Prevention of Sanitary Risks Linked to Rodents in Southeastern Africa

1. Prevention of sanitary risks linked to rodents at the rural/peri-urban interface in southeastern Africa: Overview and outcomes of the RatZooMan project • Dr Steven R. Belmain and colleagues • Natural Resources Institute, University of Greenwich, Central Avenue, Chatham Maritime, ME4 4TB, United Kingdom • T: +44 1624 883761; F: +44 1634 883379; • E: S.R.Belmain@gre.ac.uk

2. The RatZooMan Project A competitively won research project funded by the European Commission INCO-DEV programme through the theme of water and sanitation. €1.45 million over three years. Proposal developed in January 2001, submitted September 2001, notified of success in January 2002, contract negotiations complete October 2002, project officially starts January 2003, funds received February 2003, project activities start March 2003, project completed in June 2006.

3. The RatZooMan Project Rodent (RAT) ZOOnosis MANagement to huMANs Project focuses on public health risks of rodents as disease vectors and the role they play in the spread and transmission of many diseases, but particularly on plague, leptospirosis and toxoplasmosis.

4. The RatZooMan Project • Changes in rural ecology could make previously rare diseases become more common • Increasing connectivity between rural and urban areas could allow these diseases to reach cities • Deteriorating hygiene and increasing urban rodent pests could facilitate these diseases spreading and persisting in cities

5. The RatZooMan Project • Develop new insights on the risks to public health caused by rodents living in close association with humans in rural and peri-urban areas of south-eastern Africa • Apply this information for the development of risk-management strategies

6. The RatZooMan Project • Climate change • Urbanisation • Rural expansion • Increased connectivity • Sanitation

7. Expected outcomes • Increase understanding of zoonosis prevalence in rural and peri-urban areas and the impact of agro-ecological and anthropogenic factors on disease transmission pathways • Establish the impact of rodent-borne diseases on people’s livelihoods • Raise the profile of the effects of rodents on people's health

8. Expected outcomes • Inform and influence policy formulation at government, institution and community levels • Provide potential risk reduction strategies that can be used to reduce the impact of zoonotic diseases • Create predictive and simulation modelling tools to measure the threats of zoonotic disease

9. United Kingdom – lead Natural Resources Institute Denmark Danish Pest Infestation Laboratory Netherlands Royal Tropical Institute Organisation Belgium University of Antwerp

10. South Africa National Institute for Communicable Diseases ARC-Plant Protection Research Institute Durban Natural Science Museum Mozambique National Institute of Health National Veterinary Research Institute Organisation Zimbabwe Syngenta Plant Protection Research Institute Harare City Health Tanzania Sokoine University of Agriculture

11. Output dissemination and project co-ordination WP 13 Socio-economic impact and livelihood constraints of disease WP 6 Anthropogenic change factors WP 7 Land and water factors WP 5 Predictive Model WP 9 Control strategy WP 10 Geographic Information System (GIS) WP 8 Disease ecology Epidemiology WP 1 & 3 Rodent ecology WP 4 Validated tool kit Policy document WP 11 Workshop WP 12 Rodent taxonomy WP 2

12. The RatZooMan Information System

22. Land Use Changes

23. Plague • No serological or molecular detection of Yersina pestis in animals (rodents, dogs) inside or outside of plague foci • Serological detection in human samples collected from plague-endemic foci in Mozambique +1.1% (4 out of 373 human samples from Morrumbala District, Zambezia Province +2.3% (9 out of 397 human samples from Mutarara District, Tete Province

24. Leptospirosis Human results

25. Leptospirosis Rodent results • Evaluation was through a mixture of rapid tests, MAT, PCR, Isolation – results sometimes conflict • Other animals (shrews, dogs, cats, pigs, sheep, goats) also showed high numbers of positives • Serogroup Icterohaemorrhagiae appeared the most prevalent in all species

26. Modelling leptospirosis infection Holt, J., S. Davis & H. Leirs. (In press) A model of leptospirosis infection in an African rodent. Acta Tropica.

27. Juvenile Juvenile Juvenile Juvenile (susceptible) (susceptible) (infected) (infected) Sub Sub - - adult adult Sub Sub - - adult adult (susceptible) (susceptible) (infected) (infected) Leptospires in Leptospires in environment environment Adult Adult Adult Adult (susceptible) (susceptible) (infected) (infected) rodent population demographyinfection routes

28. Possible effects of rodent management of Leptospirosis riskKilling rodents reduces numbersANDprevalence Rodent killing Reducing rodent habitat Prevalence Prevalence Numbers Numbers Strength of management intervention

29. Toxoplasmosis Never previously considered a threat to human health. However, If acquired during pregnancy there is risk of miscarriage, congenital deformity, encephaly or blindness Reactivation in immuno-compromised, i.e. organ transplants, HIV-AIDS

30. Toxoplasmosis

31. Toxoplasmosis Recent surveys of AIDS patients in Maputo, Mozambique indicate 70-80% of patients have cerebro-reactivation (n=1500)

32. Toxoplasmosis Human results

33. Toxoplasmosis Rodent results Animal screening difficulties make these results unreliable

34. Identifying risk factors • Socio-economic – education, wealth • Anthropological – hunting, hygiene • Ethno-ecological – concepts of disease • Environmental – water sources, sanitation, housing • Ecology – rodent species, land use, climate

35. Integrating multidisciplinary data • How do we use ratzooman data?

36. Managing rodent-borne disease • Individual level • Reduce contact with rodents • Break transmission routes for diseases • Community level (village or settlement) • Education and information • Organize water supply and waste removal • Rodent control • Governmental level (local, regional, provincial or other relevant authority) • Monitoring, warning, education, training, • information and funding

37. Involving stakeholders 1. How should we improve surveillance and monitoring of diseases and diagnostic capacities within African countries? 2. How can we influence national and international research priorities and funding opportunities to improve knowledge about rodent transmitted diseases? 3. How do we get Departments of Agriculture, Health and Environment working together to develop national rodent management strategies? 4. How can we improve clinical treatment, prevention and interventions against rodent-borne diseases? 5. How do we raise awareness about the risk of rodents transmitting diseases with the general public, service providers and the international community?

38. Data generation – new knowledge Popular publications Scientific reports and publications Integrated data management system Government and public awareness Achievements Local government endorsement Multidisciplinary research Networking, capacity building Benchmark project – global first

39. Data analysis and interpretation Identification of key risk factors Prioritised management options Policy recommendations Further work to do

40. www.nri.org/ratzooman

41. Thank You