an experience in one health practices: the case of moyo district dr. lali mundrugo-ogo, d.v. (bvm,...
TRANSCRIPT
![Page 1: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/1.jpg)
An Experience in One Health Practices: The
case of Moyo District
Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA)
Dr. Akule R.( Dip AH, BVM)
![Page 2: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/2.jpg)
Outline of Presentation
• Background• Practices of One Health• Purpose of the Analysis• Methodology• Findings and Discussion• Constraints• Conclusion• Recommendations
![Page 3: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/3.jpg)
• Background• The concept of” one health” was embraced in
Moyo district way back in the 1990s. In 1993 a joint technical committee under the chairmanship of the then DMO, was formed for emergency control of tsetse and trypanosomosis in Moyo.
![Page 4: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/4.jpg)
Background (cont’d)
• A committee consisted of District Medical Officer(DMO) as Chairman , District Veterinary Officer (DVO) as secretary, District Entomologist(DE), Secretary for Mass Mobilization, Secretary for Health, Secretary for Production, Representatives of the DES(CAO) and all NGOs related to Trypanosomosis and tsetse control was formed.
![Page 5: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/5.jpg)
Background (cont’d)
• This committee worked jointly to combat the Trypanosomiasis menace till 1995 when there was break up and eventually funding stopped by 1997. However this marked the beginning of close working relations between Veterinarians and Physicians in modern times in Moyo.
![Page 6: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/6.jpg)
Practical Extension of 1990s experience
From year 2000 onwards, there continued the sharing of technical expertise in disease diagnosis, information, training in basic laboratory skills, participation in active screening of Trypanosomiasis and brucellosis, control of rabies, sharing facilities such as fridges, laboratory materials &reagents, sharing of vehicles during mass vaccination campaigns.
![Page 7: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/7.jpg)
Purpose of the Analysis
• Assess progress made in the experimentation of One Health Approach
• Document the good and bad practices, strengths and weaknesses of collaborative inter-disciplinary work to inform future actions
• Share experiences with others on what has been done• Make recommendations to government and other
stakeholders on the policy actions needed to leverage on the good practices for synergy in service delivery
![Page 8: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/8.jpg)
Materials and methods
• Review of reports in the Offices of DHO and DVO
• Review of Literature on One Health• Personal Experiences
![Page 9: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/9.jpg)
Scope:
• The Period under Review spans from 1993 to 2012• Moyo District has projected population of 412,000
spread in 2 Counties and 9 sub-counties.• Moyo is bordered to the North and Northeast by
South Sudan, to the West is Yumbe, to the South is River Nile that separates it from Adjumani and to the Southeast is Arua District
![Page 10: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/10.jpg)
Map of Moyo District
![Page 11: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/11.jpg)
Diseases of common Concern in Moyo
• Rabies(2 recorded deaths in 2012), Trypanosomiasis, Cysticercoses, Epilepsy, tuberculosis, brucellosis and Salmonellosis (Zoonotic)
• Previously annually occurring epidemics like cholera, meningitis
• Recently high prevalence of hepatitis B
![Page 12: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/12.jpg)
Areas of inter-disciplinary collaboration
• Joint Public Awareness campaigns• Joint planning Meetings• Report Sharing• Facility Sharing• Joint research programmes• Joint Surveillance and Diagnostic services
![Page 13: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/13.jpg)
Results
Joint awarenes campaigns
Joint Planning meetings
Report Sharing Facility Sharing Joint Research Joint Surveillance0
5
10
15
20
25
% of Collaboration time
% of Collaboration time
![Page 14: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/14.jpg)
Collaboration areas(cont’d)
• Talk shows held for Control of Rabies: DVO & DSO/DHO on local FM station.
• General Awareness Campaigns with ADEO, DSO, OPM
• In 2003: PHC Supervisor of ADEO spearheaded formation of a rabies control committee with the membership of DVO, DDHS,LCV Sec for Health, RDC, OPM and all UNHCR agencies (ADEO, AAH,IAS,ACORD,JRS) .
![Page 15: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/15.jpg)
Meetings
Multidisciplinary teams held meetings:• On Trypanosomiasis control, Rabies control
and as part of Epidemic preparedness task force.
![Page 16: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/16.jpg)
Sharing Facilities
The Veterinary sector was less resourced in the 1990s and
2000-2005 in laboratory facilities, cold chain facilities and transport especially vehicle.
• screening and diagnostic tests in Hospital and private clinics for trypanosomosis, brucellosis and sometimes to rule out tuberculosis from samples obtained from abattoirs.
• DHOs cold chain technicians always provided support whenever the veterinary department had problems.
![Page 17: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/17.jpg)
Sharing of facilities(Cont’d)
Equipment sharing: • vaccutainers, needles & holders, reagents
have been supplied to the Vet Lab by the Hospital
• Recently the hospital ran out of slides; while their order was being awaited the veterinary laboratory provided these materials.
![Page 18: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/18.jpg)
Joint Research, diagnostic and surveillance activities
• In 1997 DVO and MO i/c SS developed a joint research
proposal to validate the data on the non-reservoir status of
cattle to T.b.gambiense in West Nile
• Joint surveillance & screening of trypanosomosis by Vet
Dept and Moyo hospital Lab Technicians throughout 2000,•
![Page 19: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/19.jpg)
Joint Research surveillance(cont’d)
• Joint research involving MuK(FVM) , Vet Dept, and
Hospital Lab Technician(2002) on Trypanosomiasis,
• Joint research involving Dept and Gulu University
medical school and NALIRI on trypanosomiasis.
•
![Page 20: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/20.jpg)
Research, Diagnoses and Surveillance
In 2003, both veterinary and hospital laboratory
technicians participated in diagnostic and field
operations organized by the Veterinary department
• Joint training as preparedness against Avian Influenza
![Page 21: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/21.jpg)
Research, diagnoses Surveillance
• 2009 the epilepsy research project conducted in
Moyo by Gulu University Medical School involved
full participation of both the veterinary and
medical health professionals.•
![Page 22: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/22.jpg)
Joint training
In 2002, DVO nominated a Lab technician from
Moyo Hospital to train with a Veterinary
surgeon on laboratory diagnosis in MAAIF/
NADDEC to improve disease diagnosis.
![Page 23: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/23.jpg)
Referrals and Reporting
For control of rabies.• All dog bite cases reported to Hospital/Clinic were
refered to veterinary department for verification of risks of rabies.
• The Veterinary department investigates health of the biting dog and advises the medical personnel accordingly.
![Page 24: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/24.jpg)
Initiatives to Collaboration
Medical Veterinary Entomology0
5
10
15
20
25
30
Series1
![Page 25: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/25.jpg)
Explanation
• 67% of initiatives from Veterinary sector• 25% of initiatives from the Medical sector• 8% of initiatives from the Entomologist
![Page 26: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/26.jpg)
Benefits of Collaboration by Sector
Medical Veterinary Both Vet & Med.0
5
10
15
20
25
Series1
![Page 27: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/27.jpg)
Comment
• Both Veterinary and Medical Depts. equally benefitted from the collaboration regardless of the source of initiative.
![Page 28: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/28.jpg)
Impact of Collaboration:C.Cellulosae Cases in Moyo S/C
Moy
o
Moy
o
Oth
ers
Moy
o
Oth
ers
Moy
o
Oth
ers
Moy
o
Oth
ers
Moy
o
Moy
o
Oth
ers
Oth
ers
Oth
ers
Oth
ers
Moy
o
Oth
ers
Moy
o
moy
o
Oth
ers
Oth
ers
1998 1999 2000 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
0
2
4
6
8
10
12
14
16
Freq
![Page 29: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/29.jpg)
Explanation
• Highest recorded incidences in 1999• From 2000 to 2008 there was increased sharing
of reports between Vet and health Depts.• Around 2009/2010 : Period of Conversion of
Vets to NAADS• 2011: The study by Gulu University on the
relationship between Epilepsy and C.Cellulosae Prevalence
![Page 30: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/30.jpg)
Confirmed cases of Rabies in Sub-counties between 1998 to 2012
Metu Moyo Moyo Laropi Itula Laropi laropi0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1.8
2
![Page 31: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/31.jpg)
Explanation
• There was increased reporting of dog bite cases
• As a result these positive rabies cases were confirmed in the Laboratory at NADDEC
• Deaths due to rabies avoided as result of early intervention except for 2 cases in2012 that were reported late
![Page 32: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/32.jpg)
• Lack of sustainable formal structure of cooperation
• Initiative by COCTU collapsed with end of funding for joint operations.
• Existing “disciplinary silo” mentality that excludes horizontal cross-disciplinary collaboration
• Money-driven systems(money-orientedness)
Constraints
![Page 33: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/33.jpg)
Constraints (cont’d)
• COCTU funding for tryps. • UNICEF refrigerators (1997-2002 not allowed
for storage of Animal vacines)
![Page 34: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/34.jpg)
Conclusion
• One Health Approach is the way to go for disease control
• In the experience of Moyo, it worked well at some time but did not work some of the time
• The impact was considerable in raising awareness that led to increased reporting in case of animal/dog bites and demand for meat inspection that controlled tapeworm
![Page 35: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/35.jpg)
Recommendations
• Formalize and customize intra- and multidisciplinary collaboration: information sharing, joint surveillance,
• Re-orientation of the professionals in the intra- and multidisciplinary work
• Build capacity of professionals in leadership and management skills
• Relevant Policy to back up the collaborative structure
![Page 36: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/36.jpg)
References
• Moyo DLG: DVO reports• www.wikipedia/ One Health• Personal Experiences: Dr Akule Dr. Lali Mundrugo-Ogo
![Page 37: An Experience in One Health Practices: The case of Moyo District Dr. Lali Mundrugo-Ogo, D.V. (BVM, MBA) Dr. Akule R.( Dip AH, BVM)](https://reader035.vdocuments.site/reader035/viewer/2022062314/56649e7f5503460f94b8351d/html5/thumbnails/37.jpg)
Thank you for listening