Dear colleagues,
It is important to note that, in addition to what Prof. Nzietchueng is saying; majority of the reported PPR cases (in Tanzania it is about 90%) are based on clinical diagnosis, and few on both clinical signs and PM lesions. In most occasions, the reported cases are coming from the same places by the few individuals who are motivated to report. Therefore very little epidemiological deductions can be made from the WAHIS/WAHID or a similar data base at the national/regional levels. On the other hand we tend to use such statements as “PPR has severe impact on food security and livelihoods of the pastoral communities…” to attract funding or for decision making. But we forget that in reality, sheep and goat deaths for example, in pastoral settings are multi factorial. But because PPR is on top of the agenda, field officers simply conclude and report PPR (we have seeing “ reported PPR cases” which from PM and history were actually a combination of CCPP and FMD).
So before we control or eradicate, we need to have an epidemiological and socio-economic baselines. These two must be defined from an industrial perspective. In other words, the motive to control PPR in the Maasai land would be different from the one in South Africa. To me, living with the disease means an “endemic stability/equilibrium” whereby you have low incidence and low mortality, anything above that shall be considered to be an “epidemic”.
Fredrick
From: Establishment of a PPR Global Research and Expertise Network (PPR-GREN) [mailto:[log in to unmask]] On Behalf Of Paul Rossiter
Sent: 11 February 2014 12:01
To: [log in to unmask]
Subject: From Dr Serge Nzeitchueng on endemicity and epidemiological evidence. With moderator's comments.
I concur with the questions from Drs Taylor and Kivaria.
The word “endemic” has been mentioned several times through this forum and it seems like the assumption behind the “endemic” means high mortality. It is a mistake to think that way because a disease can be endemic with a low incidence and high morality or high incidence and low mortality or low incidence and low mortality. It is good to know that in Africa, 33 countries out of 54 have reported the disease in 2012 and I am wondering whether those countries can provide incidence information among others, but key epidemiological informations which are part of the evidences driving the decision whether we want to control or eradicate a disease.
If in our countries there is institutional framework and strategy for prevention and control HIV/AIDS it is because there are evidences-based supporting the need to invest in prevention and control of HIV/AIDS.
About PPR, what are the epidemiological, economical and more importantly food security EVIDENCES we must provide to the policy maker in order to invest into control OR eradication of PPR?
Serge Nzietchueng
Adjunct Professor, Ecosystem Health Initiative
Adjunct Instructor, School of Public Health
University Technical Advisor, USAID Grantee RESPOND Project
University of Minnesota
Department of Veterinary Population Medicine
I am not sure that everyone is actually assuming high mortality when they use the term endemic. Perhaps some of you who have contributed on this can give us your views? What is the disease "pattern" that you see in endemic areas?
- Moderator.
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