differed between the regions and was found highest in Guinea Bissau. Milk in the region is usually consumed without treatment with the exception of Guinea Bissau.. Farmers and milk vendors clearly believe that milk, if boiled once, will not ferment, therefore milk is usually not heat treated because of customers preference for fermented milk. The use of starter cultures for fermentation after heating is not known. Moreover, a good number of farmers in Senegal and The 8

10 Gambia still believe that heating of milk may significantly reduce the milk yield of the producing cow. This traditional believes might limit the willingness of these farmers to accept pasteurisation as measure to prevent the transmission of zoonoses. Observations on zoonoses by butchers The majority of butchers knew of at least one zoonotic infection. Their awareness of a second and third zoonosis was clearly reduced. The zoonoses most frequently observed by butchers were brucellosis, followed by anthrax. A higher frequency of this infection was reported for Guinea Bissau and Guinea. The execution of regular health checks of butchers varied between the countries. However, none of the check ups was documented by health certificates. Observations by veterinary health authorities The most important zoonosis in respect to mortality in man was rabies followed by anthrax. The number of reported cases of rabies in animals (all of them dogs) was very similar in the four countries. Conversely more cases of anthrax and brucellosis were observed in Guinea and Guinea Bissau. The results for disease importance ranking obtained from veterinary authorities were consistent with those obtained from farmers Observations on zoonoses by public health authorities Rabies was the highest ranked zoonosis by public health authorities followed by Salmonella infections. Patients with brucellosis or flu -like infections (fever and back/joint pain) are tested for malaria if laboratory facilities are available. If not, malaria treatment is administered symptomatically without differential diagnosis, e.g. for brucellosis. Knowledge of personnel on brucellosis (symptoms, transmission etc.) was very poor, laboratory tests were not performed in any of the locations visited. Strain identification for M. bovis in patients with symptoms of TB was not carried out in the health centres/hospitals visited in Guinea Bissau and Senegal and rarely undertaken in The Gambia and Guinea. Potential losses due to brucellosis The number of cattle herds with reports on infertile cows or abortions was higher in Guinea and Guinea Bissau than in Senegal and The Gambia. 9

11 Results of serological sampling for brucellosis B. abortus herd prevalence in bulk herd milk was significantly higher in Guinea and Guinea Bissau. Seven out of 20 volunteers tested positive for brucellosis in a high prevalence area for cattle (Dubréka, Guinea). Differences in local perception in relation to present and previous serological findings in cattle Differences observed in perception of farmers and other risk groups on brucellosis (i.e. knowledge and results of disease importance ranking) were in agreement with serological results for brucellosis in cattle. Brucellosis was ranked higher by farmers and veterinarians in the high-risk areas for cattle. The absence of BTB infection in cattle was confirmed by a general low importance assigned to this disease by farmers and veterinary health authorities (i.e. it was not considered as an important disease in the disease ranking). 10

12 1. BACKGROUND The expansion of poverty and food insecurity is a cause of major concern in sub- Saharan Africa (SSA). It is estimated that between 40 to 45% of the African continent s 730 million people live in absolute poverty with 30% classified as extremely poor. West Africa has the highest population growth (3% p.a.) and urbanisation (6 % p.a.) rates in SSA and one of the highest in the world. By 2050, the human density of much of West Africa will be similar to present day Nigeria (114 persons/sq km). People s attempts to secure livelihoods include diversification of income with a significant increase in the share of the overall household income coming from livestock production. In general, the livestock sector is intensifying in response to population and urbanisation increase. In rural areas, but also in peri-urban livestock production centres, a close relationship between the people and their animals exists, often coupled with very poor hygienic conditions. Livestock diseases are controlled only to a limited extent as veterinary services are defunct and drugs neither readily available nor easily affordable for the rural and urban poor farmers. Under these circumstances, zoonotic diseases, easily transmissible from livestock to man and, in the case of tuberculosis also vice-versa, can play an important role as a contributing factor to poor human health and poverty. In a recent study commissioned by DFID on prioritising animal health research for poverty reduction (PERRY et al, 2002), a strong link between poor human health and low income and zoonotic diseases was stated. Zoonoses can be fatal and disabling diseases, the prevention of which is usually through control in animals. For this reason, their control is often left to veterinary services, with human health services showing only a limited interest or awareness of them. For two classical animal diseases transmissible to men through infection by contact or consumption of contaminated animal products, brucellosis (B. abortus and B. melitensis) and tuberculosis (M. bovis), farmers, herders and butchers have been considered to be the main groups at risk (ADAMS & MAEGRAITH, 1984). A key risk factor is the widespread consumption of raw milk in West Africa; which earlier studies at ITC have shown to be highly contaminated with pathogens that pose a public health risk to the consumer (HEMPEN et al., 2002, UNGER et al. 2003). 11

13 Human brucellosis is known as a disease presenting a variety of symptoms, affecting multiple systems and causing different forms of localised infection. It is characterised by a febrile reaction and usually associated with enlarged spleen (splenomegalie) and osteoarticular manifestations (BATHKE, 1987; SEWELL and BROCKLESBY 1990). Further complications are hepatitis, endocarditis, orchitis and meningoencephalitis (BATHKE, 1987; DJORDJEVIC, et. al 2003; MASOURIDOU et. al 2003). The classical signs (fever and back/joint pain) are therefore easily confused with other more common ailments, e.g. malaria and hence often wrongly treated. These diagnostic difficulties are characteristic for developing countries since specific tests for brucellosis are usually not available. Tuberculosis comes in the wake of poverty, war, and immunosuppressive diseases, such as HIV and is on the increase in most developing countries. In sub-saharan Africa nearly 2 million TB cases per year occur and the Genus Mycobacteria has pathogenetic and zoonotic importance (DABORN et al., 1996). The presence of both diseases in livestock therefore represents a significant public health risk. In recent work to establish the geographic distribution and prevalence of both infections in cattle carried out by ITC ( ), various surveys were carried out in The Gambia, Guinea, Guinea Bissau and Senegal. Brucellosis was diagnosed in cattle with high variability in the prevalences between different locations within and between countries. To be more specific, herd prevalences for bovine brucellosis as high as % were reported for selected districts in Guinea Bissau and Guinea whereas in The Gambia and Senegal infections are not common. In contrast to this, for bovine tuberculosis an unexpected absence of the infection was reported for all four countries. These studies focussed primarily on updating the lack of information on the animal health aspects of brucellosis and tuberculosis in these four countries. In order to fully understand the impact and importance of these diseases on livestock and people, the perception of livestock owners and other people in close contact with animals of the human health aspect needs also to be investigated in order to complement the information obtained in livestock. Furthermore, information on the economic 12

14 importance (direct and indirect losses) of zoonotic diseases in livestock is required. The latter investigations have rarely been addressed in these countries in the past. It was therefore proposed to carry out a scoping study on the importance of those zoonotic diseases for people in livestock environments. 2. PURPOSE OF THE STUDY This study was undertaken to evaluate the direct and indirect impact of zoonoses, with special emphasis on brucellosis and bovine tuberculosis on livestock and human health in selected areas of The Gambia, Senegal, Guinea Bissau and Guinea Conakry. The study expands on work already done at ITC investigating the prevalence of both diseases in different locations in all four countries. 3 PRODUCTION SYSTEMS AND COUNTRY CHARACTERISTICS IN THE STUDY AREA In the study region two livestock production systems have been identified:: the predominant low-input system and the Market-oriented system. The low-input production system (LIPS) operates at subsistence or semi-subsistence level with farmers growing crops and keeping livestock. They are smallholder farmers who rely mainly on family labour inputs for cropping and livestock related activities. Because of the scarcity of resources, farmers in LIPS adopt a risk aversion strategy which entails limited use of externally purchased inputs that in turn is not conducive to adoption of new technologies. Livestock is kept for multiple objectives: subsistence (milk, milk products), sales or exchange, inputs to agriculture (power, manure), transportation and insurance against crop failure. The study region is characterised by large areas of medium to high livestock disease risk due to ecto- and endoparasites, vector- and vector borne diseases. LIPS farmers consequently use indigenous breeds that are adapted to the feeding, health and climatic environment, but that have limitations in their productivity. 13

15 Traditional N Dama herd in Keneba, The Gambia LIPS is also characterised by an extensive land use system, animals are fed on natural pastures and crop residues, with feed supplementation limited to selected groups of animals during the dry season. Consequently body weight and milk yield decline during the long dry seasons (particularly in The Gambia and Senegal) to such low productivity levels that leave limited surplus for marketing. The vast majority of poor farmers in the study region are found in LIPS. The farmers are unlikely to engage in innovative production processes in the absence of infrastructure, easy access to markets and high costs of transportation. However, LIPS has proven to be dynamic also and respond to new challenges like increased demand for livestock products. For instance, farmers have changed species composition due to drought and they are moving to more intensified and integrated mixed farming systems. (Fall, 2003). The LIPS is predominant in The Gambia, Guinea Bissau, Guinea and in large parts of Senegal. It is estimated that 95% of the milk production in this region is produced by the LIPS (Mbogoh, 1984). 14

16 Traditional way of milking N Dama herd in Guinea A transition process towards intensification has taken place in those areas where policies are conducive, inputs available and the agro-ecological environment suitable. It is shown in Nicholson et al. (1999) that West Africa as a region has not only one of the highest urbanisation and population growth rates, but also harbours the emerging markets in the coastal cities (Dreschel et al., 1998) that will make the region a major consumption centre of livestock products in general and dairy products in particular. This transition to the market-oriented production (MOPS) has often been induced by urbanisation and the establishment of peri-urban integrated agricultural enterprises. The systems have developed prominently in the Greater Banjul Area, peri-urban Dakar, the Nieyes and in the Bassin Arachidier of Senegal and have been studied in the framework of PROCORDEL (Somda et al., 2003, Somda et al, 2004, Dia et al, 2004) 15

17 F1 crossbred (Holstein Frisian x N Dama) with dam in Greater Banjul Area, The Gambia The MOPS is geared towards income generation and the maximization of profit. It entails the introduction of new breeds (cross-bred or purebreds), feed supplementation, resource inputs such as labour, drugs, feeds. The system is usually established near marketing structures, existing infrastructure and service providers. Management strategies need to take into consideration the major challenges: provision of animal feeds in sufficient quantities year round, processing and conservation of products (meat and milk) and marketing of products. (Akinbamijo, 2003). 3.1 Some country characteristics The Gambia The Gambia, with 11,300 km 2 one of the smallest African countries, is completely surrounded by Senegal, except for the Western Coast line. It has a population of 1,36 Million with 90% Muslim and 9% Christian. It is administratively divided in 5 Divisions and Banjul city. English is the official language, but Mandinka, Wolof and Fula are widely spoken. Population density is one of the highest in West Africa and can be compared with Nigeria. The drift to move to growing urban centres is increasing with presently 40% of the population living in towns. Agriculture 16

18 contributes 23% to the GDP (1997 estimates) with the main products groundnuts, millet, sorghum, rice, corn, cassava and palm kernels. A mixed, crop-livestock farming system is practised throughout the country. The pattern of rural settlement in The Gambia is described by villages surrounded by areas of regularly cultivated fields and fallows with, at increasing ranges, long-term fallows merging into woodland. The cattle population is estimated at 360,000, sheep at 190,000, goats at 265,000, equines at 51,000 (livestock census, 1993). More than 90% of ruminants in The Gambia are trypanotolerant breeds, namely N Dama cattle, Djallonke sheep and West African Dwarf goats. The recent introduction of cross-bred cattle for the evolving dairy sector is limited to the Greater Banjul Area. The climate is characterised by a uni-modal rainfall pattern with a long dry season (November to June). Characteristics of the livestock sector, principal constraints and counter strategies are well described by Snow in Bourn et al., Guinea Bissau Guinea Bissau covers an area of 36,120 km 2, is neighbour to Senegal in the north and Guinea in the south and east and the Atlantic coast line in the west. It is a low-lying coastal region of swamps, rain forests, and mangrove, coastal wetlands, with about 25 islands off the coast. The Bijagos archipelago extends 48 km out to sea. The population is estimated at 1,38 Mill with a growth rate of 2% and 45% Muslims, 5% Christians and 50% animists. The official language is Portuguese, but Creole is the language spoken most widely. The country is administratively divided into nine regions where the population is unevenly distributed. Likewise, the regional density of the livestock population and specifically cattle is unequal. The Eastern zone (regions of Bafata and Gabu) has the highest livestock density accounting for 74% of cattle (MDRA/DGP, 1991). The Northern zone (regions of Cacheu and Oio) follows the east in terms of livestock numbers, particularly the Oio region with 13% of cattle. Cattle belong exclusively to the N Dama breed (FAO, 1980) and are extensively managed in relation with the socio-economic background of the livestock owners (Gonçalves, 1995). 17

19 N Dama herd at watering point and nearby rice fields in Guinea Bissau Recent political developments have seen a coup d état in September 2003 by General Correia Seabra who later handed over to an interim government led by President Henrique Rosa. Legislative elections took place in March 2004 and a new government is expected to be formed in the coming weeks. Presidential elections are scheduled to take place early International disputes exist over the separatist war in Senegal s Casamance region which results in refugees and cross-border raids, arms smuggling and other illegal activities, and political instability in Guinea- Bissau Guinea Guinea covers an area of 245,857 km 2, is bordered by Guinea-Bissau, Senegal, Mali, Côte D Ivore, Liberia and Sierra Leone and has a coast line in the west. The country consists of a coastal plain, a mountainous region, a savannah interior and forest areas in the Guinea Highlands with the highest peak of Mount Nimba (1,752 m).it has a population of 9,25 Million with a relatively low density (19 inhabitants/km 2 as compared to 122/km 2 in The Gambia). The growth rate is 2.4% and religion is 85% Muslim, 8% Christian and 7% animists. Official language is French, but Malinké, Susu and Fulani are widely spoken. The country possesses enormous agricultural potential, which varies according to the four natural agro-ecological zones: Guinée Maritime, Moyenne Guinée, Haute Guinée and Guinée Forestière. Livestock numbers are 2,5 Mill cattle, 1,5 Mill small ruminants, 55,000 pigs and 9 Mill poultry (livestock census 1995).. The livestock 18

20 sector contributes 16% to the agricultural segment of the GDP. The predominant dairy cattle breed is the N Dama, which is managed under the low-input system. However, few crosses (N Dama x zebu cattle) are found in Haute Guinea. The regional distribution of cattle from the census conducted in 1995, is as follows: Maritime (17%), Moyenne (41%), Haute (34%) and Forestière (8%). The Haute Guinea thus represents the second most important region in terms of livestock production. Furthermore, several projects, including the ITC led PROCORDEL, are being implemented with a dairy component and the introduction of crossbreds. International disputes arise over domestic fighting among disparate rebel groups in Guinea, Liberia, and Sierra Leone. They have created skirmishes, deaths and refugees in border areas. Nature s beauty after the first rains in Guinea Senegal Senegal covers an area of 196,190 km 2 and is bordered by Mauritania in the north, Mali in the east, Guinea and Guinea Bissau in the south and it encloses The Gambia. The Atlantic coast line forms the western limit. It has a population of 10,59 Mill with 94% Muslim and 5% Christian. The official language is French, Wolof is widely spoken, other languages are Pular, Serr, Joal, Malinke and Soninke. Agriculture, which employs more than half the working population, represents 20% of GDP. Fishing is the country s primary source of income. Exports are concentrated in the areas of groundnuts, fishing, tourism and phosphates. The country has a per capita 19

21 GSP of $459. According to recent surveys, 65% of households consider themselves poor. (The Courier, 2003). The Casamance conflict is still not fully resolved. The subdivision of the country into ecological zones relates well to the distribution of livestock species. The trypanosusceptible Zebu, Sahelian sheep and goats and horses occupy the Sahelian region, devoid of tsetse, while the south is inhabited mainly by trypanotolerant N Dama cattle, Djallonké sheep and dwarf goats and donkeys. Diakore cattle in Senegal The sudano-sahelian and north Sudan zones (middle part of the country) have mixed populations including the Diakore (Zebu x N Dama cross), which has an intermediate level of trypanotolerance. The Diakore is a popular draught animal in this region because it is larger than the N Dama. The southern soudanian and north Guinean vegetation zones (Casamance region) are the most important areas of Senegal for rearing trypanotolerant N Dama cattle. At the national level, a period of stable cattle population is seen in the 1980s probably associated with droughts that occurred during this period. There is however a trend of a steady increase since the early 1990s. This trend is also seen in the Kolda and Ziguinchor regions where the majority of trypanotolerant livestock are found. Three main livestock production systems are described in Senegal. These are (1) the pastoral system in the Sahel zone with limited rainfall ( mm) and therefore scarce feed and water resources that drive people and livestock to great mobility 20

22 according to seasons, (2) the peri-urban production system in the Niayes area with appr exotic dairy cattle and in the surroundings of large cities like Kaolack and Fatick where crossbred dairy cattle have been introduced since the mid 1990s and (3) the agro-pastoral system with the integration of crop and livestock enterprises. 4. MATERIALS AND METHODS 4.1 Study period The study was carried out in form of a Participatory Rural Appraisal (PRA) for a period of 6 months, starting in March March 2003 was considered as the Preparation Period for the main study. During this period the national PRA teams, local authorities, villages and all target groups were identified and sensitised for the study. The PRA sessions were carried out in April and May in the chosen districts of The Gambia and Senegal, in June in Guinea and in July in Guinea Bissau. 4.2 Study area The PRA took place in two districts of The Gambia, Senegal, Guinea and one district of Guinea Bissau. All chosen districts are known for their high cattle density. Another criterion for the selection of a district was the involvement in previous ITC disease prevalence studies on bovine tuberculosis and brucellosis, since useful background information was already available. For Senegal and The Gambia the locations represented also different production systems (low input and marketorientated systems). In The Gambia the Central River Division south (CRD) and the Greater Banjul Area (GBA) were selected. The CRD is a rural area and located in the eastern part of The Gambia. The distance to Banjul is around 300 km. The cattle population consists of trypanotolerant N Dama kept on natural pasture under traditional husbandry. The GBA is a peri-urban area located around Banjul, the capital of The Gambia. The area is characterised by its current transition from the low-input to the market-orientated system. The cattle population consists of N Dama and few crossbred cattle which 21

23 where recently introduced by ITC. Milk is usually sold to markets in Banjul and the GBA. Map of Senegal and The Gambia In Senegal the districts of Kaolack and Fatick were identified, located in the Bassin Arachidier (groundnut production basin) southwest of Dakar. The distance to Dakar is 220 km from Kaolack and 190 km from Fatick. Programmes for intensification of the existing livestock system are already on-going in the Bassin Arachidier. The cattle population consists mainly of Zebu type cattle and crossbreds. The proportion of crossbreds is continuously increasing due to a national artificial insemination programme. In Guinea the Districts of Dubréka and Coyah were selected. Dubréka and Coyah are rural areas. Coyah District is located in the close vicinity of Conakry; the District capital is 60km away from Conakry. Dubréka District is also situated close to Conakry. The distance from Dubréka town to Conakry is around 70 km. Milk produced in the Dubréka and Coyah District is therefore sold also at Conakry markets. The cattle population consists of pure N Dama kept on natural pasture under traditional husbandry. The majority of cattle herds in both districts are on transhumance during March to June and thereafter move to communal pastures. 22

24 Map of Guinea The district of Bafata was selected in Guinea Bissau which is situated in the centre of Guinea Bissau, bordering Guinea. The distance from Bafata to Bissau is 120 km. Milk produced in Bafata is sold also at Bissau markets. Bafata holds 40% of the cattle population of the country and the predominant breed is the N Dama. 23

25 Map of Guinea Bissau 4.3 Survey based on Participatory Rural Appraisal (PRA) Four half day PRA sessions were held in all selected districts, except for the GBA, were only three sessions were carried out. In total 27 PRA sessions formed the basis for this study. Sessions were set to be attended by a minimum of 10 and a maximum of 15 people with 5 to 8 farmers (owners of cattle and small ruminants), 2 to 4 herders (being family members or labourers often paid with milk) and 2 to 4 milk vendors as participants. Four to 12 villages in each district were randomly chosen by the District Veterinary Officers (DVO). Hence, 40 to 60 respondents were expected per district. Before performing a PRA exercise in a selected location, the village chief was identified by the DVO, the aims of the study were explained and permission was sought to carry out the study in the village. The participants from each village were chosen by the DVO, often in agreement with the local chief, on the basis of willingness to participate. 24

26 The PRAs were carried out as group discussions. However, for specific questions, quantification of group answers was achieved by randomly selecting five individuals amongst the group of farmers. The structure of the PRA sessions is listed in Annex 1a. PRA during the rain in Guinea Bissau and in the open in Guinea Team members for PRA sessions The PRA team consisted of 6 individuals, with a variety of skills encompassing veterinary knowledge, PRA experience, local knowledge of the area and livestock systems, and fluency in the local languages, and was led by a national PRA expert. More specifically the team consisted of a PRA expert, 2 enumerators (one of them socio-economist), the project co-ordinator, the local DVO and one translator. In The Gambia, Guinea and Guinea Bissau a national PRA team was recruited for the study, while in Senegal the team consisted of 2 Gambian and one Senegalese enumerator Disease ranking This method was used to obtain perceptions about the differences in disease importance ranking within and between the countries. In a first step all clinical symptoms observed by respondents during the last 12 months were recorded. These clinical symptoms were then related to specific diseases whenever possible. Five 25

27 farmers (owners of cattle and of small ruminants) were randomly selected among the group and asked to rank the 5 most important diseases. 4.4 Survey based on semi-structured questionnaire In addition to the information obtained during the PRA, a semi-structured questionnaire was administered in each district to randomly selected farmers (n= 20), Veterinary health authorities, local butchers/meat inspectors (up to five) and Public health authorities. Key issues like the reproduction status of herds, observations on diseases transmissible to humans, observations after slaughter or in post mortem and awareness of diseases that affect the quality and quantity of milk and meat were considered in these questionnaires. 4.5 Survey based on serological sampling for brucellosis To find correlations with results of previous prevalence studies on brucellosis, bulk milk samples from the majority of farms participating in the study were collected and tested for the presence of B. abortus antibodies using Milk ELISA (Bommeli ). In addition, to obtain some base line information on brucellosis in man in a known high risk area for cattle, serological sampling in potential risk groups (farmers, veterinarians and herders) was carried out in Dubréka (Guinea). According to the recommendation of the German Reference Laboratory for brucellosis in Berlin these sera were tested for B. abortus antibodies using Rose Bengal Plate Test followed by Complement Fixation Test Data analysis For entry of data, descriptive and quantitative analysis and for graphical presentation Microsoft Excel, Statgraphics Plus and EPI-Info 5.2 software was used. For comparison of means simple t-test was applied. To find likely associations between observations (e.g. abortion occurrence and management) Yates-corrected chi-square test or Fisher exact test were performed. Significantly differences were expressed as 26

28 differences between categories marked with different superscripts. The level of significance is given separate. 5 RESULTS 5.1 Study population A total of 389 people participated in the PRA sessions, composed of 115 in the Gambia, 116 in Senegal, 100 in Guinea and 58 participants in Guinea Bissau. The average number of participants in each PRA session was 14.4 (13.19,15.61). On average, in each PRA session per location 64.9 to 82.1% (overall mean 72.6%) were male respondents and 17.5 to 35.1% (overall mean: 27.4%) were females. The highest proportion of women was found in Dubréka, Guinea (35.1%), the lowest during group discussions in the LIPS in the Bassin Arachidier of Senegal (17.9%). In general the gender distribution was quite homogenous for each district and country (Graph 1). Graph 1: Gender distribution during group discussion by region and country 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% GBA (MOS) CRD (LIS) male female MOS LIS Dubreka Coyah Bafata The Gambia Senegal (Bassin Arachidier) Guinea Guinea Bissau Overall The respondents were composed of 39.7 to 54.8% (overall mean: 47.1%) farmers, 18.7 to 37.9% herders (overall mean: 25.9%) and 19.3 to 33.3% milk vendors (overall mean: 27.0%). The specific distributions for each region are presented in 27

29 Graph 2. The proportion of herders was slightly lower in both districts of Guinea whereas the proportion of milk vendors was a bit higher. Graph 2: Composition of respondents in group discussions by region and country 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% GBA (MOS) farmer herder milk vendors CRD (LIS) MOS LIS Dubreka Coyah Bafata The Gambia Senegal (Bassin Arachidier) Guinea Guinea Bissau Overall The number of respondents in the semi-structured questionnaires is summarized in Table 1. The reduced amount of farmers selected for The Gambia results from the limited number of farmers representing the market-orientated system in the GBA (n= 15). Table 1: Number of questionnaires administered per region and involved group The Gambia (GBA and CRD) Senegal (Kaolack and Fatick) Guinea (Dubréka and Coyah) Guinea Bissau (Bafata) Farmers Veterinary health authorities Public health authorities Butchers Total Total

30 5.2 Farmers perceptions of animal diseases Disease importance ranking Results presented by country In order to obtain information on the importance of diseases/symptoms as perceived by the PRA participants a ranking was applied during the group discussions. Results for ranks are based on scoring for the 5 highest ranked diseases/symptoms in all countries and expressed as weighted average. Results for cattle are shown in Table 2. Potential zoonoses or clinical symptoms, which could indicate zoonotic infections, are shaded in grey. In addition results including the top-ten list of diseases/symptoms are presented graphically by country in Annex 1b (Graphs 1-4). The ranking for the five most important diseases/symptoms indicated always in all countries unspecific diarrhoea and H.S. (pasteurellosis). With the exception of Guinea, also Black quarter was ranked high, even number one in Guinea Bissau. Symptoms/diseases with likely zoonotic implications were reported in all countries with regional variations. Anthrax was considered as the second most important disease in Guinea Bissau. Abortions and hygromas (local name bakale ) were ranked as number four and five respectively in Guinea and Guinea Bissau but not mentioned by farmers in Senegal and The Gambia. 29

31 Table 2: Top-five diseases or symptoms in cattle as ranked by farmers in terms of importance by country Symptoms/ Gambia Guinea Guinea Senegal diseases Bissau Total no. of farmers Ranking WA* Ranking WA* Ranking WA* Ranking WA* Abortion Anthrax BQ Diarrhoea (unspecific) FMD H.S Hygroma Foot problems (unspecific) Lumpy skin Tick damage/fly sore Trypanosomosis * Weighted average (WA) of scores The results for disease ranking for the five most important diseases/symptoms for small ruminants are presented in Table 3. Potentially zoonotic diseases or associated symptoms are shaded grey. In addition, the results for the ten highest ranked diseases/symptoms are presented graphically by country in the Annex 1b (Graph 5-8). PPR was considered in three countries as the number-one disease and in one country number three. All other diseases/symptoms including likely zoonoses varied widely between the countries. With the exception of Guinea Bissau abortions were always within the top-five list. As stated already for cattle in Guinea Bissau anthrax was highly ranked also in SR in this country. 30

32 Table 3: Top-five diseases or symptoms in SR as ranked by farmers in terms of importance by country Symptoms Gambia Guinea Guinea Bissau Senegal Total no. of farmers Ranking WA* Ranking WA* Ranking WA* Ranking WA* Abortion Anthrax BQ Diarrhoea (unspecific) Foot problems (unspecific) Mange Nervous symptoms 5 0,4 Pasteurellosis PPR Tick damage/fly sore Trypanosomosis * Weighted average (WA) of scores Results presented by production system In The Gambia and in Senegal the PRA was carried out on farms characterised by different production systems. Results for the five most important diseases/symptoms in cattle according to the production system are shown in Table 4 for The Gambia and Table 5 for Senegal. In The Gambia differences in disease ranking between the production systems were observed. Trypanosomosis was ranked highest in the MOPS, but only given 5 th rank in the LIPS. In addition, more importance was attributed to tick infestations in the MOPS, wherever BQ, FMD and constipation were more frequent in the LIPS. 31

33 Table 4: Top-five diseases or symptoms in cattle as ranked by farmers in The Gambia in terms of importance by production system Symptoms/diseases GBA (MOPS) CRD (LIPS) Total no. of farmers Ranking WA* Ranking WA* BQ Constipation (unspecific) Diarrhoea (unspecific) FMD H.S Lumpy skin Tick damage/fly sore Trypanosomosis * Weighted average (WA) of scores Results for disease ranking according to production systems were more homogeneous in Senegal (Bassin Arachidier) than in The Gambia. The five most important diseases/symptoms were nearly equally ranked with the exception of diarrhoea, FMD and poisoning (Table 5). Diarrhoea and poisoning were ranked more highly in the MOPS, FMD higher in the LIPS. Table 5: Top-five diseases or symptoms in cattle as ranked by farmers in Senegal in terms of importance by production system Symptoms MOPS LIPS Total no. of farmers Ranking WA* Ranking WA* BQ Diarrhoea FMD H.S Poisoning Tick damage/fly sore

34 Trypanosomosis * Weighted average (WA) of scores Summary: Results from disease ranking from cattle differed between the countries. However, H.S. and symptoms of diarrhoea were always among the top-five in all four countries. Reports on infections with zoonotic character varied widely between the four countries. Anthrax was number two in Guinea. Clinical hygromas (indicating brucellosis) were only mentioned by farmers in Guinea Bissau and Guinea and ranked as number 5. In small ruminants PPR was the highest ranked disease in three of the four countries. In The Gambia, where unspecific diarrhoea and Pasteurellosis were ranked higher, PPR was number three among the top five. Potential zoonotic infections such as anthrax were only among the top-five list in Guinea Bissau. Differences in disease importance ranking according to the production system were observed for The Gambia while in Senegal responses were more similar Chronic diseases During group discussions information was collected on chronic diseases in cattle and small ruminants. Results for cattle are shown in Table 6 and for small ruminants in Table 7. Five farmers amongst the PRA groups were selected randomly in each location to quantify responses (see 4.3). A chronic disease was defined as an illness, which lasted more than four weeks Chronic diseases in cattle During group discussions a total of 68 cases of long lasting diseases in cattle were reported by respondents. In 21 cattle the cause of the disease was unknown. The 68 cases were observed on 60 different farms. 33

35 Among the chronic diseases reported in cattle, brucellosis (14/47) and trypanosomosis (10/47) were most frequently reported. The latter disease was noted by participants in all four countries, whereas brucellosis was only reported in Guinea and Guinea Bissau. The differences observations of brucellosis between countries were significant. Table 6: Reports by farmers during group discussions of chronic (long lasting) diseases in cattle Disease suspected Overall Gambia Guinea Guinea Bissau Senegal Total no of farmers No. of farmers with cattle suffering from chronic diseases Brucellosis (Hygroma) 14 0 a 10 b 4 b 0 a BQ Diarrhoea (unspecific) Endoparasites H.S Poisoning (plastic bag) Lumpy skin Mange Mastitis Pasteurellosis Trypanosomosis Unknown (unspecific symptoms) a:b (p<0.05) When asking farmers on their consumption habit of meat and milk of chronically sick cattle, the majority (34/60) reported that they always consume such meat and milk. Among the observed chronic diseases in cattle brucellosis (n= 14) and mastitis (n= 1) have relevant importance as milk-borne infection for man, yet milk was always consumed from diseased animals. 34

36 Differences in milk consumption patterns related to the production system were observed (Table 7). A significantly higher proportion of farmers in the LIPS consumed meat from sick cattle. The difference in milk consumption practices was significant (p= 0,06) although not at the p=0.05 level. Table 7: Consumption patterns (on farm) for meat and milk from chronic sick cattle related to production system MOPS LIPS No. of farmers who reported having chronically sick cattle No. of farmers consuming raw/fermented milk from sick animals 3 * 25 * No. of farmers consuming meat from sick animals 1 a 33 b a:b (p<0.05) * (p= 0.06) Chronic diseases in small ruminants A total of 22 chronic cases of diseases in SR was reported by 22 farmers (Annex 1b, Table 1). Only in nine of these cases were the symptoms described sufficientsly by respondents to identify the disease. Mange was reported most frequently (3/9), followed by one case each of arthritis, BQ, heartwater, lumpy skin, metritis and orf. Differences in the consumption practices according to production system were also observed for small ruminants. None of the farmers reporting chronically sick animals in the MOPS (n= 4) consumed meat from such animals whereas 13 of 18 did it in the LIPS. Milk from small ruminants is usually not consumed at all. Summary: With regional variations, brucellosis and trypanosomosis were the most frequently observed chronic diseases in cattle. Cases of brucellosis were only observed by farmers in Guinea and Guinea Bissau. Specific chronic diseases in SR (n= 9) were less frequently reported than in cattle (35). Mange (n= 3) was recorded most often. The practice of consuming milk and/or meat from chronically ill animals clearly differed between the production systems. The majority of farmers in the LIPS 35

37 system still consume meat and/or milk from chronic sick cattle or SR, while this was done only exceptionally by farmers from the MOPS. 5.3 Farmers perception on zoonoses Questionnaire results for zoonoses Results by country In the semi-structured questionnaires farmers were asked to name at least three animal diseases, which might cause also infection in man. Results are presented in Table 8. Compared to Senegal a significantly higher proportion of farmers in The Gambia, Guinea and Guinea Bissau had knowledge of at least one zoonotic infection. With the exception of Guinea Bissau the knowledge of second or third zoonoses was weak in all other countries. The difference was significant. Table 8: Proportion of farmers by country with knowledge of unspecified zoonotic diseases Overall Gambia Guinea Guinea Bissau Senegal No. of farmers interviewed Farmers knowing of one disease likely to be zoonotic (%) a 58 a 65 a 20 b Farmers knowing of two diseases likely to be zoonotic (%) 18 6 a 10 a 65 b 13 a Farmers knowing of three diseases likely to be zoonotic (%) 12 0 a 5 a 55 b 8 a a:b (p<0.05) Thereafter, farmers were asked to list these zoonotic infections. Table 9 gives a list by country of the first disease mentioned by farmers as likely to be zoonotic. 36

38 Brucellosis was reported most frequently, followed by anthrax, rabies and bovine tuberculosis. All these infections were reported by farmers in each of the four countries, however with regional variations. Brucellosis was again more frequently reported in Guinea and Guinea Bissau (p= 0.06) than in Senegal and The Gambia. Less frequently reported in some of the countries were Cl. butolinum and FMD. One farmer in Senegal believed that HIV and BQ were zoonotic infections. Table 9: Numbers of farmers identifying diseases with perceived zoonotic character (first mentioned disease) Overall Gambia Guinea Guinea Senegal Bissau Total no of farmers Brucellosis 26 3 a 15 b 7 b 1 a Anthrax Rabies BTB Cl. botulinum FMD HIV BQ a:b (p<0.05) In the next step farmers were asked to rank four given selected zoonoses (rabies, anthrax, BTB and brucellosis) according to their importance. The aggregate ranks were calculated based on scorings as follows: the first zoonotic disease mentioned was assigned a score of 4, the second 3 etc. Then the total scores were calculated. Results are presented in Table 10 by country. Among these four zoonoses, rabies was ranked highest in three of the four countries. In Guinea anthrax was graded as the most important zoonotic disease. In three of the four countries, brucellosis was believed to be the second most important zoonosis. Less importance was accorded to BTB. 37

39 Table 10: Farmers ranking of the importance of four given zoonoses by country Gambia Guinea Guinea Bissau Senegal Total no of farmers Rabies Anthrax BTB Brucellosis Information was also collected on farmers specific knowledge for each of these four zoonoses. Results are presented in Table 11a d. The following topics were discussed: Knowledge of the disease and key symptoms in cattle Modes of transmission Preventive measures Cases in animals observed by farmers (during the last three years). For rabies (Table 11a) regional differences in farmers level of knowledge were observed, this being significantly higher in Guinea Bissau followed by Senegal. Measures to prevent transmission (i.e. vaccination) were known by 100% of farmers in Guinea Bissau and 83% of farmers in Senegal, but only by a minority of respondents in The Gambia and Guinea. Suspected cases of rabies, all of them observed in dogs, were reported by farmers in all countries. Table 11a: Specific knowledge of rabies and clinical observations in animals during the last three years by country (% of farmers) Rabies Gambia Guinea Guinea Senegal Bissau Total no of farmers

40 Disease & symptoms in animals 69 a 65 a 100 b 93 b Modes of transmission 54 a 38 a 100 b 90 b Preventive measures 43 a 28 a 100 b 83 b Observed in animals* 14 a 3 a 5 a 10 a a:b (p<0.05) * dogs Similar differences in farmers knowledge of anthrax were observed. Symptoms in cattle were best known in Guinea Bissau. However, knowledge about transmission and prevention was generally poor in all countries. Clinical cases of anthrax in cattle and small ruminants were most frequently observed in Guinea Bissau. Table 11b: Specific knowledge of anthrax and clinical observations in animals during the last three years by country (% of farmers) Anthrax Gambia Guinea Guinea Senegal Bissau Total no farmers Disease & symptoms in animals 40 a 50 a 75 b 10 b Modes of transmission 20 a 33 a 25 a 0 c Preventive measures 17 a 28 a 25 a 0 b Observed in animals* 9 a 5 a 25 b 0 a a:b:c (p<0.05) *cattle or small ruminants Symptoms, transmission and prevention of BTB were well known by farmers in Guinea Bissau, whereas it was very poor in the other three countries. Suspected clinical cases of BTB (described as a vasting disease and characterised by loss of weight and chronic pulmonary symptoms) were only observed by farmers in Guinea Bissau. Table 11c: Specific knowledge of BTB and clinical observations in animals during the last three years by country (% of farmers) BTB Gambia Guinea Guinea Senegal Bissau Total no farmers Disease & symptoms in animals 20 a 50 b 75 b 15 a 39

41 Modes of transmission 9 a 15 a 75 b 13 a Preventive measures 6 a 3 a 75 b 10 a Observed in animals* a:b (p<0.05) *cattle The differences in reports of bovine brucellosis between the countries were significant. More farmers had specific knowledge of all aspects in Guinea Bissau. Though the symptoms of the disease are better known by farmers in Guinea, the knowledge of transmission and prevention was poor, likewise in The Gambia and Senegal. Suspected brucellosis-like symptoms in cattle were most frequently observed in Guinea Bissau, followed by Guinea (see also 5.9.1). Table 11d: Specific knowledge of bovine brucellosis and clinical observations in animals during the last three years by country (% of farmers) Brucellosis Gambia Guinea Guinea Senegal Bissau Total no farmers Disease & symptoms in animals 23 a 75 b 100 c 55 b Modes of transmission 11 a 28 a 100 b 23 a Preventive measures 6 a 3 a 65 b 18 a Observed in animals* 3 a 30 b 80 c 8 a a:b:c (p<0.05) * cattle Results by production system Farmers knowledge about these four zoonoses (rabies, anthrax, BTB and brucellosis) was not significantly influenced by the production system. The results are presented in Annex 1b (Tables 2a-d). Summary: Farmers knowledge of zoonoses differed between countries but not by the production system. Among the four given zoonoses (rabies, anthrax, BTB and brucellosis) rabies was ranked highest by farmers in Guinea Bissau, The Gambia and Senegal while in 40

42 Guinea anthrax was ranked highest. Number two zoonosis was brucellosis (Guinea, Guinea Bissau and Senegal) and anthrax respectively in The Gambia. The highest level of knowledge about these zoonoses was found in farmers from Guinea Bissau. This includes the knowledge of symptoms and, with the exception of anthrax, also the transmission route and how to prevent transmission. Clinical cases of anthrax and brucellosis in cattle were more frequently reported by farmers in Guinea Bissau than in the other three countries. In addition, brucellosis in cattle was more often observed by farmers in Guinea than in Senegal and The Gambia, where infections were not common as evidenced by the ITC prevalence study (see 5.9.1) Group discussion results for zoonoses Farmers knowledge about zoonoses in The Gambia was very limited. There was a general understanding that some animal diseases can be transmitted to people but the respondents could not be more specific. Anthrax was mentioned as a zoonosis by four respondents in two of the seven locations. However, the high risk of transmission to man was unknown. It was actually reported that meat of suspected anthrax cases is consumed after a specific local treatment (adding of thorns of a local plant called sumpo when cooking). Another disease of zoonotic importance mentioned was lumpy skin disease in cattle. One respondent pointed out that human TB can be transmitted via sputum from man to cattle; another farmer suffered from serious diarrhoea in the last year and related it to the consumption of meat from a chronically sick and emaciated bovine. In seven of the eight selected locations in Guinea farmers had some knowledge of animal diseases, which can also affect man. Anthrax was always cited. Some respondents believed the steam during cooking to be a likely source of infection for man. Only in two locations were animals, suspected to have died from anthrax, burned and buried. In particular if veterinary services are not available, e.g. when an animal died far away in the bush during transhumance, only the spleen is discarded but the meat is consumed after proper cooking. Recent outbreaks of anthrax in cattle were reported from two locations. In addition cases of anthrax in cattle were observed in 2001 in a cattle herd from Tambaya when on transhumance in 41

43 Forehcariah. Furthermore rabies, brucellosis, BQ, lumpy skin and tuberculosis were mentioned. However, the modes of transmission were often not known. Related to brucellosis the majority of farmers pointed out that cattle with hygromas are not considered to be sick. Therefore the milk of those cattle is consumed. However, there was a consensus that they would never buy such an animal from markets or neighbours. In three of the eight locations respondents mentioned BQ as a zoonotic infection. Only in one location are such carcasses burned, otherwise the meat is consumed, with the exception of the affected parts. The majority of participants in the group discussions in Senegal believed that some animal diseases can be transmitted to humans through milk and meat. However, they were usually not able to specify any such disease. Only in two locations was anthrax cited as a zoonosis. When observed, meat is not consumed and the carcass needs to be burned and buried. Other diseases, thought to be zoonotic, which were mentioned only in one location each, were mastitis, BTB, FMD and rabies. Respondents related some experiences of similar disease symptoms observed in livestock and people, but these were of anecdotal value only. With respect to the handling of an aborted foetus (see below) there is a traditional belief in one location that hanging it on a tree might reduce the occurrence of abortion in the herd. As was the case with the replies to the questionnaire, the level of knowledge emerging from the group discussions was found to be higher in Guinea Bissau than in the other three countries. In all locations participants had specific knowledge of rabies, brucellosis, BTB and anthrax. The transmission routes and preventive measures were usually clearly known. Only in two locations no knowledge of the measures for avoiding anthrax infection in man was established. Summary: Farmers in Guinea Bissau appear to have a higher level of knowledge about zoonotic diseases. This includes knowledge of the symptoms, transmission routes and how to avoid transmission. In particular, knowledge of the public health importance of anthrax was generally poor. The majority of participants in The Gambia, Senegal and Guinea 42

44 indicated that meat of such animals is consumed after proper cooking or application of traditional treatment. The results of group discussions in Guinea indicated that cattle with hygroma are often not considered to be sick and their milk is consumed unpasteurised. 5.4 Specific observations on brucellosis Symptoms of brucellosis Information on the pathognomic symptoms of brucellosis in cattle (hygroma) and potentially linked symptoms like abortions (cattle and SR) and sterility (cattle) were collected during interviews and in group discussions. For quantification of results obtained from group discussions, five farmers with cattle and/or SR were selected randomly during each group session (see 4.3). Cow with hygroma in Guinea Bissau Results by country for cattle Results from questionnaires and group discussions are consistent regarding reports of clinical hygromas and abortions in cattle (Table 12). The frequency of abortions was higher in cattle on farms in Guinea Bissau and Guinea than in The Gambia and Senegal. The differences are significant. 43

45 Table 12: Clinical signs potentially indicative of brucellosis infection observed by farmers in their cattle (proportion of farmers by country) Gambia Guinea Guinea Bissau Senegal Questionnaire results No. of farmers interviewed % observing abortions in their cattle (during last 12 months) 23 a 53 b 70 b 33 a % observing hygromas in their cattle 3 a 65 b 75 b 5 a % observing infertile cows in their cattle (>2 years without calf) 6 a 45 a 60 b 25 a Group discussion results No. of respondents % observing abortions in their 29 a 6% b 95 c 43 a cattle (during last 12 months) % observing hygromas in their cattle 0 a 60 b 75 b 0 a 1 Five randomly selected farmers per group discussion a:b:c (p<0.05) Results by country for small ruminants Results from interviews and group discussions on abortions observed in SR both indicate that there is no significant difference between countries (Table 13). 44

46 Table 13: Clinical signs potentially indicative of brucellosis infection observed by farmers in their small ruminants (proportion of farmers by country) Gambia Guinea Questionnaire results Guinea Bissau Senegal No. of farmers interviewed % observing abortions in their small ruminants (during last 12 months) Group discussion results No. of respondents % observing abortions in their small ruminants (during last 12 months) Five randomly selected farmers per group discussion Results by production system The number of abortions reported during the last 12 months did not differ significantly between the production systems within the same country as shown in Table 14. Table 14: Abortions observed by farmers in their cattle or small ruminants (proportion of farmers by production system and country) Questionnaire Results Gambia Senegal MOPS LIPS MOPS LIPS No. of farmers interviewed

47 % observing abortions in their cattle (during last 12 months) % observing abortions in their small ruminants (during last 12 months) Five randomly selected farmers per group discussion Handling of aborted foetus Results by country Information was collected during the interviews on how aborted foetuses are handled. Farmers answers were categorised as follows: Definite destruction (foetus are buried or cremated) Partial destruction o Thrown away o Fed to dogs o Hanging on a tree Seasonal (dry season) definite or partial (rainy season) destruction (same subcategories as described above) Results from the questionnaire indicate regional differences in handling of aborted foetuses. A significantly higher proportion of farmers in Guinea Bissau (13/20) and in Guinea (16/40), bury the aborted foetuses. This proportion is even higher in the rainy season as some farmers practise this method only during this period. The majority of farmers in The Gambia (29/35) and Senegal (28/40) simply throw away the foetuses (Table 15). Table 15: Ways of handling aborted foetuses by country (proportion of farmers interviewed) Questionnaire Results Guinea Gambia Guinea Bissau Senegal No. of farmers interviewed % burying or cremating (definite destruction) 9 a 40 b 65 b 20 a 46

48 % throwing away (partial destruction) 82 a 20 b - b 70 a % hanging on a tree (partial destruction) % feeding to dogs (partial destruction) % throwing away or burying according to season - a 38 b 25 a - a % didn t know a:b (p<0.05) Results by production system No differences in the handling of aborted foetuses on farm according to the production system were found. Results are nearly similar as presented in Table 16. Table 16: Ways of handling aborted foetuses by production system and country (proportion of farmers interviewed) Questionnaire Results Gambia Senegal MOPS LIPS MOPS LIPS No. of farmers interviewed % burying or cremating (definite destruction) % hanging on a tree (partial destruction) % feeding to dogs (partial destruction) % throwing away or burying according to season Handling of milk from cows with previous history of abortion or observed hygromas Results by country Farmers were asked what they do with milk from cows with an history of abortion (last 12 months) or with clinical hygromas. As shown in Table 17, the majority of 47

49 farmers still consume milk from such cattle. However, fewer farmers do it in Guinea Bissau (11/20) and nine of twenty farmers indicated that this milk is fed to dogs, a habit which was more common in Guinea Bissau than in the other three countries. Table 17 : Farmers ways of dealing with milk from cows with a history of abortion or observed hygroma by country (proportion of farmers) Questionnaire Results Guinea Gambia Guinea Bissau Senegal No. of farmers interviewed % throwing milk away 23 a 23 a 0 b 13 ab % feeding milk to dogs 0 a 3 a 45 b 8 a % consuming milk a:b (p<0.05) Results by production system The handling of milk from cows with a history of abortion or observed hygromas did not differ significantly between the production systems (Table 18). Table 18: Farmers ways of dealing with milk from cows with a history of abortion or observed hygroma by production system and country (proportion of farmers) Questionnaire Results Gambia Senegal MOPS LIPS MOPS LIPS No. of farmers interviewed % throwing milk away % feeding milk to dogs % consuming milk Summary: 48

50 The number of reports of abortions and hygromas in cattle was significantly higher in Guinea and Guinea Bissau. Reports of sterile cows were more frequent in Guinea Bissau. The occurrence of abortions and hygromas in cattle was similarly distributed in both production system Abortions in SR were not influenced by country or production systems Handling of aborted foetuses differed between countries but not between production systems Handling of milk produced from cows with abortion history or observed hygroma differed also between countries but not between production systems 5.5 Attitudes to the importance of quality of livestock products During group discussions farmers perceptions of the importance of meat and milkquality produced on-farm was discussed. This included the following key issues: diseases which can influence the quality of milk and meat, changes related to animal diseases observed in meat and milk, handling of affected milk and meat. Information from the questionnaire on handling of milk produced on-farm was also included (5.4.3) Observations on meat quality related to animal diseases In all group discussions participants agreed that livestock diseases can affect the quality of meat. The main indicators for reduced meat quality mentioned were bad smell, pale colour, and higher water content. The handling of such meat and specific knowledge of the causes varied widely between the countries. Participants in The Gambia noted the following changes in meat quality from sick animals: slimy, higher water content, black spots on meat and intestines, pale colour and hardening of the liver. The causes were usually not known. In two locations participants were able to relate changes in meat, such as black colour of meat and blood to anthrax infection. As mentioned above, some participants had some 49

51 knowledge about the zoonotic character of this disease. Meat from animals thought to be diseased or meat of bad quality is usually consumed after proper cooking or sometimes washed with vinegar before cooking. No differences in perceptions related to meat quality were observed in the different production systems. The main changes in meat of bad quality reported by respondents in Senegal were: black spots on the meat, pale, containing less blood/anaemic, higher water content, tasteless, bad smell and spots on the liver. The causes were usually not known. Some participants in one location related bad smell and taste of meat, slimy and pale colour to emaciation and pulmo-nasal symptoms in cattle, yet they consumed this meat. There was a general consensus that such affected meat can still be consumed after proper cooking. Differences in perception related to the production systems were not observed. The observations of participants in Guinea regarding meat quality were in general similar to the observations made in Senegal and The Gambia. In addition, respondents were able to relate some changes to animal diseases. Farmers knowledge was better than in Senegal and The Gambia. In six of the eight locations, participants were able to describe clearly the changes in meat due to anthrax: enlarged spleen, black colour of meat and blood and rapid rotting. However, there was little awareness of the related high risk to humans. As mentioned earlier (see 5.3.2) meat is often consumed in particular when animals died far way in the bush. Other diseases causing changes in meat quality were BQ and lumpy skin. Oedematous swelling of muscles was related to BQ. The affected part is discarded but the remaining carcass usually consumed after proper cooking. Bad odour and blood spots in meat, was linked to lumpy skin disease in cattle by some participants. Participants in Guinea Bissau considered anthrax, BQ, pasteurellosis and trypanosomosis as animal diseases, which reduce the quality of meat. Furthermore, chronic diseases, which were not further specified, might lead to watery and anaemic meat. The general changes in meat of bad quality were the same as listed for The Gambia and Senegal. The changes in anthrax-infected animals were well known. Only in one of the four locations did respondents state that such meat should be 50

52 consumed only after proper cooking and discarding of the spleen. Oedema in meat was related to BQ; in this case the affected parts are discarded and the remaining carcass is consumed. Summary: The main indicators for reduced meat quality mentioned by farmers in all four countries were bad smell, pale colour, and higher water content. The handling of such meat and specific knowledge of the causative agent varies widely between the countries. The highest level of knowledge was found in Guinea Bissau followed by Guinea. Comparatively, knowledge in The Gambia and Senegal was poor. Accordingly meat of bad quality was also handled differently, i.e. usually consumed in Senegal and The Gambia while often discarded by farmers in Guinea Bissau Observations on milk related to animal diseases There was a general agreement in all group discussions that milk is an excellent source of energy and healthy but that certain animal diseases can affect the quality of the product and may even be transmissible to man. Changes in milk quality were generally characterized by a higher water content, clotting and faster fermentation. Some respondents (Senegal and The Gambia) mentioned also slower fermentation as a sign of reduced quality. This observation was mainly made by milk vendors. The main indicators for milk of bad quality noted during group discussions in The Gambia were as described above, plus discolouring, bad smell and presence of blood spots. Participants agreed that such milk is not sold or consumed because it can pose a health risk for the consumer. However, the nature of this risk could not be specified by any of the respondents (milk vendors). Despite the general agreement that milk can transmit diseases to man, it is usually not pasteurised. There is a traditional belief of farmers that boiling of milk might reduce the milk yield of the lactating cow. Only 51

53 two farmers in one location (Sareh-Ngai, LIPS) pointed out that women after delivery should only drink pasteurised milk to avoid the risk of transmission of disease. During group discussions in Senegal milk of bad quality was characterized as described above. Such milk is not sold and discarded by the farmers or vendors. In Kaolack (a location representing the market-orientated system), some farmers related reduced milk quality and changes in consistency to mastitis in F1 cattle. In the same location milk vendors have heard about the advantages of boiling but they do not do this because of the difficulty of selling such a milk product. However, some farmers pasteurise their milk for home consumption. In two more locations, one representing the MOPS (Fatick) and one the LIPS (Koutal), milk vendors and farmers boil their milk when used for home consumption in particular when used for pregnant women and young children. Milk is usually not heated due to the local belief that boiling of milk over fire may result in sores on the udder of the cow which produced the milk. Participants in Guinea described the same changes as mentioned above for reduced milk quality. This milk is generally discarded. Respondents were usually not able to relate changes in milk quality to animal diseases. Only in Tambaya one respondent related lumpy skin disease to reduced quality of milk. The zoonotic importance of brucellosis was only mentioned by farmers in Tanene and Tambaya. Farmers do not boil milk in any of these locations. The highest level of knowledge was again found in Guinea Bissau. Milk of poor quality was characterized in group discussions by higher water content, faster fermentation and clotting. If this is observed such milk will be discarded. The diseases mentioned as influencing the quality of milk were brucellosis (mentioned in 3 locations) and TB (mentioned in one location). In three of the four chosen locations (Sintuna Mamodou, Aguira and Buntusso) farmers boil milk for home consumption so as to avoid the transmission of animal diseases. Fermented milk is never boiled. Summary During all group discussions it was agreed, that milk is a good source of energy and healthy but certain animal diseases can affect the quality of the product and may even be transmissible to man. 52

54 Poor quality milk was generally characterized by higher water content, clotting and faster fermentation. Milk of reduced quality is usually not used for home consumption. Specific knowledge of the causative agents and of how to prevent transmission varied between regions and was found to be best in Guinea Bissau. Milk in the region is usually consumed without heat treatment. However, most of the respondents in Guinea Bissau heated their milk when used unfermented for home consumption Handling of milk produced on farms During the interviews, information was collected on the handling of milk produced on farm. Results are given in Table 19. All farmers filtered their milk before home consumption or sale. How the milk was handled depended on the final product desired. In the case of sour milk production, none of the farmers in the regions heated the milk. However, when consumed as raw (unfermented) milk at home, regional differences were observed regarding boiling of milk. Milk was boiled by the majority of farmers in Guinea Bissau (15/20). Conversely in Senegal (9/40) and The Gambia (4/35) heat treatment was rarely undertaken and in Guinea not at all. Table 19: Processing of milk produced on-farm presented by country (% of farmers) Gambia Guinea Guinea Bissau Senegal No. of farmers interviewed % filtering

55 Raw milk % not heating 88 a 100 a 15 b 78 a % heating if used at home 9 a 0 a 85 b 22 a % heating (only for pregnant woman) Sour milk % not pasteurising a:b (p<0.05) Farms in the MOPS showed a higher acceptance of pasteurisation (Table 20). However, the differences were not significant. Table 20: Processing of milk produced on-farm presented by production system and country (% of farmers) Gambia Senegal No of farmers interviewed % filtering Raw milk % not heating % heating if used at home Pasteurised (only for pregnant woman) in % Sour milk Not pasteurised in % Summary MOPS LIPS MOPS LIPS Milk produced on-farm was always filtered. Only raw milk was pasteurised. Acceptance of pasteurisation differed between the countries and was more common on farms in Guinea Bissau. 54

56 Use of pasteurisation was not significantly influenced by different production systems. 5.6 Observations on zoonoses by other groups involved Butchers An overview of selected aspects of the slaughter process, such as number of animals slaughtered per week, place of slaughter, time of slaughter etc. is given in Table 21. The average number of animals slaughtered per week, location and butcher varied between the countries. Generally fewer cattle (range ) were slaughtered than SR (6.8 24). With the exception of some butchers in Guinea (n= 2) slaughtering was carried out at the local abattoirs and mainly between 6.00 and in the morning. Meat was sold by the majority of butchers on the same day. Some (7/28) sold their meat also on the following day. With few exceptions no records on disease observations were kept by butchers. However, all butchers indicated that the local veterinarian will be informed in case of any suspicion of epidemic diseases. Table 21: General information on aspects related to slaughter and sale of cattle and small ruminants (number per butcher per week) Slaughter animals per butcher/week Gambia Guinea Guinea Bissau Senegal 55

57 Cattle (mean) 11.4 (4.9,17.9) 4,7 (2.7, 6.7) 7.0 (6.3, 7.7) 4,9 (3.2, 6.6) SR (mean) 24.0 (8.5, 39.5) 7,3 (1.2, 13.4) 17.5 (7.9, 27.1) 6,8 (2.7, 10.9) No of butchers interviewed Place of slaughter Farm abattoir Time of slaughter 6-10 AM other Time of sale Same day Same & next day Records on observations during slaughter do exist yes Contacts to VH do exist yes In brackets CI for the mean Butchers knowledge of zoonoses Butchers were asked to list at least three zoonotic animal diseases. The knowledge of butchers was found broadly similar in all locations and differences were not significant (Table 22). The majority of butchers did know of at least one zoonotic infection. Their knowledge of a second and third zoonosis was clearly limited. It appears that butchers in The Gambia were better informed. Table 22: Proportion of butchers with knowledge of unspecified zoonotic diseases by country Gambia Guinea Guinea Senegal Bissau No. of butchers interviewed Butchers knowing of one disease

58 likely to be zoonotic (%) Butchers knowing of two diseases likely to be zoonotic (%) Butchers knowing of three diseases likely to be zoonotic (%) Zoonotic diseases observed during the last 12 months The observations of zoonotic infections made by butchers during slaughter are shown in Table 23. As most of the butchers did not record their observations it was usually not possible to exactly quantify the number of cases observed. Therefore, the numbers in Table 23 should be interpreted as recall data rather than as indicating the exact number of cases. The most frequently observed zoonosis was brucellosis, followed by anthrax and cysticercosis. A higher frequency of anthrax and brucellosis were found in Guinea Bissau and Guinea and of C. bovis infections in The Gambia. Table 23: List of suspected diseases with zoonotic importance observed by individual butchers during slaughter (last 12 months) Symptoms Suspected Gambia Guinea Guinea Senegal disease Bissau No. of butchers interviewed Enlarged spleen Anthrax 1/8 3/7 3/5 - Hygroma Brucellosis 1/8 4/7 3/5 - Oedema (muscle) BQ 1/ /9 Aphthae FMD /9 Cysts C. bovis 4/ /9 TB like lesions TB (M. bovis)* 1/9-1/5 1/9 * not confirmed Knowledge of animal diseases which can influence meat quality Butchers were asked to list diseases or to describe clinical symptoms, which can influence the quality of meat (Table 24). The only symptom, which was known by the majority of butchers, was liver indurations due to fasciolosis. Eight out of thirty 57

59 butchers indicated that symptoms related to anthrax and BTB can reduce meat quality. Other diseases mentioned were trypanosomosis, cysticercosis and BQ. Table 24: Butchers knowledge of symptoms and associated diseases which can influence meat quality Symptom observed Related disease Gambia (No.) Guinea (No.) GB (No.) Senegal (No.) No. butchers Dark blood, Anthrax 3/8 2/7 3/5 1/9 enlarged spleen Liver Fasciolosis 4/8 4/7 3/5 5/9 indurations Pneumonia Pasteurellosis - 2/7 - - Emaciation/ BTB 2/8 2/7 3/5 1/9 caseatic lesions Watery/ Trypanosomosis 3/ /9 pale meat Cyst Cysticercosis 4/8-1/5 1/9 Oedema BQ / Health status of butchers Information was collected on the health status of butchers, including their regular health check ups. Special emphasis was given on the occurrence of symptoms likely related to TB infections and/or brucellosis, such as: arthritis and orchitis for possible brucellosis infections and chronic coughing for TB. Regular health checks and examination of faecal samples was noted when carried out at least once during the last year. As shown in Table 25 the execution of regular health checks of butchers varied between the countries. All butchers in The Gambia confirmed having had such an investigation during the last year, a minority in Senegal and Guinea and none of the butchers in Guinea Bissau. However, we could not verify these health checks by a medical statement. No significantly differences between countries were observed for brucellosis-like symptoms. Chronic cough, a 58

60 clinical symptom that could be related to TB in man, had a similar distribution in the countries. Table 25: Observations on health status of butchers Total Gambia Guinea GB (No.) Senegal (No.) (No.) (No.) (No.) Total no. of butchers Regular medical check-up Self observation of selected symptoms possible related to brucellosis or TB: Arthritis Orchitis Cough (chronic) Summary The majority of butchers knew of at least one zoonotic infection. Their knowledge of a second and third zoonosis was clearly reduced. The zoonosis most frequently observed by butchers was brucellosis, followed by anthrax. A higher frequency of these infections was reported for Guinea Bissau and Guinea. 8 of 30 butchers indicated that symptoms related to anthrax and BTB can reduce meat quality The extent to which butchers had regular health checks varied between countries, None of these check-ups were documented by health certificates Veterinary health authorities The veterinary authorities consulted were veterinarians and veterinary technicians as shown in Table 26. The District Veterinary Officer (DVO) was always among the respondents in each location. Table 26: Information on the interviewed VH respondents 59

61 Gambia Guinea GB Senegal Total Total respondents Veterinarian Veterinary technician Observations on zoonotic infections in animals This information was obtained from records of DVO s for the last three years. The most serious zoonosis was rabies followed by anthrax (Table 27). The number of reported cases of rabies in animals (all of them dogs) was broadly similar in the four countries. Conversely anthrax seems to occur more frequently in Guinea and Guinea Bissau. The same applies for brucellosis in cattle. Infections due to C. bovis in cattle were reported for Senegal and The Gambia. Rift Valley Fever (RVF) was only observed in The Gambia were people also died. However, there was no proof of a direct relationship between observed cases in animals and man in this outbreak. Table 27: Zoonotic infection in animals and humans reported by VH respondents in the study districts during the last 3 years Symptoms How Gambia Guinea GB. (No.) Senegal (No.) diagnosed (No.) (No.) animals humans animals humans animals humans animals humans Anthrax p.m Clinical & Brucellosis p.m C. bovis p.m Rabies RL* RVF RL* * Reference laboratory p. m. post mortem Animal diseases observed during the last year Veterinary services were asked to list the most common animal diseases observed in the last year and to rank them according to their importance. Results are presented in Table 28 for cattle and Table 29 for SR. Zoonotic diseases are shaded grey. For comparison the results from group discussions (see ) are also included in the Table. 60

62 Trypanosomosis was ranked highest in The Gambia, anthrax in Guinea and Guinea Bissau and H.S. in Senegal. Brucellosis and anthrax were indicated as important diseases only in Guinea and Guinea Bissau. With some exceptions there was a good agreement between results obtained from veterinarians and farmers. Table 28: Diseases or symptoms in cattle ranked by DVOs according to their importance over the last 12 months by country Gambia Guinea Guinea Bissau Senegal Ranking Ranking Ranking Ranking (*) (*) (*) (*) Abortions - 5 (4) - - Anthrax - 1 (5) 1 (2) - BQ 4 (4) 4 (9) 3 (1) 3 (4) Brucellosis - 3 (5) 4 (7) - Endoparasites 3 (-) FMD 5 (5) H. S. 2 (3) 2 (5) 2 (5) 1 (1) Lumpy skin - 5 (2) - 5 (-) Pasteurellosis Red water (-) Trypanosomosis 1 (2) 4 (-) - 2 (3) (*) Results of disease ranking by farmer (see ) In SR the highest ranked disease was PPR, followed by abortions (The Gambia) and pasteurellosis (Guinea and Guinea Bissau). With one exception (Pasteurellosis in Guinea was ranked lower by farmers than veterinarians) the results were broadly similar to the rankings made by the farmers during the group discussions. Table 29: Diseases or symptoms in SR ranked by DVOs according to their importance over the last 12 months by country Symptoms Gambia Guinea Guinea Bissau Senegal 61

63 Ranking Ranking Ranking Ranking (*) (*) (*) (*) Abortions 2 (4) Orf Diarrhoea (unspecific) 4 (1) 4 (4) - 3 (6) Pasteurellosis 3 (3) 2 (8) 2 (3) Cowdryosis 3 (5) 5 (8) PPR 1 (2) 1 (1) 1 (1) 1 (1) Ticks 5 (7) Trypanosomosis (*) Results of disease ranking by farmer (see ) Summary The most important zoonosis in terms of mortality in man was rabies followed by anthrax. The number of reported rabies cases in animals (all of them dogs) was much the same in the four countries. However, more cases of anthrax and brucellosis were observed in Guinea and Guinea Bissau than in the other countries. The ranking of diseases by veterinarians was broadly similar to that done by the farmers (see ) Public health sector Hospitals and local health centres were visited in each country and a questionnaire was administered (Table 30). Whenever possible the central hospital for the region was contacted. In addition, local health centres were visited. The respondents consisted of physicians, PH-officers and laboratory technicians. Table 30: Location Numbers of interviewed public health facilities in the study districts by country Gambia GB Guinea Senegal Hospital Health centre

64 Respondent s jobs Physician PH officer Laboratory technician When asked about exchange of information with veterinary health authorities, differences between countries were observed as shown in Table 31. All respondents in Guinea Bissau (3/3) and the majority in Guinea (3/4) indicated that there is a regular exchange of data related to zoonoses. Health Centres in Guinea Bissau (left) and Guinea (right) Table 31: Exchange of information between PH and VH authorities Gambia Guinea Guinea Bissau Senegal Number of respondents Number exchanging information with VH authorities on a regular basis