Veterinary Epidemiology, Economics and Public Health Group, Royal Veterinary College, Hawkshead Lane, AL9 7TA, UK; The Pirbright Institute, Ash Rd, Pirbright, Woking GU24 0NF, UK.
Foot-and-mouth Disease National Reference Laboratory, Embakasi, Nairobi, Kenya.
Prev Vet Med. 2021 May;190:105315. doi: 10.1016/j.prevetmed.2021.105315. Epub 2021 Mar 2.
Interpreting the interplay between politics, social demographics and epidemiology is essential for understanding how a disease's occurrence and control evolve over time. Foot-and-mouth disease (FMD) virus was first detected in Kenya in 1915 and serotyped in 1932. This review aims to describe and appraise initiatives to control FMD in Kenya since its independence from British rule in 1964, using information from the scientific literature. We describe the historical dynamics of FMD epidemiology in the country and determine socio-political factors that have shaped the control strategies used. PubMed, Scopus, CAB abstracts, Science Direct, Web of Science and Google Scholar were used to search and retrieve papers, using predetermined search criteria encompassing FMD, Kenya and disease control programme descriptors. In total 1234 papers were identified and screened for relevance using the World Health Organization's guidelines for rapid review. Ultimately 69 references from this search were included, and information extracted and consolidated. These papers highlight that following independence, there was a structured effort to control FMD consisting of a compulsory subsidised vaccination programme in the Rift Valley with movement controls and quarantine when outbreaks occurred. This programme led to an initial decrease in recorded FMD outbreaks. However, endemic circulation continued and this programme was discontinued due to multiple factors, including political deprioritisation and changes in the structure of veterinary services. Only low levels of active surveillance have been applied since 1964; most surveillance is passive and relies on outbreak reports. Currently control focuses on outbreak management and a mixture of public- and privately-funded vaccination. This review highlights critical drivers influencing disease control programme implementation including veterinary service structure, the active participation of stakeholders with farming systems and availability of affordable and matched FMD vaccine. Additionally, it appraises the availability of historical information and draws attention to gaps in the historical record.
解释政治、社会人口统计学和流行病学之间的相互作用对于理解疾病的发生和控制如何随时间演变至关重要。口蹄疫（FMD）病毒于 1915 年在肯尼亚首次检测到，并于 1932 年定型。本综述旨在描述和评估自 1964 年从英国统治下独立以来肯尼亚控制口蹄疫的举措，利用来自科学文献的信息。我们描述了该国口蹄疫流行病学的历史动态，并确定了塑造所使用控制策略的社会政治因素。使用 PubMed、Scopus、CAB 摘要、Science Direct、Web of Science 和 Google Scholar 搜索和检索论文，并使用包含口蹄疫、肯尼亚和疾病控制计划描述符的预定搜索标准。总共确定了 1234 篇论文，并根据世界卫生组织的快速审查指南对其相关性进行了筛选。最终，从这次搜索中确定了 69 篇参考文献，并从中提取和整合了信息。这些论文强调，独立后，有一个有组织的努力来控制口蹄疫，在裂谷实施强制性补贴疫苗接种计划，并在爆发时进行移动控制和隔离。该计划导致记录的口蹄疫爆发最初减少。然而，持续的地方性循环，以及由于包括政治优先事项的变化和兽医服务结构的变化，该计划被终止。自 1964 年以来，仅应用了低水平的主动监测；大多数监测是被动的，依赖于疫情报告。目前，控制重点是疫情管理和公私混合疫苗接种。本综述强调了影响疾病控制计划实施的关键驱动因素，包括兽医服务结构、与农业系统积极参与的利益相关者以及负担得起和匹配的口蹄疫疫苗的可用性。此外，它评估了历史信息的可用性，并提请注意历史记录中的空白。
