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Cycle 9 (2020 Deadline)
Enhancing capacity of local communities in Laikipia County, Kenya: increasing preparedness and response to emerging infectious diseases in parallel with preservation of biodiversity
PI: Joseph Kamau (muiruri@uonbi.ac.ke), University of Nairobi
U.S. Partner: Dawn Zimmerman, Smithsonian Institution
Project Dates: April 2021 - June 2023
Project Overview
The burden of zoonotic diseases has been increasing globally over the last few decades, raising concern among governments. Zoonotic disease has led to increased household health-care costs, loss of income from livestock trade, and loss of endangered and rare wildlife biodiversity, among many other negative impacts. These diseases impair progress towards attainment of Sustainable Development Goals, the African Union Agenda 2063, and Kenya’s Vision 2030. The factors contributing to the increasing burden of these diseases include the expanding population, degrading wildlife habitats, international travel and trade, changing farming systems, urbanization, cultural practices, poverty, and climate change, among others. The One Health approach that brings the interconnection between biosafety, biosecurity, and biodiversity, involving multisectoral and multidisciplinary collaboration between human health, animal health, and environment sectors among other stakeholders, is only one approach that presents a viable solution to this challenge.
A key finding of the USAID-funded PREDICT-2 program in Laikipia County, Kenya, was a general lack of awareness in all communities that contact with animals can cause disease in people. Laikipia has closely interacting human, wildlife, and livestock elements in an environment under multiple pressures, such as land use changes and increasing livestock, wildlife, and human populations. Unpublished USAID PREDICT-Kenya data identified the following gaps: (1) the role of biological diversity and its ecological role in relation to transmission of emerging infectious diseases (EIDs); (2) potential behavioral and cultural practices that potentially expose the community to EIDs; and (3) lack of EID risk awareness in terms of sources, identification, and interventions. It is on this basis that future risk mitigation strategies should emphasize education tailored to specific sites to be socially and culturally acceptable. Targeted training of community-based health workers, community leaders, rangers, and wardens who are chosen by the community would provide a communication channel for dissemination of national and tailored local public health initiatives to vulnerable people living at high-risk human-animal interfaces. This study sought to increase preparedness and response to EIDs by enhancing the local communities’ understanding, through a more integrated One Health approach, of the importance of ecological correlates to global EIDs.
Final Summary of Project Activities
Over the course of the project, which among other activities involved organization of 29 public events attracting 790 participants, the team was able to increase preparedness and response to diseases among the community members, resulting in a more alert community that is conscious of their interaction with animals and the environment. They also increased the communities’ awareness on the role of biodiversity on disease dynamics, including emergence, transmission, and spillover, and stakeholders now appreciate the role of biodiversity and its conservation in emerging diseases. The community members were also able to relate their traditional and current knowledge of biodiversity to disease dynamics.
The project also enhanced capacities of various cadres of health workers on disease epidemiology and occurrence using the One Health approach. Health workers are now applying the acquired knowledge in diagnosis and management of diseases. This has led, for example, to the quick identification of the potential origin of disease symptoms. In one case, a health worker linked patients to ingestion of meat from a dead camel.
Lastly, the project worked on the incorporation of emerging diseases and pandemics as a threat in the Laikipia County Community Strategy 2021-2025. The County Health Department incorporated disease emergence and pandemics as one of the threats that required concerted effort in preparedness and response. To support this, the county has allocated resources to address disease emergence and pandemics. Despite the progress made on the project, the PI Dr. Kamau and his team note that there remains much work to be done to address the disconnect between the One Health approach to disease surveillance and clinical diagnostics. There is a need for further education to raise awareness at the county level (particularly county disease surveillance officers and health managers). In particular, they recommend two key areas for improvement. First, a training module should be developed that incorporates the project findings regarding tick-borne disease, disease epidemiology, and disease ecology. Second, the training module should be accredited to count towards continuing medical education requirements for healthcare workers and other health professionals. Although the PEER project has ended, Dr. Kamau and his colleagues will continue working to build on their stakeholder linkages and research partnerships to further their efforts in this regard.
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