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      “We do not bury dead livestock like human beings”: Community behaviors and risk of Rift Valley Fever virus infection in Baringo County, Kenya

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          Abstract

          Background

          Rift Valley Fever (RVF), is a viral zoonotic disease transmitted by Aedes and Culex mosquitoes. In Kenya, its occurrence is associated with increased rains. In Baringo County, RVF was first reported in 2006–2007 resulting in 85 human cases and 5 human deaths, besides livestock losses and livelihood disruptions. This study sought to investigate the county’s current RVF risk status.

          Methodology and principal findings

          A cross-sectional study on the knowledge, attitudes and practices of RVF was conducted through a mixed methods approach utilizing a questionnaire survey (n = 560) and 26 focus group discussions (n = 231). Results indicate that study participants had little knowledge of RVF causes, its signs and symptoms and transmission mechanisms to humans and livestock. However, most of them indicated that a person could be infected with zoonotic diseases through consumption of meat (79.2%) and milk (73.7%) or contact with blood (40%) from sick animals. There was a statistically significant relationship between being male and milking sick animals, consumption of milk from sick animals, consuming raw or cooked blood, slaughtering sick livestock or dead animals for consumption (all at p≤0.001), and handling sick livestock with bare hands (p = 0.025) with more men than women engaging in the risky practices. Only a few respondents relied on trained personnel or local experts to inspect meat for safety of consumption every time they slaughtered an animal at home. Sick livestock were treated using conventional and herbal medicines often without consulting veterinary officers.

          Conclusions

          Communities in Baringo County engage in behaviour that may increase their risk to RVF infections during an outbreak. The authors recommend community education to improve their response during outbreaks.

          Author summary

          The study focuses on the knowledge and socio-cultural practices around Rift Valley Fever (RVF) in Baringo County. It is intended to identify means through which communities in Baringo County could be exposed to RVF in the event of an outbreak. Specifically, it addresses knowledge of RVF transmission routes, practices in handling and consumption of meat, milk and blood; livestock disease management and disposal of dead animals/aborted foetuses. The study found that community members engaged in practices that would expose them to RVF in the event of an outbreak. These practices include milking and consuming milk from sick animals; consuming meat from slaughtered sick animals and those that die from disease; rarely having animals that were slaughtered at home inspected by a veterinary officer or a local animal expert before consumption; using uncertified techniques to test meat for safety of consumption; and treating sick livestock with both conventional and herbal treatments without the guidance of veterinary personnel. Further, RVF infections are likely to follow a gendered pattern based on the division of labor in livestock production. Based on their results, the study authors recommend community education to increase RVF awareness.

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          Most cited references23

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          Climate and satellite indicators to forecast Rift Valley fever epidemics in Kenya.

          All known Rift Valley fever virus outbreaks in East Africa from 1950 to May 1998, and probably earlier, followed periods of abnormally high rainfall. Analysis of this record and Pacific and Indian Ocean sea surface temperature anomalies, coupled with satellite normalized difference vegetation index data, shows that prediction of Rift Valley fever outbreaks may be made up to 5 months in advance of outbreaks in East Africa. Concurrent near-real-time monitoring with satellite normalized difference vegetation data may identify actual affected areas.
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            An Outbreak of Rift Valley Fever in Northeastern Kenya, 1997-98

            In December 1997, 170 hemorrhagic fever-associated deaths were reported in Carissa District, Kenya. Laboratory testing identified evidence of acute Rift Valley fever virus (RVFV). Of the 171 persons enrolled in a cross-sectional study, 31(18%) were anti-RVFV immunoglobulin (Ig) M positive. An age-adjusted IgM antibody prevalence of 14% was estimated for the district. We estimate approximately 27,500 infections occurred in Garissa District, making this the largest recorded outbreak of RVFV in East Africa. In multivariate analysis, contact with sheep body fluids and sheltering livestock in one’s home were significantly associated with infection. Direct contact with animals, particularly contact with sheep body fluids, was the most important modifiable risk factor for RVFV infection. Public education during epizootics may reduce human illness and deaths associated with future outbreaks.
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              Rift Valley fever virus epidemic in Kenya, 2006/2007: the entomologic investigations.

              In December 2006, Rift Valley fever (RVF) was diagnosed in humans in Garissa Hospital, Kenya and an outbreak reported affecting 11 districts. Entomologic surveillance was performed in four districts to determine the epidemic/epizootic vectors of RVF virus (RVFV). Approximately 297,000 mosquitoes were collected, 164,626 identified to species, 72,058 sorted into 3,003 pools and tested for RVFV by reverse transcription-polymerase chain reaction. Seventy-seven pools representing 10 species tested positive for RVFV, including Aedes mcintoshi/circumluteolus (26 pools), Aedes ochraceus (23 pools), Mansonia uniformis (15 pools); Culex poicilipes, Culex bitaeniorhynchus (3 pools each); Anopheles squamosus, Mansonia africana (2 pools each); Culex quinquefasciatus, Culex univittatus, Aedes pembaensis (1 pool each). Positive Ae. pembaensis, Cx. univittatus, and Cx. bitaeniorhynchus was a first time observation. Species composition, densities, and infection varied among districts supporting hypothesis that different mosquito species serve as epizootic/epidemic vectors of RVFV in diverse ecologies, creating a complex epidemiologic pattern in East Africa.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS Negl Trop Dis
                PLoS Negl Trop Dis
                plos
                plosntds
                PLoS Neglected Tropical Diseases
                Public Library of Science (San Francisco, CA USA )
                1935-2727
                1935-2735
                24 May 2017
                May 2017
                : 11
                : 5
                : e0005582
                Affiliations
                [1 ]Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
                [2 ]Animal and Human Health, International Livestock Research Institute, Nairobi, Kenya
                [3 ]Research, Innovation and Outreach, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
                [4 ]Cooperative Development, Research and Innovation, The Cooperative University of Kenya, Nairobi, Kenya
                School of Veterinary Medicine University of California Davis, UNITED STATES
                Author notes

                The authors have declared that no competing interests exist.

                • Conceptualization: ENM SAB BKB BAE IKN.

                • Data curation: ENM.

                • Formal analysis: ENM SAB BKB BAE IKN.

                • Funding acquisition: SAB, BKB, BAE, IKN.

                • Investigation: ENM.

                • Methodology: ENM SAB BKB BAE IKN.

                • Project administration: SAB BAE IKN.

                • Resources: SAB BKB BAE IKN.

                • Supervision: SAB BKB BAE IKN.

                • Validation: SAB BKB IKN.

                • Visualization: ENM.

                • Writing – original draft: ENM.

                • Writing – review & editing: ENM SAB BKB BAE IKN.

                Author information
                http://orcid.org/0000-0002-7511-9116
                Article
                PNTD-D-16-01480
                10.1371/journal.pntd.0005582
                5460880
                28542242
                8e168842-3628-4da7-80c4-72e6a5810c29
                © 2017 Mutua et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 18 August 2016
                : 19 April 2017
                Page count
                Figures: 3, Tables: 2, Pages: 17
                Funding
                This study, nested in WHO/TDR/IDRC Project ID B20278, received financial assistance from the World Health Organization's Special Programme for Research and Training in Tropical Diseases (TDR) through a grant agreement with the International Development Research Centre of Canada (106905–00). This work was also partly supported by the CGIAR Research Program on Agriculture for Nutrition and Health led by the International Food Policy Research Institute, Washington. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
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                Biology and Life Sciences
                Agriculture
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                Biology and Life Sciences
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                Custom metadata
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                2017-06-06
                All relevant data are within the paper and its Supporting Information files.

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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