Biosecurity survey in relation to the risk of HPAI outbreaks in backyard poultry holdings in Thimphu city area, Bhutan

Background A questionnaire survey was conducted to assess the biosecurity and other practices of backyard poultry holdings and knowledge and practices of poultry keepers following an outbreak of highly pathogenic avian influenza (H5N1) virus in poultry in Thimphu city area, Bhutan. Results The study identified 62 backyard poultry holdings in 12 settlement areas, and the owners were subsequently interviewed. The birds are kept in a low-input low-output system, fed locally available scavenging feed base, and supplemented with food scraps and some grain. Although the birds are housed at night in a small coop to protect them against theft and predators, they are let loose during the day to scavenge in the homestead surroundings. This invariably results in mixing with other poultry birds within the settlement and wild birds, creating favorable conditions for disease spread within and between flocks. Moreover, the poultry keepers have a low level of knowledge and awareness related to the importance of biosecurity measures, as well as veterinary care of the birds and reporting systems. Of particular concern is that sick birds within backyard holdings may not be detected rapidly, resulting in silent spread of disease and increased risk of humans contacting the virus (e.g. HPAI) from infected poultry. Nevertheless, all the respondents have indicated that they know and practice hand washing using soap and water after handling poultry and poultry products, but rarely use face-masks and hand gloves while handling poultry or cleaning poultry house. Conclusions This study highlights the importance of educating poultry keepers to improve the housing and management systems of poultry farming within the backyard holdings in the Thimphu city area in order to prevent future disease outbreaks. Full text here: https://www.researchgate.net/publication/316345785_Biosecurity_survey_in_relation_to_the_risk_of_HPAI_outbreaks_in_backyard_poultry_holdings_in_Thimphu_city_area_Bhutan

  • Oct/17/2020 1:30 PM
  • Dr Tenzin
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Seroprevalence and risk factors of canine distemper virus in the pet and stray dogs in Haa, western Bhutan

Background: Canine Distemper Virus (CDV) is a highly contagious virus belonging to family Paramyxovirade, genus Morbillivirus and responsible for high morbidity and mortality in dogs worldwide. Infected domestic dogs can cause spillover infections to wild carnivores that are in contact. We conducted a seroprevalence survey of CDV in domestic dogs in two areas of western Bhutan (Haa district) located at the periphery of the Jigme Khesar Strict Nature Reserve, which is home to several endangered wildlife. A total of 238 serum samples, 119 each from the pet and stray dog, were collected during summer and winter seasons. Samples were tested for CDV antibodies using a sandwich enzyme-linked immune-sorbent assay (ELISA) test. Results: The seroprevalence of CDV was found to be 11.3% (95% CI 6.7–14.2). Dogs sampled during winter were less likely to test seropositive against CDV antibodies than those sampled during summer (adjusted odds ratio: -2.6; 95% CI: −1.2–6.1). Dogs in good body condition were found to be more likely to test seropositive against CDV than dogs in poor condition and obese dogs (adjusted odds ratio: 2.2; 95% CI: 0.1–5.9). There were no significant differences in the seroprevalence of CDV among different sexes, breeds and age classes, pet and stray dogs and between the two study sites. Conclusions: Our study indicates that CDV seroprevalence was equally distributed among pet and stray dogs. We suggest strengthening the management practices of dogs through responsible dog ownership, dog population management and waste management to minimize the transmission risk of infectious diseases to wildlife. Keywords: Free-roaming dog, Canine distemper virus, Protected area, Western Bhutan Full text here: https://www.researchgate.net/publication/341365724_Seroprevalence_and_risk_factors_of_canine_distemper_virus_in_the_pet_and_stray_dogs_in_Haa_western_Bhutan

  • Oct/17/2020 1:24 PM
  • Dr Tenzin
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A community-based Knowledge, Attitude, and Practice survey on rabies among cattle owners in selected areas of Bhutan

Rabies remains a disease of significant zoonotic and economic concern in rabies endemic areas of Bhutan. Rabies outbreaks in livestock threaten the livelihoods of subsistence farming communities and pose a potential public health threat. As a part of identifying approaches to prevent rabies in cattle, a Knowledge, Attitude, and Practice (KAP) survey was conducted among cattle owners in selected rural areas of the southern rabies high-risk zone and low-risk zone in eastern Bhutan. Between March and April 2017, 562 cattle owners (281 in the east and 281 in the south) were interviewed using a questionnaire. Eighty-eight percent of the participants had heard of rabies but only 39% of the participants who had heard of rabies had adequate knowledge about rabies. Multivariable logistic regression analysis showed that residing in the south [OR = 9.25 (95% CI: 6.01–14.53)] and having seen a rabies case [OR = 2.46 (95% CI: 1.6–3.82)] were significantly associated with having adequate knowledge about rabies. Based on our scoring criteria, 65% of the total participants who had heard of rabies had a favorable attitude towards rabies control and prevention programs. The participants residing in the east were two times more likely to have a favourable attitude than their counterparts in the south [OR = 2.08 (95% CI: 1.43–3.05)]. More than 70% of the participants reported engaging in farm activities such as examining the oral cavity of sick cattle and assisting cattle during parturition. Only 25% of the participants reported using personal protective equipment while undertaking these activities. Despite a high level of rabies awareness, we observed that there is a lack of comprehensive knowledge about rabies regarding susceptible hosts, transmission routes, the health outcome of rabies infection in humans, and appropriate health-seeking behaviours. This study highlights the need to strengthen rabies education programs in rural communities to address the knowledge gaps that have been identified. Full text: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007305

  • Oct/17/2020 1:18 PM
  • Dr Tenzin
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A Qualitative Risk Assessment of Rabies Reintroduction Into the Rabies Low-Risk Zone of Bhutan

In Bhutan, dog-mediated rabies has been successfully eliminated from most regions of the country but remains endemic in the Southern region and sporadic incursions are also reported in the East. Elimination of rabies from the southern part of Bhutan is challenged by the porous border with the neighboring states of India which facilitates free and unregulated movement of animals. Around 17 outbreaks of rabies are reported annually in dogs and other domestic animals, posing continuous public health risks and economic losses. Furthermore, due to anthropogenic factors, such as increasing human settlements along highways, increased animal transportation, and the complex and changing human-pet relationship, there is potential to reintroduce rabies from rabies high-risk zone to rabies low-risk zone. This study was undertaken to estimate the risk of rabies re-introduction to the rabies low-risk zone by performing a qualitative risk assessment. The assessment was conducted for three risk pathways (stray dog-pathway, pet dog-pathway and cattle-pathway) under two scenarios: (1) no risk mitigation measures in place and (2) current risk mitigation measures in place. The current control measures include Government led programs, such as mass dog vaccination and dog population management, regulation of the movment of animals through pre-travel check-up and health certification, regular awareness education and rabies surveillance in the rabies endemic areas. The probability of an event occurring was assigned using the data from the available literature. Where gaps in knowledge existed, expert opinion, elicited through modified Delphi method, was used. Under the scenario in which no risk mitigation measures were in place, the risk of rabies re-introduction was estimated to be medium for the stray-dog pathway with a low level of uncertainty, low for pet-dog pathway with a low level of uncertainty, and very low for the cattle-pathway with a medium level of uncertainty. When current risk-mitigation measures were included, the risk of rabies reintroduction was estimated to be very low for the stray-dog pathway with a medium level of uncertainty, low for the pet dog-pathway with a low level of uncertainty, and extremely low for the cattle-pathway with a medium level of uncertainty. The risk of rabies re-introduction through all the pathways was greater than negligible. These findings highlight the importance of maintaining and enhancing current risk mitigation measures to prevent re-introduction of rabies into rabies low-risk zone. The full text can be accessed from this link: https://www.researchgate.net/publication/342918448_A_Qualitative_Risk_Assessment_of_Rabies_Reintroduction_Into_the_Rabies_Low-Risk_Zone_of_Bhutan

  • Oct/17/2020 1:11 PM
  • Dr Tenzin

Determinants of health seeking behavior of animal bite victims in rabies endemic South Bhutan: A community-based contact-tracing survey

Background Dog bites are the main source of rabies infection and death in humans, contributing up to 99% of all cases. We conducted a contact-tracing study to evaluate the health seeking and treatment compliance behaviors of people following potential exposure to rabies in rabies endemic south Bhutan. Methods Using information from the rabies post exposure prophylaxis (PEP) register, animal-exposed victims who had visited five hospitals in south Bhutan between January and March 2017 were traced and further data were collected from them using a structured questionnaire. A snowballing technique was used to identify victims who did not seek PEP.The survey was conducted between April and June 2017. Logistic regression was performed to assess factors associated with PEP-seeking and compliance behavior by the victims. Results Amongst 630 who reported to hospitals, 70% (444) of people could be traced and additional 8% (39) who did not seek PEP was identified through contact tracing. Therefore, a total of 483 people were interviewed. Seventy one percent (344/483) of exposure were due to animal bites of which 80% (365/455) were considered to be provoked incidents. Common reasons for not seeking health care included assumptions that risks of infection were minor if bitten by an owned or vaccinated dog. The victims who are male (OR: 0.36; 95% CI: 0.16–0.77) and educated (OR: 0.41; 95% CI: 0.17–0.96) were less likely to seek PEP, while those that experienced unprovoked bite (OR: 5.10; 95% CI: 1.20–21.77) were more likely to seek PEP in the hospitals. Overall, 82% of the victims sought PEP from the hospitals within 24 h after exposure. Eighty three percent completed the PEP course prescribed by the physician. The respondents living in urban areas (OR: 2.67; 95% CI: 1.34–5.30) were more likely to complete the prescribed PEP course than rural dwellers. Conclusions There is high risk of rabies infection in southern Bhutan. It is critical to bridge knowledge gaps and dispel existing myths which will help to improve PEP seeking and compliance behavior of people exposed to rabies infection from animals. A risk-based advocacy program is necessary to prevent dog-mediated human rabies deaths. Electronic supplementary material The online version of this article (10.1186/s12889-019-6559-x) contains supplementary material, which is available to authorized users. the full text can be accessed from this link: https://www.researchgate.net/publication/331384273_Determinants_of_health_seeking_behavior_of_animal_bite_victims_in_rabies_endemic_South_Bhutan_A_community-based_contact-tracing_survey

  • Oct/17/2020 12:58 PM
  • Dr Tenzin
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Rabies Prevention and Control Program in Bhutan: Self-assessment using SARE Tool

Abstract Free-roaming dogs and dog bites are a common public health problem in Bhutan. Several control measures were implemented during the 1980s including the mass killing of dogs by shooting and poisoning. Other control measures such as ad-hoc sterilization and vaccination against rabies, translocation, and impounding of dogs were also implemented to reduce the dog population and control rabies in the country. From 2009, the catch-neuter-vaccinate-release program was initiated to manage the dog population and control rabies in the country. Currently, rabies outbreaks in animals are commonly reported in southern parts of the country with the sporadic incursion into interior rabies-free areas. However, no human rabies deaths were reported since 2017. The country is on track to achieve its target to eliminate dog-mediated human rabies deaths by 2030 through One health approach. In this study, we reviewed the rabies situation in Bhutan in terms of past and current control measures, gaps, and future needs for rabies control using a “Stepwise Approach towards Rabies Elimination [SARE] tool”. We highlighted the areas where more attention is required in order to eliminate rabies in Bhutan. The SARE output was used to develop a “Strategic plan for the elimination of dog-mediated rabies in Bhutan by 2023” by incorporating all the agreed activities of the Global framework for the elimination of dog-mediated human rabies. The Full text can be accessed here: https://www.researchgate.net/publication/333105295_Rabies_Prevention_and_Control_Program_in_Bhutan_Self-assessment_using_SARE_Tool

  • Oct/17/2020 12:46 PM
  • Dr Tenzin

Evaluation of a rapid immunochromatographic test kit to the gold standard fluorescent antibody test for diagnosis of rabies in animals in Bhutan

Background: Rabies kills approximately 59,000 people each year worldwide. Rapid and accurate diagnosis of rabies is important for instituting rapid containment measures and for advising the exposed people for postexposure treatment. The application of a rapid diagnostic tests in the field can greatly enhance disease surveillance and diagnostic activities, especially in resource poor settings. In this study, a total of 179 brain tissue samples collected from different rabies suspect animal species (113 dogs, 50 cattle, 10 cats, 3 goats, 2 horses, and 1 bear) were selected and tested using both rapid immunochromatographic kit and the reference standard fluorescent antibody test (FAT). We evaluated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of a rapid antigen detection test kit produced by BioNote, Inc. (Hwaseong-si, Korea) relative to a FAT for its fit-for-purpose for confirmation of clinical cases of rabies for early response and enhancing rabies surveillance. Results: Among 179 samples examined in this study, there was a concordance in results by the rapid test and FAT in 115 positive samples and 54 negative samples. Test results were discordant in 10 samples which were positive by FAT, but negative (false negative) by rapid kit. The rapid test kit showed a sensitivity of 92% (95% CI: 85.9-95.6) and specificity of 100% (95% CI: 93.4-100) using FAT as the reference standard. The positive and negative predictive values were found to be 100% (95% CI:96.7-100) and 84.4% (95% CI: 73.6-91.3), respectively. Overall, there was 94.4% (95% CI: 90-96.9) test agreement between rapid test and FAT (Kappa value = 0.874) with a positive percent agreement and negative percent agreement of 92 and 100%, respectively. Conclusions: Our finding demonstrated that the rapid test kit (BioNote) can be used for rabies surveillance and confirming the clinical case of rabies in animals for making rapid decisions particularly controlling rabies outbreaks in resource-poor settings. The full text can be accessed here: https://www.researchgate.net/publication/342019453_Evaluation_of_a_rapid_immunochromatographic_test_kit_to_the_gold_standard_fluorescent_antibody_test_for_diagnosis_of_rabies_in_animals_in_Bhutan

  • Oct/17/2020 12:37 PM
  • Dr Tenzin

Community Perceptions of Free-Roaming Dogs and Management Practices in Villages at the Periphery of a Protected Area in Bhutan

Abstract In Bhutan, free-roaming dogs pose health hazards to humans, livestock, and wildlife. Understanding the perceptions and practices of local communities regarding free-roaming dogs is important to mitigate negative impacts. A community-based study was conducted in the buffer zone of Strict Nature Reserve, western Bhutan. The study was conducted in February-October 2018 using a household questionnaire survey, ‘free-listing’ of dog diseases, group discussions, and key-informant interviews. A total of 140 households from Katsho and Esue geogs (sub-districts) were interviewed. People classify dogs under three categories: ‘Gokhi’/pet dog, ‘Changkhi’/stray dog, and ‘Shakhi’/feral dog. A higher proportion of rural people owned pet dogs, which were considered important to guard crops and livestock from wildlife and protect households’ properties. Owning a dog also contributed significantly to the non-material well-being of the respondents, especially in rural villages. In contrast to the perceived positive impacts of the pet dogs, 81% of the respondents considered stray and feral dogs a problem in the community. The threats were attacks/bites by free-roaming dogs to humans, livestock, and also wildlife. Rabies was the most frequently (69.7%) known dog diseases with the highest rank (1.46) in the list, followed by scabies (49.5%, rank 1.52). The majority (56%) of the respondents indicated that stray and feral dogs originate from abandoned pet dogs. This study calls for a multi-sectoral/One Health approach to mitigate the threats posed by free-roaming dogs and more detailed ecological and epidemiological studies are required to control their impacts. Keywords: Free-roaming dogs, Perceptions, Livestock, Protected areas, Bhutan The full text can be accessed here: https://www.researchgate.net/publication/340304969_Community_Perceptions_of_Free-Roaming_Dogs_and_Management_Practices_in_Villages_at_the_Periphery_of_a_Protected_Area_in_Bhutan

  • Oct/17/2020 12:25 PM
  • Dr Tenzin

Foot and Mouth Disease Control Document 2016

Foot-and-mouth disease (FMD) is a highly infectious viral disease of cloven-hoofed species characterized by fever and vesicles in the mouth and on the muzzle, teats, and feet. In a susceptible population, morbidity approaches 100% but the disease is rarely fatal except in young and very old animals. There are 7 immunologically distinct serotypes: A, O, C, Asia 1, and SAT1, SAT2, and SAT3 (Southern African Territories).

  • Jan/05/2017 12:32 AM
  • Lokey Thapa
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NCAH Annual Progress Report for FY 2015-2016

The NCAH Annual Progress Report for the FY 2015-2016 has been published. The document is available for download at: http://www.ncah.gov.bt/reports.php

  • Dec/28/2016 2:46 AM
  • Dr Tenzin