CIRAD, UMR ASTRE, Sainte Clotilde, La Réunion, France.
ASTRE, Univ Montpellier, CIRAD, INRAE, Montpellier, France.
Transbound Emerg Dis. 2021 Jul;68(4):1966-1978. doi: 10.1111/tbed.13920. Epub 2021 Feb 21.
This article presents a participative and iterative qualitative risk assessment framework that can be used to evaluate the spatial variation of the risk of infectious animal disease introduction and spread on a national scale. The framework was developed through regional training action workshops and field activities. The active involvement of national animal health services enabled the identification, collection and hierarchization of risk factors. Quantitative data were collected in the field, and expert knowledge was integrated to adjust the available data at regional level. Experts categorized and combined the risk factors into ordinal levels of risk per epidemiological unit to ease implementation of risk-based surveillance in the field. The framework was used to perform a qualitative assessment of the risk of introduction and spread of foot-and-mouth disease (FMD) in Tunisia as part of a series of workshops held between 2015 and 2018. The experts in attendance combined risk factors such as epidemiological status, transboundary movements, proximity to the borders and accessibility to assess the risk of FMD outbreaks in Tunisia. Out of the 2,075 Tunisian imadas, 23 were at a very high risk of FMD introduction, mainly at the borders; and 59 were at a very high risk of FMD spread. To validate the model, the results were compared to the FMD outbreaks notified by Tunisia during the 2014 FMD epizootic. Using a spatial Poisson model, a significant alignment between the very high and high-risk categories of spread and the occurrence of FMD outbreaks was shown. The relative risk of FMD occurrence was thus 3.2 higher for imadas in the very high and high spread risk categories than for imadas in the low and negligible spread risk categories. Our results show that the qualitative risk assessment framework can be a useful decision support tool for risk-based disease surveillance and control, in particular in scarce-data environments.
本文提出了一种参与式和迭代式的定性风险评估框架，可用于评估国家范围内传染病动物疾病传入和传播风险的空间变化。该框架是通过区域培训行动研讨会和实地活动开发的。国家动物卫生服务部门的积极参与使风险因素得以识别、收集和分级。在实地收集定量数据，并整合专家知识以调整区域层面的可用数据。专家将风险因素分类并组合成每个流行病学单位的风险等级，以方便在实地实施基于风险的监测。该框架用于对突尼斯口蹄疫（FMD）传入和传播风险进行定性评估，作为 2015 年至 2018 年期间举行的一系列研讨会的一部分。与会专家结合了流行病学状况、跨界运动、接近边界和可达性等风险因素，评估突尼斯 FMD 爆发的风险。在突尼斯的 2075 个免疫区中，有 23 个非常容易受到 FMD 传入的影响，主要在边界地区；有 59 个非常容易受到 FMD 传播的影响。为了验证该模型，将结果与突尼斯在 2014 年口蹄疫疫情期间报告的 FMD 爆发进行了比较。使用空间泊松模型，显示了传播的高风险和极高风险类别与 FMD 爆发之间的显著一致性。在高风险和极高风险传播类别中的免疫区发生 FMD 的相对风险比在低风险和可忽略风险传播类别中的免疫区高 3.2 倍。我们的研究结果表明，定性风险评估框架可以成为基于风险的疾病监测和控制的有用决策支持工具，特别是在数据稀缺的环境中。
