Dr Abel B. Ekiri

Digital disease detection tools are technologically sophisticated, but dependent on digital information, which for many areas suffering from high disease burdens is simply not an option. In areas where news is often reported in local media with no digital counterpart, integration of local news information with digital surveillance systems, such as HealthMap (Boston Children's Hospital), is critical. Little research has been published in regards to the specific contribution of local health-related articles to digital surveillance systems. In response, the USAID PREDICT project implemented a local media surveillance (LMS) pilot study in partner countries to monitor disease events reported in print media. This research assessed the potential of LMS to enhance digital surveillance reach in five low- and middle-income countries. Over 16 weeks, select surveillance system attributes of LMS, such as simplicity, flexibility, acceptability, timeliness, and stability were evaluated to identify strengths and weaknesses in the surveillance method. Findings revealed that LMS filled gaps in digital surveillance network coverage by contributing valuable localized information on disease events to the global HealthMap database. A total of 87 health events were reported through the LMS pilot in the 16-week monitoring period, including 71 unique reports not found by the HealthMap digital detection tool. Furthermore, HealthMap identified an additional 236 health events outside of LMS. It was also observed that belief in the importance of the project and proper source selection from the participants was crucial to the success of this method. The timely identification of disease outbreaks near points of emergence and the recognition of risk factors associated with disease occurrence continue to be important components of any comprehensive surveillance system for monitoring disease activity across populations. The LMS method, with its minimal resource commitment, could be one tool used to address the information gaps seen in global 'hot spot' regions.

As the world continues to react and respond inefficiently to emerging infectious diseases, such as Middle Eastern Respiratory Syndrome and the Ebola and Zika viruses, a growing transdisciplinary community has called for a more proactive and holistic approach to prevention and preparedness – One Health. Such an approach presents important opportunities to reduce the impact of disease emergence events and also to mitigate future emergence through improved cross-sectoral coordination. In an attempt to provide proof of concept of the utility of the One Health approach, the US Agency for International Development’s PREDICT project consortium designed and implemented a targeted, risk-based surveillance strategy based not on humans as sentinels of disease but on detecting viruses early, at their source, where intervention strategies can be implemented before there is opportunity for spillover and spread in people or food animals. Here, we share One Health approaches used by consortium members to illustrate the potential for successful One Health outcomes that can be achieved through collaborative, transdisciplinary partnerships. PREDICT’s collaboration with partners around the world on strengthening local capacity to detect hundreds of viruses in wild animals, coupled with a series of cutting-edge virological and analytical activities, have significantly improved our baseline knowledge on the zoonotic pool of viruses and the risk of exposure to people. Further testament to the success of the project’s One Health approach and the work of its team of dedicated One Health professionals are the resulting 90 peer-reviewed, scientific publications in under 5 years that improve our understanding of zoonoses and the factors influencing their emergence. The findings are assisting in global health improvements, including surveillance science, diagnostic technologies, understanding of viral evolution, and ecological driver identification. Through its One Health leadership and multi-disciplinary partnerships, PREDICT has forged new networks of professionals from the human, animal, and environmental health sectors to promote global health, improving our understanding of viral disease spillover from wildlife and implementing strategies for preventing and controlling emerging disease threats.

Collaboration between higher education institutions and intergovernmental organizations is desirable in order to produce professionals with global competences in animal health, public health and food security. The mission of intergovernmental organizations and their strategic plans normally align well with those of higher education institutions, particularly colleges of agriculture and health sciences, making the two actors natural partners. Historically, intergovernmental organizations and higher education institutions have collaborated in several ways including utilizing intergovernmental organizations� information, sharing courses and academic programs, research, and hosting collaborating centers. The objectives of this paper are: 1) To describe a case study of how multiple higher education institutions (Washington State University (lead), University of Minnesota, University of California Davis, North Dakota State University, University of Prince Edward Island, Iowa State University, and Makerere University) engaged collaboratively with several intergovernmental organizations in training graduate students in global policy formulation under the project �Capacity building in Integrated Management of Transboundary Animal Diseases and Zoonoses�, 2) To discuss various ways higher education institutions and intergovernmental organizations could engage to affect global animal health, public health and food security. Lessons learned from the multi-institutional collaborative experience are discussed including possible models of engagement between higher education institutions and intergovernmental organizations. The paper summarizes possible ways higher education institutions could engage with Intergovernmental Organizations in the Training of Students on Global Animal Health, Public Health and Food Security.

In Uganda, delivery of veterinary services is vital to animal health and productivity, and is heavily dependent on well-trained and skilled animal health professionals. The purpose of this study was to identify and prioritize areas for refresher training and continuous professional development of animal health professionals (veterinarians and veterinary paraprofessionals), with the overarching aim of improving veterinary service delivery in Uganda. A survey was administered electronically to 311 animal health professionals during the period November 14–30, 2019. Data were collected on relevant parameters including demographics, knowledge on preventive medicine, diagnostics, disease control and treatment, epidemiology, and One Health, as well as participants’ opinions on training priorities, challenges faced, and constraints to veterinary service delivery. Most respondents were veterinarians 26–35 years old, were male, and worked in clinical practice. Lowest perceived knowledge was reported on subjects relating to laboratory diagnostics, antimicrobial resistance (AMR), and nutrition. Training topics considered to be of most benefit to respondents included laboratory diagnostics, treatment of common livestock diseases, AMR, and practical clinical skills in reproductive and preventive medicine. Participants preferred to receive training in the form of practical workshops, in-practice training, and external training. This study highlights the need to prioritize training in practical clinical skills, laboratory diagnostics, and AMR. Wet labs and hands-on practical clinical and laboratory skills should be incorporated to enhance training. Provision of targeted and successful trainings will be dependent on the allocation of adequate resources and support by relevant public and private stakeholders across the veterinary sector.

An international experience helps create an awareness of international perspectives and prepares students for a global workforce. Creating an effective study abroad experience requires strong collaboration and active involvement of local and foreign host partner institutions. This paper describes a one month summer study abroad experience in Uganda developed jointly by North Dakota State University (NDSU) and Makerere University in Kampala, Uganda to offer international educational experiences with an emphasis on animal production and health. The elements shared in this paper include: course overview and objectives; course requirements, content and evaluation, management and funding; student participation; the experiential learning experience in Uganda; impact; benefits; challenges; student comments; and future directions in promoting international learning experiences. The course supports NDSU’s mission to “address the needs and aspirations of people in a changing world,” its vision to “be globally identified as a contemporary metropolitan land grant institution” and its core values to “reflect and serve geographically and culturally diverse populations,” “remain committed to serving people globally” and “value collaboration with colleges and universities around the world.” When considering a study abroad experience, students should be encouraged to broaden their choice of place and include non-traditional destinations such as developing countries in Africa.

Today�s increasingly interconnected world has laid to bear several health challenges associated with globalization. Trans-boundary infectious diseases and zoonoses, once thought to be limited by geographical demarcations, are now a constant threat to global animal and human health, trade, food security, and socio-economic wellbeing. Tackling such wide-scale challenges requires innovative, global, and collaborative approaches. Tthe project: �Capacity building in Integrated Management of Trans-boundary Animal Diseases and Zoonoses - CIMTRADZ� was a collaboration of Higher Education Institutions in Africa and North America focused on advancing Higher Education-led development in Africa. The project aim was to improve capacity for effective disease management, through transformative education and collaborative research and training in integrated disease management, with a focus on trans-boundary animal diseases and zoonoses that affect East and Central Africa and the world. Additionally the project engaged local communities in sustainable resource management practices, which promote animal and public health, and food security. The accomplishments discussed include: joint academic programs involving a study abroad program, a master�s degree program, and a training program at the science and policy interface; joint research initiatives; joint professional development initiatives for faculty and leadership; joint community service initiatives; and joint sustainable development initiatives. This paper highlights CIMTRADZ project accomplishments, challenges faced, lessons learned and considerations for future implementers of global health activities.

Experiential learning provides an opportunity for students to bridge classroom and research knowledge and experiences with the realities of creating solutions for difficult policy issues. Experiential learning becomes even more powerful for capacity building when it involves cultural and geographic diversity and multiple public and private institutions. Our next generation of leaders will need these bridging experiences to address and solve global challenges like climate change, food security and transboundary diseases. These challenges cannot effectively be solved by individual countries or institutions and require creating new frameworks and partnerships that are transdisciplinary and global. The objectives of this paper were 1) to describe an experiential learning experience through the National Animal Health and Food Security Policy course conducted in Washington DC and 2) discuss ways the curriculum of this multi-institutional course could be internationalized and adopted globally. The paper discusses possible ways of internationalizing this course including: formation of partnerships with institutions that are already involved in multi-institutional global courses; involvement of international agencies whose missions align with the national health and food security policy course; and signing memoranda of understanding among governments to use this course for capacity building for their public servants.

Antimicrobial resistance (AMR) is a global health concern and the inappropriate use of antibiotics in animals and humans are considered contributing factors. A cross-sectional survey to assess the knowledge, attitudes and practices of veterinarians regarding AMR and antimicrobial stewardship was conducted in Nigeria. A total of 241 respondents completed an online survey. Only 21% of respondents correctly defined the term antimicrobial stewardship and 59.8% were unaware of the guidelines provided by the Nigeria AMR National Action Plan. Over half (51%) of respondents indicated that prophylactic antibiotic use was appropriate when farm biosecurity was poor. Only 20% of the respondents conducted antimicrobial susceptibility testing (AST) frequently, and the unavailability of veterinary laboratory services (82%) and the owner’s inability to pay (72%) were reported as key barriers to conducting AST. The study findings suggest a focus on the following areas of potential intervention may be useful in improving appropriate antibiotic use and antimicrobial stewardship among veterinarians in Nigeria: increased awareness of responsible antimicrobial use among practicing and new graduated veterinarians, increased dissemination of 33 regularly updated antibiotic use guidelines, increased understanding of the role of good biosecurity 34 and vaccination practices in disease prevention, and increased provision of AST at affordable costs.

Trans-boundary infectious diseases and zoonoses once thought to be limited by geographical demarcations are now a constant threat to global animal and human health, trade, food security, and socio-economic wellbeing. Many colleges and schools worldwide are training students to serve as professionals who will improve animal health, public health and food security globally. With this realization, Makerere University and North Dakota State University (NDSU) developed the first US-Africa trans-Atlantic degree addressing integrated disease management and international biosecurity. Both institutions received a grant from United States Department of Agriculture, Higher Education Challenge program to develop a joint Master of Science degree in International Infectious Disease Management (MS-IDM). This grant also funded four graduate students� stipend and research. Additionally, the two institutions received funds through �Capacity building in Integrated Management of Transboundary Animal Diseases and Zoonoses (CIMTRADZ)" project that supported students from Uganda. Faculty from CIMTRADZ participating institutions offered short term training to MS-IDM students, including workshops at The International Scientific Boma and conference in Uganda. A joint degree (MS-IDM) was developed in 2011. Ten MS-IDM students graduated and over 20 fellowships were awarded. Student exchange and joint mentorship of students by faculty at both institutions occurred. There were challenges experienced and valuable lessons learnt. The MS-IDM degree provided opportunities for human capacity development to manage transboundary animal diseases and zoonoses in East and Central Africa. This paper describes the curriculum development, challenges experienced and lessons learned, and informs future similar endeavors in internationalizing curricula in higher education.

Background: There are currently several voluntary guidelines and recommendations that aim to promote the responsible use of antimicrobials (AMU) and to reduce misuse of these medicines in both food-producing animals and companion animals. They have been developed by a number of organisations and implemented in several European countries with the aim of reducing the impact of AMU on antimicrobial resistance (AMR). However, the extent of implementation of these guidelines and their effectiveness in changing behaviours associated with AMU are unknown in most cases. This review assesses the extent of implementation of guidelines, and the impact of these on levels and patterns of AMU in food-producing animals and companion animals in order to inform the development and implementation of better voluntary approaches for reducing AMU in the animal health sector. Methods: Databases including Science Direct and MEDLINE were searched for studies assessing the extent of implementation and impact of guidelines on levels and patterns of AMU in food-producing animals and companion animals. Additional searches using reference tracking, snowballing and grey literature were also performed. Quality of evidence and risk of bias assessment were conducted. A narrative synthesis approach was followed to assess and present the evidence gathered across eligible studies. Results: A total of 784 studies were screened. Fourteen studies were deemed eligible for inclusion. All, apart from three, were conducted in Europe. Several voluntary guidelines on prudent AMU were referred to in these studies, mostly developed by international or regional bodies. There is limited evidence on the extent of implementation and the effectiveness of these guidelines in food-producing animals and companion animals. In food-producing animals, the quality of studies was deemed low as most were cross-sectional and based on convenience sampling. There were differences in uptake of prudent AMU guidelines including use of antimicrobial susceptibility testing (ASTs) and critically important antimicrobials (CIAs) among countries. Voluntary initiatives from levy bodies supporting farmers involving reduction and ban of use of CIAs (e.g. third generation cephalosporins), combined with changes in animal husbandry and farming practices, and improvement of vaccination strategies were deemed amongst the most effective in the swine (UK and Denmark) and poultry (UK) sectors, and to a lesser extent in the dairy cattle production sector (Denmark). There may be lessons to be learnt from these countries for more effective AMU reduction strategies. Nevertheless, there are still scarce data on the potential impact of voluntary interventions on animal health and welfare, and productivity. One of the few countries to have assessed the impact of the promotion of prudent use campaigns, on animal health and welfare, and productivity was Denmark which has recently reported that their impact waslow in the short term according to surveillance data, though further assessments are required to assess impact in the long-term. There was even less evidence available for companion animals, and the quality of studies was lower; as consequence, these studies were not deemed suitable for the assessment of impact of prudent use recommendations and guidelines. Conclusions: Prudent use guidelines are available in most European countries, at different levels: international (Europe-wide); national (countrywide or for members of associations); and local (e.g. at hospital level). In some countries like the UK, the livestock and poultry industries have taken the initiative to reduce the use of AMs by adopting national and international recommendations for the reduction of use the use of critically important antimicrobials. However, there is currently limited quantitative evidence of the impact of the recommendations voluntary interventions in AMU in both food-producing and companion animals, and, particularly, their impact on animal health and welfare, and productivity. This is due to the lack of systematic assessment of surveillance data and of longitudinal studies to investigate the effectiveness of guidelines in changing antibiotic use in animal populations the promotion of prudent AMU. Targeted adoption of prudent use practices by farmers and veterinarians were reported to be an effective approach to reduce AMU, including CIAs in poultry, swine and dairy cattle.

In 2010, the United States Agency for International Development, The Association of Public and Land-grant Universities and Higher Education for Development awarded 11 Africa-US Higher Education partnership grants of $1.1 million each to universities in Africa and the US to address national and regional priorities in sub-Saharan Africa. Each partnership will develop collaborative research and academic programs to build the capacity of the African and US institutions to affect change in Africa. This paper describes one of the partnerships between North Dakota State University (NDSU) and Makerere University (Mak) in Uganda that addresses capacity building in integrated management of transboundary animal diseases and zoonoses in Eastern and Central Africa. In addition, NDSU and Mak are part of a consortium of twelve North American and African institutions of higher learning working collaboratively to offer global educational experiences with an emphasis on animal production and health and food security. Several components of the aforementioned partnership will be discussed including: 1) Africa-US Partnerships, the twinning model; 2) global perspective of Higher Education training; 3) centers of excellence model and the academic-community-public-private partnerships framework under the Africa Institute for Strategic Services Development; and 4) the challenges and achievements of the NDSU-Mak partnership.

There is limited information on canine spinal epidural empyema (SEE). The aim of this multicenter retrospective study is to describe the clinical presentation and outcome of dogs undergoing spinal surgery or conservative management for SEE. Forty-one dogs met the inclusion criteria; the SEE was treated surgically in 17 dogs and conservatively in 24 dogs. Two dogs underwent spinal surgery after failure of conservative management, meaning that 19 dogs in total had spinal surgery. Long-term (i.e., >6 months) follow-up was available in 35 dogs (19 conservatively treated and 16 surgically treated dogs). Recovery to a functional pet status was achieved in 15/19 (78.9%) conservatively treated and 12/16 (75%) surgically treated dogs. There was no significant difference (p = 1.000) in long-term outcome between conservatively and surgically treated dogs (78.9 and 75%, respectively). However, significantly more surgically treated dogs were non-ambulatory at presentation (9/17 vs. 5/24, p = 0.048) compared with conservatively treated dogs. This study suggests that conservative treatment may be appropriate for dogs with SEE that are ambulatory at presentation and that surgically treated dogs generally have good outcomes. Age may be a negative prognostic indicator as dogs with poor long-term outcomes were significantly older than dogs with a good long-term outcome (p = 0.048). A larger prospective randomized study may provide further insight on treatment and outcome of SEE in dogs.

The aims of this study were to: determine the prevalence of pectinate ligament dysplasia (PLD) in populations of Basset hounds (BH), Flatcoated retrievers (FCR) and Dandie Dinmont terriers (DDT) resident in the UK; investigate possible associations between the degree of PLD and age, sex and intraocular pressure (IOP) and; investigate possible associations between IOP and age and sex. Gonioscopy was performed in both eyes of 198 BH, 170 FCR and 95 DDT and the percentage of iridocorneal angle affected by PLD was estimated and classified as unaffected (0 %), mildly affected (90 %). Rebound tonometry was performed bilaterally in the majority of enrolled dogs. Seventy-six of 198 (38.4 %) BH, 36/170 (21.2 %) FCR and 21/95 (22.1 %) DDT were moderately or severely affected by PLD. The prevalence of PLD was significantly higher in BH than both FCR and DDT. In all breeds there was a significant positive correlation between PLD and age. In the BH only there was a significant association between PLD and sex. In the DDT only there was a weak negative correlation between PLD and IOP and a moderately strong negative correlation between IOP and age. PLD is prevalent and significantly associated with age in all three breeds we investigated. The linear relationship between PLD and age can be explained by the progression of PLD over time which would contribute to the high prevalence of PLD despite widespread screening.

Global perspectives in agriculture are critical to the safety of food and agricultural resources, trade and consumers globally, yet very few opportunities exist for their study. North Dakota State University and Makerere University in Uganda responded to this need by developing a joint Master of Science and Graduate Certificate in International Infectious Disease Management and Biosecurity in 2011. The program requires completion of 30 credits with core courses offered jointly by both institutions. The program is innovative, learner-centered, with student engagement, empowerment and responsibility. There is interdisciplinary learning, problem-based learning and service learning, with cross pollination of teaching methods from both institutions. Graduates of this program will have a better understanding of international agricultural, animal health and biosecurity issues, making them much more viable in today’s competitive job market. This unique program within the US and African educational systems is the first US-Africa trans-Atlantic degree addressing integrated disease management and international biosecurity. The following components of the aforementioned program will be discussed: program development; overview of the program; successes; challenges faced; opportunities; and recommendations for the way forward in internationalizing curriculum on two campuses across continents.