Zoonosen bei Pastoralnomaden: Die Umsetzung des "One Medicine" Konzeptes in Epidemiologie, Modellierungen und Gesundheitsökonomie

• Forschungsstelle: TPH
• Projektnummer: 8.05
• Projekttitel Englisch: Zoonosen bei Pastoralnomaden: Die Umsetzung des "One Medicine" Konzeptes in Epidemiologie, Modellierungen und Gesundheitsökonomie

Schlüsselwörter (Deutsch)

Zoonosen, Pastoralisten, Nomaden, Tschad, Tuberkulose, Anthrax, Epidemiologie, Gesundheitsökonomie, Transmissionsmodelle

Schlüsselwörter (Englisch)

Zoonoses, pastoralists, nomads, Chad, tuberculosis, anthrax, epidemiologie, health economy, transmission models

Kurzbeschreibung (Englisch)

In a first approach, the attributable fraction of Mycobacterium bovis derived tuberculosis in human tuberculosis will be assessed by a case-control study in several Chadian hospitals and health centres. Isolates from this study and from livestock will be characterised by IS6110 Restriction fragment length polymorphism (RFLP) and spoligotyping to derive their phylogenetic relationship, population dynamics and their antibiotic resistance. In addition, existing and new Chadian isolates of B. anthracis will be compared to vaccine strains with molecular methods. In a second approach deterministic animal to human transmission models will be extended to statistical Bayesian models which allow the estimation of the precision of the transmission parameters and can easier incorporate spatially structured correlation. Both types of models will be compared and tested for Chadian and other data sets, so they may inform national and district-level policy and services, and for evaluating the performance of ongoing joint animal and human vaccination interventions.

The innovative elements of this project are a) the first systematic quantification of the role of zoonotic tuberculosis in the human tuberculosis epidemic in Africa and b) the formulation and development of novel joint animal and human health strategies, and tools for their intersectoral assessment. This new dimension complements existing health indicators. This approach should have broader applicability for control of zoonoses and extend health efficiency concepts to consider new trans-sectoral determinants. We expect it to demonstrate the practical value of conceptual links between animal and human health.

The interdisciplinary framework of this project encompasses microbiology, classical and molecular epidemiology, transmission modelling, health-economics and health system components. Its international partners comprise institutions in Chad, Mongolia, United Kingdom and Switzerland. The World Health Organisation (WHO) and Food and Agriculture Organisation (FAO) collaborate in the development of health intervention assessment applications of zoonotic diseases.

Projektziele (Englisch)

This project's objectives are to:·

Assess the importance and molecular epidemiology of Mycobacterium bovis derived zoonotic tuberculosis in human tuberculosis, with reference to population dynamics and antibiotic resistance.·

Characterise and compare field and vaccine strains of Bacillus anthracis for their genetic diversity and virulence plasmid content.

Develop animal-human deterministic SIR (Susceptible-Infected-Recovered) models as well as statistical Bayesian transmission models for the control of zoonotic diseases that project their economic impact and the value of improved health services for pastoral people.

Abstract (Englisch)

The project "The interface between human and animal health in West and Central African nomads: towards 'the one medicine'" is part of the "Health of nomads in Chad"
of the STI and the National Centre for Competence in Research (NCCR) North-South "Research Partnerships for Mitigating Syndromes of Global Change" http://www.sti.ch/en/research/public-health-and-epidemiology/human-and-animal-health.html
of the Swiss National Science Foundation and co-financed by the Swiss Agency for Development and Cooperation http://www.deza.admin.ch (SDC). The goal of this project is to contribute to the development of a delivery system to improve health care for nomad communities, based on a joint human and veterinary medical approach with emphasis on the control of zoonotic diseases ZOONOSES. The main objectives are to assess and develop synergies between veterinary extension services and the provision of primary health care, to quantify the importance of selected zoonotic diseases, and to develop and test models for integrated human and animal health care for nomad populations based on a "one medicine concept".

Publikationen / Ergebnisse (Englisch)

1. Zinsstag J., Schelling E., Daoud S., Schierle J., Hofmann P., Diguimbaye C., Daugla D. M., Ndoutamia G., Knopf L., Vounatsou P. and Tanner M. (2002) Serum retinol of Chadian nomadic pastoralist women in relation to their livestocks' milk retinol and beta-carotene content. Journal of Vitamin and Nutrition Research. International Journal of Vitamin and Nutrition Research. 72(4): 221-228.

2. E. Schelling, C. Diguimbaye, S. Daoud, J. Nicolet, P. Boerlin, M. Tanner, J. Zinsstag (2003) Brucellosis and Q-fever seroprevalences of nomadic pastoralists and their livestock in Chad Prev. Vet. Med. 61 279-293



Articles submitted to peer reviewed journals

1. Esther Schelling , Mahamat Béchir, Kaspar Wyss, Marcel Tanner, Doumagoum M. Daugla, Jakob Zinsstag (2003) Cost sharing through joint human and livestock vaccination campaigns among nomadic pastoralists of Chad

2. E. Schelling , S. Daoud, D.M. Daugla, P. Diallo, M. Tanner, J. Zinsstag (2003) Morbidity and nutrition patterns of three nomadic pastoralist communities of Chad Acta Tropica submitte (revision)

3. E Schelling, M Wiese, M Bechir, S Daoud, K Wyss, M Tanner and J Zinsstag (2003) Utilisation of health services of three nomadic pastoralist communities of Chad

4. E Schelling, F Krönke, M Béchir, M Wiese, S Daoud, M Tanner, K Wyss, J Zinsstag (2003) Nomadic pastoralists' perception on future joint human and animal vaccination campaigns

5. J. Zinsstag and Y. Idriss (2003) Pastoralisme nomade et santé au Tchad (Revue de Médecine Tropicale in press)

6. G. Fokou, T. Haller, J. Zinsstag (2003) A la recherche des déterminants institutionnels pour le bien-être des populations sédentaires et nomades dans la plaine du Waza-Logone de la frontière camerounaise et tchadienne (Revue de Médecine Tropicale in press)

7. D. M. Daugla S. Daoud, M. Tanner, J. Zinsstag, E. Schelling (2003) Répartition de la morbidité chez trois communautés nomades du Chari- Baguirmi et du Kanem - Tchad (Revue de Médecine Tropicale in press).

8. E. Schelling, C. Diguimbaye, S. Daoud, J. Nicolet, J. Zinsstag. (2003) - Séroprévalences des maladies zoonotiques chez les pasteurs nomades et leurs animaux dans le Chari-Baguirmi du Tchad (Revue Médecine Tropicale in press)

9. J. Zinsstag, E. Schelling, S. Daoud, J. Schierle, P., Hofmann, C. Diguimbaye, D . M. Daugla, G. Ndoutamia, L. Knopf, P. Vounatsou, M. Tanner. (2003) Rétinol sérique des femmes pasteurs nomades en relation avec la teneur du rétinol et du beta-carotène dans le lait de leur bétail au Tchad (Revue de Médecine Tropicale in press)

10. C. Diguimbaye, E. Schelling, G. Pfyffer, R. Ngandolo, G. Ndoutamia, M. Tanner, J. Zinsstag (2003)Mycobacterium bovis chez l'homme et l'animal: les premiers isolements au Tchad (Revue de Médecine Tropicale in press)

11. K. Wyss, M. Bechir, E. Schelling, D. M. Daugla, J. Zinsstag. (2003) Quels types de services de santé pour les populations nomades? Apprentissages des activités de recherche et d'action au Tchad (Revue de Médecine Tropicale in press)

12. M. Bechir, E. Schelling, D. M. Daugla, S. Daoud, J. Zinsstag, K. Wyss (2003) Approche novatrice des vaccinations en milieu nomade (Revue de Médecine Tropicale in press)

13. E. Schelling, M. Béchir, K. Wyss M. Tanner, D. M. Daugla, J. Zinsstag (2003) Coûts des campagnes de vaccination conjointes en santé publique et en élevage


Books and Book chapters

1. Wyss K. & Zinsstag J. (Eds.) (2000) Réflexions pour une meilleure prise en charge de la santé en milieu nomade au Tchad. Institut Tropical Suisse. Sempervira N°8 Centre Suisse de Recherches Scientifiques01 B.P. 1303 Abidjan, Côte d'Ivoire ISSN 1025-8167 115 pp.

2. Zinsstag J., Bidjeh K. and Idriss A. (2000) L'interface entre la santé humaine et animale chez les nomades en Afrique: vers "une médecine unie". In: Les populations nomades et la santé humaine et animale en Afrique et notamment au Tchad. (1998) APT Report. ISSN 09 49-6645.

3. Zinsstag J. (2002) Rind oder Hund: Zur Bedeutung des inter-kulturellen Austausches im tierethischen Diskurs. In: Die Würde des Tieres. M. Liechti (Hg.) Harald Fischer Verlag ISBN 3-89131-406-X 378 pp.

4. Zinsstag J. (2002)Nord-Süd Forschungspartnerschaft zur Gesundheit von Pastoralnomaden im Tschad. Eine Herausforderung für die Natur- und Geisteswissenschaften In: Forschungspartnerschaft mit Entwicklungsländern. Schweiz. Akademie der Geistes- und Sozialwissenschaften, Bern, ISBN 3-907835-37-9 103 pp.