Category: Fellows’ posts

What’s the worry about antibiotics? Andy Stringer reports

Ethiopia relies on livestock. They are crucial to the livelihoods of the majority of the country’s population and to the country’s economy. However, infectious diseases impact the health of livestock in Ethiopia, making antimicrobials vital in combating these diseases. Antimicrobial resistance (AMR) is recognised as a significant threat to global health. Estimates have highlighted that drug resistant infections will cause 10 million extra deaths a year and cost the global economy up to $100 trillion by 2050. The highest mortality due to AMR will be found on the African continent.

The landmark report on AMR, authored by Lord O’Neil, identified a number of important interventions, including the need for a global public awareness campaign, and reducing the unnecessary use of antibiotics in agriculture. Our project, funded by the Soulsby Fellowship, is based in central Ethiopia, specifically in the Ada district of Oromia regional state, and aims to tackle this grand global challenge.

Selection of veterinary pharmaceuticals for sale through an informal seller in central Ethiopia
Selection of veterinary pharmaceuticals for sale through an informal seller in central Ethiopia. Photo: Keli Gerken

The project involves focus group discussions with both animal health professionals and livestock owners to explore themes surrounding antimicrobial use and prescribing behaviors. Previous studies have identified a lack of knowledge by livestock owners regarding antibiotics. Considerable issues surrounding the availability, accessibility and affordability of antibiotics, and drive inappropriate usage practices. Certain antibiotics are purchased by traders and then decanted into previously used, smaller drug bottles, for resale.

Small ruminant being injected with antibiotic by an Ethiopian Animal Health Assistant
Small ruminant being injected with antibiotic by an Ethiopian Animal Health Assistant. Photo: Keli Gerken

Primary veterinary healthcare in Ethiopia is delivered by numerous different animal healthcare professionals. Veterinarians, diploma-holding Animal Health Assistants, Animal Technicians, Community Animal Health Workers and private drug sellers. Across these formal and informal providers there is a greatly varying degree of knowledge, attitudes and behavioral practices to the appropriate usage of antibiotics. To date, there is scant information on the motivations for prescribing antibiotics. This information is vital in any future program designed to address inappropriate usage.

Our project has identified the study location, the study participants, and is currently piloting the methodologies that will be used in the focus group discussions. It is anticipated that the data collection phase will begin, and be completed, in February. The aim of our project is to ascertain a better understanding of behavioral determinants and human motivations for prescribing and using antimicrobials. This information will facilitate the design and development of culturally appropriate interventions focused on mitigating AMR, helping both animal and human populations.

PPRV research update – Camilla Benfield reports

A PPRV-positive goat from the Ngorongoro District of Tanzania showing profuse nasal discharge (Photo courtesy of Bryony Jones)

The exotic location of RVC Potters Bar has been the setting for my PPRV research since my first blog. My research trips to Tanzania and Glasgow, generously supported by The Soulsby Foundation, are scheduled for Spring 2019.

The focus of my recent work was analyzing samples from wild ruminants that succumbed to PPRV in the large epidemic in Mongolia in 2017. These were couriered on dry ice (i.e. frozen CO2at an impressive -78.5 oC) from a collaborating lab in Ulaanbaatar. This was my first coal-face experience of international sample shipment. These samples were regulated under CITES (the Convention on International Trade inEndangered Species) and CITES and Defra permits all had to be obtained. Let’s just say the process honed my project management skills and I was delighted when the samples finally arrived at RVC at the end of summer 2018.

My aim is to analyse these samples to determine the host and viral factors underlying the disease outbreak in endangered Mongolian wildlife. To fund this project, I won a Research Grant from The Royal Society.

With travel costs ineligible under the Royal Society scheme, The Soulsby Fellowship is enabling a collaboration with a lab in Glasgow to learn the specialized techniques needed for this project. Now that I have succeeded in obtaining key gene sequences from theMongolian samples, I can take these data and head to Glasgow next month (coinciding almost perfectly with Glasgow’s annual meterological low point!)

As I mentioned before, the fascinating thing is the starkly different picture in sub-Saharan Africa where wildlife apparently get infected by PPRV but don’t express clinical disease. This isn’t merely of great scientific interest. A real concern is that the largeAfrican migrating populations, economically vital to Tanzania andKenya, may succumb to PPRV disease under certain conditions in the future. Better understanding PPRV in wildlife is crucial, not only for livestock agriculture but also for biodiversity conservation and the related economy.

Networking with Tanzanian scientists was an important motivation for my Soulsby Fellowship application. Pleasingly, this network is growing even with my feet still on Hertfordshire not Tanzanian soil. I now co-supervise a PhD student at SACIDS (Southern African Centre forInfectious Disease Surveillance) with the host scientist for my Soulsby Fellowship visit. With the wonders of modern-day video-conferencing (we use an excellent platform called ‘Zoom meeting’), supervising across the 6,911 miles separating Potter Bar and Morogoro is now a meaningful reality. However, it will be super to meet this student in person when I visit.

A final aspiration for my Tanzanian visit is to see the context, ecosystem and agricultural systems in which PPRV is endemic. The honest fact remains that despite my time in mixed veterinary practice, 14 years researching viruses and 6 years lecturing on them, I have not witnessed much veterinary viral disease! Travelling to Tanzania provides me the opportunity to see for myself the clinical signs and impact of PPRV on small ruminant farming, deepening my understanding of this devastating disease and directing my future research to develop practical and meaningful solutions.

An orphaned saiga antelope calf in Mongolia where a PPRV outbreak in 2017 killed ~60% of this critically endangered species (Photo courtesy of Richard Kock)
An orphaned saiga antelope calf in Mongolia where a PPRV outbreak in 2017 killed ~60% of this critically endangered species (Photo courtesy of Richard Kock)
A PPRV-positive goat from the Ngorongoro District of Tanzania showing profuse nasal discharge (Photo courtesy of Bryony Jones)
A PPRV-positive goat from the Ngorongoro District of Tanzania showing profuse nasal discharge (Photo courtesy of Bryony Jones)

Tanzania and the Peste des petits ruminants virus, or ‘PPRV’

I’m a Lecturer in Virology at the Royal Veterinary College. I’ve been there for 5 years now and it’s a role in which I balance research and teaching. I always had a strong zoological interest and my realisation that vets could make broad impacts on global health was what drove me back from the Bedfordshire fields into a lab at Cambridge Vet School to do my PhD in molecular virology. There’s more on my career path in a Veterinary Record article ‘From herpetology to virology: how did that happen?’.

Ethiopia and a Global One Health Challenge

Welcome to this first blog post! I graduated with a veterinary degree from the University of Liverpool in 2005 and immediately spent time volunteering for a veterinary charity in Morocco. This experience provided me with an appreciation of the important role animals have in the livelihoods of communities in Africa. This was my first exposure to One Health – the recognition that the health of animals and the health of humans are intrinsically linked.