dr. nanyingi_rvf (world bank_bellagio) aug 2012
DESCRIPTION
Interdecadal and interannual climate variability has led to emergence and reemergence of zoonoses in Kenya. We take cognizance of a community based approach in early and timely detection of RVF is vital to veterinary, health authorities and policy-makers in immediate decision making. It contributes to an integrated climate risk assessment of livestock vulnerability analysis using climate dependent RVF model to develop predictive risk maps that will be crucial in current and future control plans of other climate sensitive diseases and possibly provide Early Warning Systems (EWS). The output will contribute to institutional contingency frameworks dealing with concepts and indicators of warning systems which will facilitate the early identification of potential climate sensitive epidemics and decision support systems.TRANSCRIPT
Climate Change Early Warning Systems for Rift Valley Fever Pandemic Preparedness in Kenya
Nanyingi M O Department of Public Health, Pharmacology and Toxicology
University of NairobiKENYA
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25,2012
2
Climate Change Impacts in Kenya
In 2006 and 2007, PH Burden of RVF OB resulted
in 3.4 DALYs per 1000 people and household
costs of about Ksh 10,000 (USD120)
3%GDP loss$500M/(2012)$1-2 B(2030)
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25,2012
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Disease Early Warning Systems (DEWS)
MEWS (MODIS_NDVI)MEWS (MODIS_NDVI)
Are these tools available universally and utilized adequately?
HEALTH MAPPERHEALTH MAPPER
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
RVF Contingency plans for EWS in Kenya (ongoing) Linkage with communities to monitor climatic parameters. Precipitation ,flooding and mapping of “dambos”
Remote sensing and GIS data(NDVI of 0.43-0.45/ SST by 0.5 degrees ) epidemic indicative
Community-Based Early Warning System (CB-LEWS) DVS trains communities to capture data relevant for RVF-EW
Monitoring of vector dynamics and virus activity in sentinel herds?
Farmer/public awareness programmes by Veterinary Communications and Extension Officer.
Community radios ,flyers and mobile phones for preparedness.
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Kenya : Stakeholders in Climate Sensitive Diseases
Veterinary ,Public Health, Agriculture,Met Universities,Research Institutions
Government
Vulnerable Communities CAPACITY BUILDINGRisk AssessmentLab DiagnosisInformation MSSimulation Exercise
COMMUNICATION System Appraisal strategy Participatory message devt (FGD)Media Engagement(Radio, TV)
ONE HEALTH COORDINATION
DISEASE CONTROL Community Sentinel Surveillance Vaccinations and Vector Control
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Current Research: RVF Spatiotemporal Epidemiology
Participatory Epidemiology: Rural appraisal and Community EWS to RVF investigated.
Sero-monitoring of sentinel herds and Geographical risk mapping of RVF hotspots?
Trans-boundary Surveillance for secondary foci(Neighboring country- Uganda)
Disease burden analysis and predictive modeling
Decision support tools for community utilization(Risk maps, brochures, radio and video clips)
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Participatory Community Sensitization
Disease surveillance Committees (Animal health workers ,Pastoralists , Veterinary and Public health officers)
Community mapping of watering Points/Dams or “Dambos”
Training of trainers(TOT) on EWS using flyers
Information feedback mechanisms ( Schools, Churches, village meetings)
Trans-boundary security committees
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
RVF Monitoring and Surveillance -Community Model
e-surveillance and data gathering by (Mobile phones, PDA)
Community sensitization/awareness by Syndromic surveillance
Dissemination of Information through community vernacular radio,SMS
Aanansen et al., 2009, Madder et al., 2012
e-surveillance
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Communication tools : Risk Maps of RVF in Kenya
Bett et al.,2012
Is there geographical restriction of the Diseases or Epidemiologic drifts?
What other factors (confounders) are involved in endemicity of RVF?
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Further secondary data analysis for RVF prediction Precipitation and Temperature from the Kenya Meteorological Department/ECMWF for time series analysis (2000-2011)
Sero-prevalence and inter-epidemic estimates of RVF from the DVS
Disease burden analysis using demographics from Human National Census (Public Health)
Vegetative Index (NDVI) and Soil type cover for suitability of vector analysis.
Process based geographical risk modeling and Linear regression analysis for RVF distribution (ILRI,DVS)
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Outbreak Maps of RVF in Kenya –(1912-2010)
Bett et al.,2012
Response can be geographically targeted(Disease Information Systems).
Vaccine allocation and distribution is site specific(cost saving mechanism)
Secondary foci of outbreaks in semi-urban locations (Vectorial competence).
Controlled Human and Animal migration to curb the spread of climate sensitive diseases
Post Vaccination Sero-monitoring( AVID)
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Climate EWS Caveats in Kenya Lack of human capacity and expertise to contextualize climate change sensitive disease predictions and scenarios.
Dysfunctional or non existent communication channels (technological inadequacies in rural communities)
Trans-boundary armed conflicts (Pastoral cattle rustling)
Financial Constraints in Climate Change Research(Parsimony??)
Ethno-Religious Barriers and Insecurity(Al-Shabab)
Ineffective government policies on climate sensitive Diseases
Lack of efficient infrastructure(Roads, Electricity)
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Target beneficiaries of climate early risk assessment
Sustainable planning and decision making tools to support the development of appropriate climate change adaptation and mitigation policies.
Simulation exercises to test response to RVF epizootic and strengthen working between veterinary, medical, and entomological sectors.
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Contributions to EWS in Kenya: Stakeholders Capacity and Networks
Zoonoses Working Group has been established (One Health concept).-CDC
Linking expert institutions through global networks within both the animal and health sectors
Improvements in governance, infrastructure and capacity building will also prove valuable to secure the livelihoods of vulnerable populations.
Participatory approaches : Farmer Field Schools and livestock owners’ training on climate change for zoonoses preparedness and prevention.
Improved surveillance, early detection and timely diagnosis, transparency of animal disease information
Rapid response to outbreaks as well as the potential use of the network approach in providing data for studies related to climate sensitive diseases.
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Acknowledgements
Data and Financial Support
Contributing Authors
Bett B, International Livestock Research Institute, Kenya
Thumbi SM, University of Edinburgh, UKProject Advisors
Kiama SG, Wangari Maathai Institute, University of Nairobi
Muchemi GM, Department of Public Health, Pharmacology and Toxicology University of Nairobi