Fondation Pierre Fabre

Reducing the burden of diseases transmissible between animals and humans

Main beneficiary country:
Tanzania

About the sponsor

SACIDS One Health Foundation at Sokoine University

Sokoine University of Agriculture (SUA) is a public university that was established by Act No. 6 of 1984 which was subsequently repealed in 2005 by the Universities Act No. 7 of 2005. Following the enactment of the Universities Act, the university was granted the SUA Charter of 2007. Currently SUA has five campus colleges namely the College of Agriculture; College of Veterinary Medicine and Biomedical Sciences; College of Forestry, Wildlife and Tourism; College of Social Sciences and Humanities and the Solomon Mahlangu College of Science and Education. SUA has also one School of Agricultural Economics and Business Studies. On average, SUA coordinates and manages about 150 research projects and programs with an average annual transaction of research funds of Tanzanian Shillings (TZS) 26 billion. In 2016, SUA won to host two Africa Centers of Excellence (ACE) funded by the World Bank through the Government of the United Republic of Tanzania. These ACEs are SACIDS-Africa Centre of Excellence for Infectious Diseases in Humans and Animals in Southern and Eastern Africa (SACIDS-ACE) and the African Centre of Excellence for Innovative Rodent Pest Management and Biosensor Technology Development (IRPM & BTD- Rat Tech).

Sector: Academic entities: Universities, research laboratories, etc.

Country of origin: Tanzania

The organisation has:

5
Full-Time Equivalents
7
Employees
1
Volunteer
505
Service providers

Initiative overview

Healthcare themes targeted

  • Primary healthcare
  • Infectious diseases

Stage of development:

  • Pilot project/testing/trials

Area where initiative is utilised

  • Provincial/regional (in one region of a single country)

Initiative start date

  • 04/01/2019

Initiative end date

  • 12/31/2019

Financing

Financing method

  • Public (grant/subsidies, call for proposals/call for tender, etc.)
  • Private (private investors, crowdfunding, philanthropy, etc.)
  • In kind contribution of volunteers and Government

Economic model(s)

  • Subsidies
  • Donations
  • In kind contribution

About the initiative

Infectious diseases remain a significant cause of mortality and morbidity globally. The global economic burden due to diseases transmissible between animals and humans (zoonoses) in some countries has been estimated to be US$ 80,000,000,000 (World Bank, 2012). Approximately, 75% of emerging human diseases are of animal origin (Taylor et al., 2001; Woolhouse & Gaunt, 2007; Dahal & Kahn L, 2014). This has been largely caused by an increased interactions between animals and humans because of the increased human and animal populations, expanding agricultural systems, increased global trade and urbanization, and climate change. To address this problem, there is increasing appreciation of the relevance of One Health approaches to the detection and appropriate management of infectious diseases, especially zoonotic diseases (Karimuribo et al., 2007, John et al., 2008, Swai et al., 2009, Sambo et al, 2013).

In order to identify strengths and gaps in healthcare provision by medical and veterinary practitioners in Tanzania, self-assessment exercise in public and animal health was carried out through the WHO led Joint External Evaluation (JEE) in 2016 and the Performance of Veterinary Services (PVS) in 2008, respectively. One of the gaps identified by both JEE and PVS was low knowledge of One Health issues among frontline healthcare workers in human and animal health sectors. Information available indicates that zoonotic diseases are prevalent in Tanzania especially rabies, brucellosis, anthrax and bovine tuberculosis (John et al., 2008). Due to low knowledge on One Health concepts, most of zoonotic diseases are under-diagnosed and consequently poorly managed leading to unnecessary sufferings of affected patients.

This initiative address the challenges of delayed diagnosis and management of selected zoonotic diseases (brucellosis and rabies) attributed to low knowledge on zoonoses and One Health concepts among frontline healthcare workers. Previous studies in Tanzania indicate that brucellosis cases are managed as malaria patients due to similar signs and symptoms in affected individuals. Similarly, suspected rabies cases may be managed as normal wounds if healthcare professionals cannot link animal bites to the risk of rabies infection. Both cases can lead to unnecessary suffering and deaths attributed to low knowledge of zoonoses among healthcare workers.

This initiative promote health education and awareness among healthcare workers so that they can achieve prompt diagnosis and hence accurate management of brucellosis-affected and high risk to rabies groups in intervention areas.

Through application of e-based intervention using AfyaData system, we aim to a significant reduction of time to manage properly brucellosis-affected patients and those individuals at high risk of developing rabies through animal bites. In addition, this initiative should reduce costs that would have been incurred by printing hard copies of training manuals through uploading training materials on AfyaData app uploaded on healthcare mobile phones. Finally, the AfyaData app will also support data collection in in-depth interviews as well as recording and reporting zoonotic disease surveillance data thus providing real time data to the epidemiology unit via routine surveillance system.

The overall objective of this initiative is to promote management of selected zoonoses through One Health Awareness creation among Frontline Healthcare Workers in Tanzania.

Specific objectives are:

  1. To assess knowledge, awareness and practices of frontline healthcare workers in selected pastoral communities
  2. To develop, test and assess the performance of e-based in timely provision of accurate management of zoonotic cases intervention in selected pastoral communities

An ethical clearance application was submitted for approval to the National Ethical Clearance Committee of the Ministry of Health before embarking on the study. The proposed research is carried out in two stages. Stage I involves conducting in-depth interviews of frontline healthcare workers (clinical officers and nurses) using structured questionnaire digitized on the AfyaData app. The interview is carried out to assess knowledge, awareness and practices on handling selected zoonotic diseases prevalent in their areas particularly brucellosis and/or rabies. In order to compare effectiveness of the intervention, two populations in the “Control” and “Intervention” areas/villages were recruited to participate in the study.

Stage II involves developing, testing and assessing the performance of e-based intervention in timely provision of accurate management of zoonotic cases based on enhanced knowledge and awareness creation using e-based training on One Health Concept and provision of access to One Health Knowledge Repository uploaded on smartphones of healthcare workers in the “Intervention” areas/villages. On the other hand, healthcare workers in the “Control” areas/villages are left to continue practicing routinely as they are doing before the proposed research. Monitoring of cases of and handling of zoonotic diseases will be carried out using tradition Integrated Disease Surveillance and Response Strategy (IDSR) which is currently used in Tanzania.

The AfyaData system operates through a mobile app for cell phones and a web-based application for data management and analysis. It was developed by a Team of Health (human and animal health) experts and ICT programmers. Afyadata can be used for human diseases, animal diseases and zoonoses. It can be used for data entry and management, processing and feedback to the user, analysis and visualisation of data sets. It can also be used for messaging to contributors through cell phones. Users have access to decision support tools, which help them carry out surveillance activities. The web application provides data visualisation analytical results, graphs and maps.

The following are expected outputs of this study:

  1. Knowledge, awareness and practices on zoonotic diseases among frontline healthcare workers in selected pastoral communities documented.
  2. Knowledge on One Health among frontline healthcare workers in “Intervention” areas/villages enhanced.
  3. Timely and proper management of selected zoonotic diseases among frontline healthcare workers in “Intervention” areas/villages achieved.
  4. At least one paper published in an open-access peer reviewed journal.
Field report of the initiative

Fields of application:

Health professional training

Target audience

  • Healthcare professionals and structures (hospitals, healthcare centres/clinics, health networks)
  • Sick people

Initiative objectives

  • Decreased morbidity
  • Reduced suffering

Key figures

700 Number of beneficiaries since launch

300 Number of users per Month

Materials used

  • Cellular (mobile) phone
  • Smartphone
  • Computer

Technologies used

  • Internet
  • Geolocation
  • Mobile app (Android, iOS, Windows Phone, HTML5, etc.)

Offline use

Yes

Open Source

Yes

Open Data

No

Independent evaluation

Yes
evaluated independently

Partners

Ending Pandemics of the TIDES Foundation, US

Organizational: Communities, public authorities, NGOs, associations, foundations, etc.

Partners

Collaborators

startupBrics