PESTE DES PETITS RUMINANTS IN SHEEP IN THE SUDAN: A STUDY ON SERO- PREVALENCE AND RISK FACTORS

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PESTE DES PETITS RUMINANTS IN SHEEP IN THE SUDAN: A STUDY ON SERO- PREVALENCE AND RISK FACTORS A THESIS SUBMITTED TO THE SCHOOL OF GRADUATE STUDIES OF ADDIS ABABA UNIVERSITY, TO THE DEPARTMENT OF PUBLIC HEALTH, FACULTY OF VETERINARY MEDICINE, FREIE UNIVERSITÄT BERLIN AND TO THE COLLEGE OF GRADUATE STUDIES, SUDAN UNIVERSITY OF SCIENCE AND TECHNOLOGY IN THE PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE ATTAINMENT OF MASTER IN TRANSBOUNDARY ANIMAL DISEASE MANAGEMENT (MTADM) BY YASSIR ADAM SHUAIB MOHAMED ADDIS ABABA UNIVERSITY SCHOOL OF VETERINARY MEDICINE JOINT MASTER PROGRAM IN TRANSBOUNDARY ANIMAL DISEASE MANAGEMENT DECEMBER, 2011 DEBRE ZEIT, ETHIOPIA PESTE DES PETITS RUMINANTS IN SHEEP IN THE SUDAN: A STUDY ON SERO- PREVALENCE AND RISK FACTORS

ADVISORS Prof. Abd-Alhamid A. M. El-Fadil (SUST, the Sudan) Prof. Karl-Hans Zessin (FUB, Germany) Dr. Haileleul Negussie (AAU, Ethiopia) Prof. Mahasin Elnur Abd-Alrahman (SVRI, the Sudan) Dr. Gelagay Ayelet (NVI, Ethiopia) DECEMBER, 2011 DEBRE ZEIT, ETHIOPIA

Board of Examiners Name Signature Date Abd Al-Hamid M. El-Fadil (BVSc, MSc, PhD) Professor and Head Department of PM and PH, College of Veterinary Medicine, Sudan Univesity of Science and Technology Khartoum North, the Sudan Mobile Phone: +249 9 156 896 30 Email: aaelfadil@yahoo.com Karl-Hans Zessin (DVM, MSc, PhD) Professor and Head International Animal Health Faculty of Veterinary Medicine Freie Universität Berlin Berlin, Germany Telephone: +49 30 838 62540 Email: zessin.karl@vetmed.fu-berlin.de Berhanu Adamasu (DVM, MSc, PhD) Associate Professor Tufts Univesity Addis Ababa, Ethiopia Mobile Phone: (617) 627 3423 Email: berhanu.admassu@tufts.edu Khitma Hassan Almalik (BVSc, MSc, PhD) Associate Professor and Head Department of Veterinay Epidemiology, College of Veterinary Medicine, Univesity of Khartoum Khartoum North, the Sudan Mobile Phone: +249 9 123 525 45 Email: kelmalik@hotmail.com... 21 st December2011... 21 st December2011... 21 st December2011... 21 st December2011 3

ACKNOWLEDGEMENTS Above all, praise is to my almighty Allah for giving me a good health, wisdom, ability, and strength to carry out this work and for all other graces. I would like to express my deep and sincere gratitude and appreciation to my supervisors Prof. Abd-Alhamid A. M. El-Fadil, Sudan College of Veterinary Medicine, University of Science and Technology, the Sudan; Prof. Karl-Hans Zessin, Faculty of Veterinary Medicine, Freie Universität Berlin, Germany; Dr. Haileluel Negussie, School of Veterinary Medicine, Addis Ababa University, Ethiopia, for their excellent guidance, support, and constant encouragement throughout this project and also for their invaluable assistance and instructions, without which, it would not have been possible to accomplish this project and for reading and correcting the manuscript. I am also indebted to Prof. Mahasin Elnur Abd-Alrahman, the head of the Department of Virology, Soba Veterinary Research Institute, the Sudan and Dr. Gelagay Ayelet, National Veterinary Institute, Ethiopia for their kind assistance and guidance and would like to thank them very much. I would also like to thank the people of the Department of Virology, Soba Veterinary Research Institute for their endless and kind help during carrying out the celisa test. I would like to express my sincerest appreciation and deepest thank to the German Academic Exchange Service (Deutscher Akademischer Austausch Dienst "DAAD") and the he European Union; the African, Caribbean and Pacific Group of States; the ACP-EU Cooperation Programme in Higher Education (EduLink) for their significant contribution and providing scholarship, without which it would not have been possible to accomplish this project. I offer my sincere gratitude also to Dr. Yilkal Asfaw, the dean of the School of Veterinary Medicine, Addis Ababa University, Ethiopia, Dr. Maxmillian Baumann, Freie Universität Berlin, Faculty of Veterinary Medicine, all the representatives and academic staff of the partner universities, and Dr. Kelay Belihu, Food and Agriculture Organization of the United Nations (FAO), Ethiopia, for their very useful assistance and instructions from the beginning 4

of the course up to the end. The input of the late Dr. Moses Kyule during the course is acknowledged. I would like to thank Dr. Zerihun Taddesse, International Livestock Research Institute (ILRI), Ethiopia, for his significant assistance during the workshop of the statistical analysis. I am grateful to the Unit of Field Investigation, Directorate of Animal Health and Epizootic Diseases Control (DAH and ED), Ministry of Animal Resources and Fisheries (MARF), Khartoum, the Sudan and to Soba Veterinary Research Institute (SVRI), Khartoum, the Sudan for their kind help during sampling and field missions. I am also grateful to the Unit of Statistics and Geographical Information System (GIS), Directorate of Animal Health and Epizootic Diseases Control, Ministry of Animal Resources and Fisheries for providing the Chloropleth maps. I would also like to thank the Federal Ministry of Animal Resources and Fisheries and the Ministries of Animal Resources of North Kordofan and Kassala States for their support, help, and facilitating the field missions and sampling. I am really grateful to Dr. Mohamed Abd-Alraazig the director general of MARF, Prof. Amel Omer Bakhiet the dean of CVM, SUST, Dr. Wilfried Hartwig the technical consultant of the Livestock Epidemio-Surveillance Project (LESP), Prof. Abdel Rahim Mohamed El-Hussein the head of Animal Resources Research Corporation (ARRC), Prof. Mohamed Abd-Alsalam Abdalla the deputy dean of CVM, SUST, Dr. Khedir Mohamed Al-Faky the head of DAH and ED, Dr. Al-Fatih Ahmed Abd Alrahman, Dr. Nawal Sarsar, Dr. Haitham Fadlallah Al-Tayeb, Dr. Yahia Hassan Ali, Dr. Burhan Nasar Mahjoob, Dr. Idris Ahmed Yagoub, Dr. Ibtihal Hammad, Dr. Ahmed Younis Al-Souffi, Dr. Leila Mohamed Ibrahim, and Dr. Asma Ibnouf Abdalla for their kind cooperation and support. I am thankful to all my colleagues and sheep owners and herders for answering the questionnaires and also thankful to all people who helped me in way or another to accomplish this work. Many thanks to my class mates of the first joint Master Program in Transboundary Animal Disease Management (MTADM) for their everlasting cooperation and encouragement. Finally, I am thankful to my parents, my beloved sisters and brother, and to all my friends for their everlasting support. 5

DEDICATION This work is dedicated To my family, especially my parents, who believed in The importance of education. it is also dedicated To my grandfathers and grandmothers, To my friends, associates and To The soul of The late professor mohamed musa mohamed-ahmed. TABLE OF CONTENTS 6

LIST OF TABLES Page No. Table 1: Number of detected outbreaks of PPRV in different parts of the Sudan and number of herds at risk (2000 to 2007). 12 Table 2: Rank of the most common and important diseases for which animals were barred by veterinary inspectors from selling at the primary and secondary markets in the three states of Sudan... 13 Table 3: Crude case fatality rates for diseases reported by household respondents in Sudan as important (2003 to 2005).. 14 Table 4: Detection of PPRV in wildlife species 22 Table 5: Number of vaccinated small ruminants against PPRV in the Sudan in the period (2005 to 2008). 39 Table 6: PPRV (genus Morbillivirus) strains and sequences retrieved from GenBank, Africa (2000 to 2009).. 45 Table 7: Frequencies and distributions of tested serum samples by state, locality, breed, age, and sex for PPR in North Kordofan and Kassala States (April to July 2011)... 58 Table 8: Estimated sero-prevalence rates of PPR by state, locality, breed, age and sex in North Kordofan and Kassala States (April to July 2011).. 66 Table 9: Univariate associations of risk factors with celisa PPR-sero-positivity in sheep in North Kordofan and Kassala States (April to July 2011).. 67 Table 10: Results of univariate associations of herd size, number of males, females, and young animals in herds with celisa PPR-sero-positivity in sheep in North Kordofan and Kassala States (April to July 2011). 68 Table 11: Results of univariate associations of herd management risk factors with celisa PPR-sero-positivity in sheep in North Kordofan and Kassala States (April to July 2011).. 69 Table 12: Results of multivariate analyses of associations of risk factors with celisa PPR-sero-positivity in sheep in North Kordofan and Kassala States (April to July 2011).. 70 Table 13: Frequencies of owners' and herders' general information in North Kordofan and Kassala States (survey from April to July 2011)... 72 Table 14: Mentioning and ranking of economically important animal diseases by owners and herders in North Kordofan and Kassala States (survey from April to 7

July 2011)... 73 Table 15: Frequencies of responses of sheep owners and herders on clinical symptoms of PPRV infection in their herds in North Kordofan and Kassala States (survey from April to July 2011)... 74 Table 16: Frequencies of responses of sheep owners and herders on vaccination against PPRV and number of vaccinated animals in North Kordofan and Kassala States (survey April to July 2011)... 75 Table 17: Frequencies of responses of sheep owners and herders on the susceptibility of different age groups and sexes to PPRV infection in North Kordofan and Kassala States (survey from April to July 2011)... 76 Table 18: Frequencies of responses of sheep owners and herders on sources of PPRV infections and their economic impacts in North Kordofan and Kassala States (survey from April to July 2011)... 77 Table 19: Frequencies of responses of sheep owners and herders on seasonality and frequency of occurrence of PPRV infections in North Kordofan and Kassala States (survey from April to July 2011)... 77 Table 20: Frequencies of responses of sheep owners and herders on seasonality and frequency of occurrence of PPRV infections in North Kordofan and Kassala States, (survey from April to July 2011)... 78 Table 21: Frequencies of responses of sheep owners and herders on experience with PPRV outbreaks in North Kordofan and Kassala States (survey from April to July 2011)... 78 Table 22: Frequencies of veterinarians' general information in North Kordofan and Kassala States (interviews from April to July 2011)... 79 Table 23: Ranking of economically important animal diseases by veterinarians in North Kordofan and Kassala States (interviews from April to July 2011)... 80 Table 24: Frequencies of responses of veterinarians on routine diagnosis, control practices and control measures taken for the ranked diseases in North Kordofan and Kassala States (interviews from April to July 2011)... 81 Table 25: Frequencies of responses of veterinarians on the last occurrence of PPR and its seasonality in North Kordofan and Kassala States (survey from April to July 2011)... 82 Table 26: Frequencies of responses of veterinarians on diagnosis of PPRV and control measures taken against PPRV in North Kordofan and Kassla States (survey from April to July 2011)... 83 Table 27: Frequencies of responses of veterinarians on the most susceptible species and breed to PPRV infection in North Kordofan and Kassala States (survey from April to July 2011)... 84 8

Table 28: Frequencies of responses of veterinarians on the most susceptible age group and sex to PPRV infection in North Kordofan and Kassala States (survey from April to July 2011)... 84 Table 29: Frequencies of responses of veterinarians on the major clinical signs of PPRV infection seen frequently in North Kordofan and Kassala States (survey: April to July 2011)... 85 Table 30: Frequencies of responses of veterinarians on last vaccination against PPRV and the number of vaccinated animals in North Kordofan and Kassala States (survey from April to July 2011)... 86 Table 31: Frequencies of responses of veterinarians on farming systems, migratory routes of nomads, and the sources of PPRV outbreaks in North Kordofan and Kassala States (survey from April to July 2011)... 87 Table 32: Responses of veterinarians on problems they face when implementing disease control programs in North Kordofan and Kassala States (survey: April to July 2011)... 88 Table 33: Comments, advises, and additional information of veterinarians they want to give to the MARF/public/policy makers on PPR control and management of PPR in North Kordofan and Kassala States (survey: April to July 2011)... 89 LIST OF FIGURES Page No. Figure 1: Structure of Morbillivirus. 8 Figure 2: Phylogenetic Analysis of the 1232 1560 nt Sequence of the N Protein Gene of Sequenced PPRV Strains 10 Figure 3: Distribution of PPRV across West Africa from 2000 to 2010. 11 Figure 4: Distribution of PPRV across East Africa from 2000 to 2010... 15 Figure 5: Distribution of PPRV across Central Africa from 2000 to 2010.. 16 Figure 6: Distribution of PPRV across North Africa from 2000 to 2010... 17 Figure 7: Distribution of PPRV across Asia from 2000 to 2010 19 Figure 8: Common Clinical Signs of Acute PPRV infection in Small Ruminants: Ocular and Nasal Discharges... 24 Figure9: Common Clinical Signs of Acute PPRV infection in Small Ruminants: Early Oral Lesions and Necrosis of the Gum... 24 Figure 10: Map of the Study Regions.. 48 Figure 11: Map of the Selected States in the Study Regions... 51 Figure 12: Map of the Selected Localities in each State in the Study Regions... 52 Figure 13: Plate Layout of celisa for PPR... 55 Figure 14: Estimated state sero-prevalence rates for PPR in sheep in North Kordofan and Kassala States (April to July 2011)... 59 Figure 15: Map of state sero-prevalence rates for PPR in sheep in North Kordofan and Kassala States (April to July 2011)... 60 9

Figure 16: Estimated locality sero-prevalence rates for PPR in sheep at localities in North Kordofan and Kassala States (April to July 2011). 61 Figure 17: Map of locality sero-prevalence rates for PPR in sheep in North Kordofan and Kassala States (April to July 2011)... 62 Figure 18: Estimated breed sero-prevalence rates for PPR in sheep in North Kordofan and Kassala States with 95% CI (April to July 2011).. 63 Figure 19: Estimated age group sero-prevalence rates for PPR in sheep in North Kordofan and Kassala States (April to July 2011)... 64 Figure 20: Estimated sex sero-prevalence rates for PPR in sheep in North Kordofan and Kassala States (April to July 2011)... 65 LIST OF ANNEXES Page No. Annex 1: Competitive ELISA Reagents and Solutions... 124 Annex 2: PPR Questionnaire Format for Owners and Herders... 125 Annex 3: PPR Questionnaire Format for Veterinarians... 133 10

LIST OF ACRONYMS aa Abs Ag AGID AGPT APS ATCC # CCL81 BB BDSL BHK-21 bp BPS CBS CCFR CCPP cdna CDV celisa CFT CIEP CIRAD CIRAD CPE DAAD DAAD DAH & ED DDW DIVA DNA dntps EDI EduLink F FAO FEE GDP GHA GIS GIT GREP H H 2 O 2 HA Amino Acid Antibodies Antigen Agar Gel Immunodiffusion Agar Gel Precipitation Test Animal Production System American Type Cell Culture Blocking Buffer Biological Diagnostic Supplies Limited Baby Hamster Kidney Base pair Buffered Physiological Saline Central Bank of Sudan Crude Case Fatality Rate Contagious Caprine Pleuro-Pneumonia Complementary Deoxyribonucleic Acid Canine Distemper Virus Competitive Enzyme Linked Immuno-Sorbent Assay Complement Fixation Test Counter immunoelectrophoresis Centre de Coopération Internationale en Recherché Agronomique pour le Développement The International Cooperation Centre in Agronomic Research for Development Cytopathic Effect Deutscher Akademischer Austausch Dienst The German Academic Exchange Service Directorate of Animal Health and Epizootic Diseases Control De-ionized Distilled Water Differentiation of Infected from Vaccinated Animals Deoxyribonucleic Acid Deoxonucleoside triphosphate ELISA Data Interchanges Software The Connecting Learning Communities The Fusion Gene Food and Agriculture Organization of the United Nations Foreign Exchange Earnings Gross Domestic Product The Greater Horn of Africa Geographical Information System The Gastrointestinal Tract Global Rinderpest Eradication Project The Haemagglutinin Gene Hydrogen Peroxide Hemagglutination Test 11

HRPO Horseradish Peroxidase Conjugate IcELISA Immunocapture Enzyme Linked Immuno-Sorbent Assay IGAD Intergovernmental Authority on Development ILRI International Livestock Research Institute M The Matrix Gene MAb Monoclonal Antibody MAR Mean Average Rainfall MARF Ministry of Animal Resources and Fisheries MDBK Madin-Darby Bovine Kidney Cells MDT Mean Daily Temperatures MEPD Ministry of Environment and Physical Development mrna Messenger Ribonucleic Acid MT Metric Tones MTADM Master Program in Transboundary Animal Disease Management MV Measles Virus of Humans N The Nucleocapsid Gene NES Nuclear Export Signal NLS Nuclear Localization Signal No. Number NP Nucleoprotein NPV Net Present Value NS Normal saline nt Nucleotide ºC Degree Centigrade OD Optical Density OIE The International Organization for Animal Heath OPD Ortho-Phenylenediamine Orf Contagious Ecthyma ORF Open Reading Frame PAGE Electrophoretic Profile in Polyacrylamide Gel PANVAC The Pan African Veterinary Vaccine Centre PARC The Pan-African Rinderpest Campaign PBMC Peripheral Blood Mononuclear Cell PBS Phosphate Buffered Saline PCR Polymerase Chain Reaction PCV Packed Cell Volume PD Phosphate diluents ph Measure of the Acidity or Basicity PI Percentage of Inhibition PPR Peste Des Petits Ruminants PPRV Peste Des Petits Ruminants Virus RBCs Red Blood Cells RBOK The Kabete 0 Strain of Rinderpest RNA Ribo-nucleic Acid RNP Ribonucleo-Protein RPV Rinderpest Virus RT Reverse Transcriptase Enzyme RT-PCR Reverse Transcription Polymerase Chain Reaction Shoats Sheep and Goats SP Strong Positive 12

SPS SPSS SVRI T cells CD4+ T cells CD8+ Taq TCID TCID 50 TCRV UN US$ USAID Vero VNT WP μl Sanitary and Phyto-Sanitary The Statistical Package for Social Sciences for Windows Soba Veterinary Research Institute T helper Lymphocytes Cytotoxic T Lymphocytes Thermostable DNA Polymerase Tissue Culture Infective Dose 50% Tissue Culture Infective Dose The Tissue Culture Rinderpest Vaccine The United Nations United States Dollar United States Agency for International Development African Green Monkey Kidney Cell Virus Neutralization Test Weak Positive Microliter SUMMARY The results of the study have increased knowledge on the epidemiology of PPR in sheep in North Kordofan and Kassala States of the Sudan, by using celisa testing and a questionnaire survey. The estimated overall sero-prevalence rate was found to be 70.2% (576/820) (95% CI: 67.1-73.3). The sero-prevalence rates estimated in the two states were statistically not different, while there were differences in the sero-prevalence rates between individual surveyed localities, with both Jebrat Al-Shiekh and Shiekan locality showing significantly higher sero-prevalence rates than the other 5 localities. For breeds, Zaghawa was showing a higher sero-prevalence rate than other breeds. There were no statistically significant differences in the sero-prevalence rates among differentiated age groups. For sexes, females were showing a higher sero-prevalence rate than males. Significant risk factors associated 13

with a celisa positive status for PPRV in the univariate analysis using the chi square test were found to be state, locality, breed, sex and number of males with p-value 0.05. Age, herd size, number of females in the herd, number of young animals in the herd, buying animals from outside, measures taken before introducing a new animal into the herd, production system practiced, mixing herds at communal points, and where herds get mixed, in contrast, were not identified as significant risk factors. The factors found to be significantly associated with increased odds of being celisa positive in the multivariate analysis were localities (Jebrat Al-Shiekh, Barra, and Al-Girba) and sex (females), number of males ( 10) and number of young animals (>40) in the herd, while the factors found not significantly associated with increased odds of being celisa positive were breeds, ages, and where herds get mixed. The results of the questionnaire survey showed that sheep owners and herders in North Kordofan and Kassala States have a solid good knowledge of PPR infection, its clinical signs, the effect of animal movements, practicing communal grazing and watering on the spread of the disease and its impact on their animals. At the same time there exist considerable reservations of a sizeable number of herders against vaccination against PPR. Investigation results suggest that PPR has taken an endemic pattern of occurrence in the Sudan as reported from other countries in East Africa. Urgent need therefore exists to initiate a realistic network for surveillance, control and eradication of this important disease in the Sudan and in the region. Such scheme is suggested and supported at high levels and it should immediately be launched as recommended by OIE. Keywords: Sudan, sheep, PPR, sero-prevalence, risk factors 14