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      Setting priorities for surveillance, prevention, and control of zoonoses in Bogotá, Colombia Translated title: Establecimiento de prioridades en la vigilancia, la prevención y el control de las zoonosis en Bogotá, Colombia

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          OBJECTIVE: To establish priorities for zoonoses surveillance, prevention, and control in Bogotá, Colombia. METHODS: A Delphi panel of experts in veterinary and human medicine was conducted using a validated prioritization method to assess the importance of 32 selected zoonoses. This exercise was complemented by a questionnaire survey, using the knowledge, attitudes, and practices (KAP) methodology, administered in 19 districts of Bogotá from September 2009 to April 2010 to an at-risk population (workers at veterinary clinics; pet shops; butcher shops; and traditional food markets that sell poultry, meat, cheese, and eggs). A risk indicator based on level of knowledge about zoonoses was constructed using categorical principal component and logistic regression analyses. RESULTS: Twelve experts participated in the Delphi panel. The diseases scored as highest priority were: influenza A(H1N1), salmonellosis, Escherichia coli infection, leptospirosis, and rabies. The diseases scored as lowest priority were: ancylostomiasis, scabies, ringworm, and trichinellosis. A total of 535 questionnaires were collected and analyzed. Respondents claimed to have had scabies (21%), fungi (8%), brucellosis (8%), and pulicosis (8%). Workers with the most limited knowledge on zoonoses and therefore the highest health risk were those who 1) did not have a professional education, 2) had limited or no zoonoses prevention training, and 3) worked in Usme, Bosa, or Ciudad Bolívar districts. CONCLUSIONS: According to the experts, influenza A(H1N1) was the most important zoonoses. Rabies, leptospirosis, brucellosis, and toxoplasmosis were identified as priority diseases by both the experts and the exposed workers. This is the first prioritization exercise focused on zoonoses surveillance, prevention, and control in Colombia. These results could be used to guide decision-making for resource allocation in public health.

          Translated abstract

          OBJETIVO: Establecer prioridades en la vigilancia, la prevención y el control de las zoonosis en Bogotá, Colombia. MÉTODOS: Se constituyó un grupo Delfos de expertos en veterinaria y medicina que utilizó un método validado de asignación de prioridades con objeto de evaluar la importancia de 32 zoonosis seleccionadas. Esta actividad se complementó con una encuesta de cuestionario que utilizó el método de conocimientos, actitudes y prácticas (CAP) y que se administró en 19 distritos de Bogotá, de septiembre del 2009 a abril del 2010, a una población en situación de riesgo (empleados de consultorios veterinarios, tiendas de mascotas, carnicerías y mercados de alimentos tradicionales que venden aves de corral, carne, queso y huevos). Se creó un indicador de riesgo basado en el nivel de conocimiento acerca de las zoonosis mediante análisis de componentes principales para datos categóricos y análisis de regresión logística. RESULTADOS: En el grupo Delfos participaron doce expertos. Las enfermedades calificadas como de mayor prioridad fueron la gripe A(H1N1), la salmonelosis, la infección por Escherichia coli, la leptospirosis y la rabia. Las enfermedades calificadas como de menor prioridad fueron la anquilostomiasis, la escabiosis, la tiña y la triquinosis. Se recopilaron y se analizaron un total de 535 cuestionarios. Los encuestados informaron de que habían padecido escabiosis (21%), infecciones por hongos (8%), brucelosis (8%) y pulicosis (8%). Los trabajadores cuyos conocimientos sobre zoonosis eran más limitados y por consiguiente estaban sometidos a un mayor riesgo para su salud fueron los que 1) no tenían una formación profesional, 2) contaban con poca o nula capacitación en materia de prevención de zoonosis, y 3) trabajaban en las localidades de Usme, Bosa o Ciudad Bolívar. CONCLUSIONS: Según los expertos, la gripe A(H1N1) fue la zoonosis más importante. La rabia, la leptospirosis, la brucelosis y la toxoplasmosis fueron consideradas como enfermedades prioritarias tanto por los expertos como por los trabajadores expuestos. Esta es la primera actividad de asignación de prioridades centrada en la vigilancia, la prevención y el control de las zoonosis en Colombia. Estos resultados podrían servir de guía en la toma de decisiones para la asignación de recursos en salud pública.

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          Most cited references 41

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          The perception of risk

           P Slovic (1987)
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            Prioritizing Emerging Zoonoses in The Netherlands

            Background To support the development of early warning and surveillance systems of emerging zoonoses, we present a general method to prioritize pathogens using a quantitative, stochastic multi-criteria model, parameterized for the Netherlands. Methodology/Principal Findings A risk score was based on seven criteria, reflecting assessments of the epidemiology and impact of these pathogens on society. Criteria were weighed, based on the preferences of a panel of judges with a background in infectious disease control. Conclusions/Significance Pathogens with the highest risk for the Netherlands included pathogens in the livestock reservoir with a high actual human disease burden (e.g. Campylobacter spp., Toxoplasma gondii, Coxiella burnetii) or a low current but higher historic burden (e.g. Mycobacterium bovis), rare zoonotic pathogens in domestic animals with severe disease manifestations in humans (e.g. BSE prion, Capnocytophaga canimorsus) as well as arthropod-borne and wildlife associated pathogens which may pose a severe risk in future (e.g. Japanese encephalitis virus and West-Nile virus). These agents are key targets for development of early warning and surveillance.
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              Evidence-based semiquantitative methodology for prioritization of foodborne zoonoses.

              To prioritize an extended list of food- and water-borne zoonoses to allow food safety authorities to focus on the most relevant hazards in the food chain. An evidence-based semiquantitative methodology was developed. Scores were given by 35 scientific experts in the field of animal and public health, food, and clinical microbiology and epidemiology to 51 zoonotic agents according to five criteria related to public health (severity and occurrence in humans), animal health (severity of disease coupled with economic consequences and occurrence in animals), and food (occurrence in food). The scoring procedure was standardized and evidence-based as experts were provided, for each zoonotic agent, a same set of up-to-date help information data related to the five criteria. Independently, the relative importance of the five criteria was weighted by seven food chain risk managers. The zoonotic agents were ranked based on overall weighted scores and were grouped in four statistically different levels of importance. The following foodborne zoonotic pathogens were classified as "most important": Salmonella spp., Campylobacter spp., Listeria monocytogenes, and verocytotoxigenic Escherichia coli. A second group of "significant importance" included Toxoplasma gondii, the agent of bovine spongiform encephalopathy, Clostridium botulinum, Staphylococcus aureus, Cryptosporidium parvum, Mycobacterium bovis, Echinococcus granulosus, Streptococcus spp., Echinococcus multilocularis, Yersinia enterocolitica, Mycobacterium avium, Fasciola hepatica, Giardia intestinalis, and Rotavirus. This methodology allowed to rank 51 zoonotic agents with objectivity and taking account of a combined input from risk assessors and risk managers. These results support food safety policy makers to establish the multiannual monitoring program of foodborne zoonoses. They also enable to identify knowledge gaps on specific zoonotic agents and to formulate key research questions. Principally, this method of prioritization is of general interest as it can be applied for any other ranking exercise and in any country.

                Author and article information

                Revista Panamericana de Salud Pública
                Rev Panam Salud Publica
                Organización Panamericana de la Salud (Washington, Washington, United States )
                May 2013
                : 33
                : 5
                : 316-324
                Bogotá orgnameUniversidad de La Salle orgdiv1Facultad de Ciencias Agropecuarias Colombia
                Bogotá orgnameSecretaria Distrital de Salud orgdiv1Sección de Vigilancia en Salud Pública Colombia
                Torino orgnameUniversità degli Studi di Torino orgdiv1Dipartimento di Scienze Veterinarie Italy
                S1020-49892013000500002 S1020-4989(13)03300500002

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