Duguma Bojia E, Tesfaye Tewodros, Kassaye Asmamaw, Kassa Anteneh, Blakeway Stephen J
The Donkey Sanctuary-Ethiopia Office, Addis Ababa, Ethiopia.
Director, International Department, The Donkey Sanctuary, Sidmouth, United Kingdom.
Front Vet Sci. 2021 Nov 12;8:648267. doi: 10.3389/fvets.2021.648267. eCollection 2021.
From 2010 to 2017, as part of a wider animal welfare program, The Donkey Sanctuary piloted an integrated, community-based model for the control and prevention of epizootic lymphangitis (EZL) in cart mules in Bahir Dar, Ethiopia. Stakeholders included muleteers, service providers, and transport and animal health regulatory authorities. Interventions included muleteer education, wound prevention, harness improvement, animal health professional training, treatment of early EZL cases, euthanasia for advanced cases, and review of transport services and traffic guidelines. The project followed a participatory project management cycle and used participatory learning and action tools to facilitate stakeholder engagement and ownership. Participatory and classical epidemiology tools were employed to raise and align stakeholder understanding about EZL for effective control and prevention and to evaluate the progress impact of the model through annual prevalence surveys. During the intervention, the annual prevalence of EZL reduced from 23.9% (102/430) (95%CI: 19.8%-27.0%) in 2010 to 5.9% (58/981) (95% CI: 4.4%-7.4%) in 2017, and wound prevalence from 44.3% in 2011 to 22.2% in 2017; trends in the reduction of the prevalence maintained in the face of a mule population that increased from 430 in 2010 to ~1,500 in 2017. While non-governmental organization (NGO)-led interventions can facilitate change by trialing new approaches and accessing new skills and resources, sustainable change requires community ownership and strengthening of service provision systems. To this effect, the project raised muleteer competence in mule husbandry and EZL prevention strategies; strengthened veterinary competence; facilitated more mule-friendly traffic, transport, and waste disposal guidelines and practices; supported mule-community bylaws to control EZL; and established a supportive network between stakeholders including trusting relationships between muleteers and veterinary services. To advance the intervention model in other endemic areas, we recommend elucidation of local epidemiological factors with other stakeholders prior to the intervention, early engagement with veterinary and transport service regulatory authorities, early development of bylaws, exploration of compensation or insurance mechanisms to support euthanasia of advanced cases, and additional social, economic, and epidemiological investigations. In line with the OIE Working Equid Welfare Standards, we suggest that integrated community-based interventions are useful approaches to the control and prevention of infectious diseases.
2010年至2017年期间，作为一项更广泛动物福利计划的一部分，“驴子庇护所”在埃塞俄比亚巴赫达尔的役用骡子中试点了一种基于社区的综合性马皮疽（EZL）控制与预防模式。利益相关者包括赶骡人、服务提供者以及运输和动物卫生监管当局。干预措施包括对赶骡人进行教育、预防伤口、改进挽具、对动物卫生专业人员进行培训、治疗早期EZL病例、对晚期病例实施安乐死，以及审查运输服务和交通指南。该项目遵循参与式项目管理周期，并使用参与式学习与行动工具来促进利益相关者的参与和自主管理。采用参与式和传统流行病学工具来提高利益相关者对EZL的认识并使其达成共识，以实现有效控制和预防，并通过年度患病率调查来评估该模式的进展影响。在干预期间，EZL的年度患病率从2010年的23.9%（102/430）（95%CI：19.8%-27.0%）降至2017年的5.9%（58/981）（95%CI：4.4%-7.4%），伤口患病率从2011年的44.3%降至2017年的22.2%；尽管骡子数量从2010年的430头增加到2017年的约1500头，但患病率下降趋势仍得以保持。虽然非政府组织主导的干预措施可以通过试验新方法以及获取新技能和资源来促进变革，但可持续的变革需要社区自主管理以及加强服务提供系统。为此，该项目提高了赶骡人在骡子饲养和EZL预防策略方面的能力；增强了兽医的能力；促进了更有利于骡子的交通、运输和废物处理指南及做法；支持控制EZL的骡子社区规章；并在利益相关者之间建立了一个支持性网络，包括赶骡人与兽医服务之间的信任关系。为了在其他流行地区推广该干预模式，我们建议在干预前与其他利益相关者阐明当地的流行病学因素，尽早与兽医和运输服务监管当局接触，尽早制定规章，探索补偿或保险机制以支持对晚期病例实施安乐死，以及开展更多的社会、经济和流行病学调查。根据世界动物卫生组织的工作用马福利标准，我们认为基于社区的综合干预措施是控制和预防传染病的有效方法。
