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Indigenous knowledge of pastoralists on respiratory diseases of camels in northern Kenya
Accepted Manuscript Title: INDIGENOUS KNOWLEDGE OF PASTORALISTS ON RESPIRATORY DISEASES OF CAMELS IN NORTHERN KENYA Author: D.D. Wako M. Younan T.S. Tessema I.V. Glucks ¨ M.P.O. Baumann PII: DOI: Reference:
S0167-5877(16)30138-6 http://dx.doi.org/doi:10.1016/j.prevetmed.2016.05.008 PREVET 4033
To appear in:
PREVET
Received date: Revised date: Accepted date:
22-12-2015 6-5-2016 13-5-2016
Please cite this article as: Wako, D.D., Younan, M., Tessema, T.S., Glucks, ¨ I.V., Baumann, M.P.O., INDIGENOUS KNOWLEDGE OF PASTORALISTS ON RESPIRATORY DISEASES OF CAMELS IN NORTHERN KENYA.Preventive Veterinary Medicine http://dx.doi.org/10.1016/j.prevetmed.2016.05.008 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
1 INDIGENOUS KNOWLEDGE OF PASTORALISTS ON RESPIRATORY DISEASES OF CAMELS IN NORTHERN KENYA D.D. Wako1,2,6, M. Younan1, T.S. Tessema2,3, I.V. Glücks4 and M.P.O. Baumann2, 5*
1
Kenya Arid & Semi-Arid Lands (KASAL) Research Programme, Kenya Agricultural
Research Institute, Kenya; [email protected]; [email protected] 2
Joint Master Programme in Transboundary Animal Disease Management (MTADM),
Addis Ababa University, Ethiopia and Freie Universität Berlin, Addis Ababa, Ethiopia [email protected] 3
Addis Ababa University, Institute of Biotechnology; Addis Ababa, Ethiopia;
[email protected] 4
Vétérinaires sans Frontières (VSF) Suisse, Kenya Programme, VSF-Suisse Regional Office
Nairobi, Kenya ; [email protected] 5
FAO Reference Centre for Veterinary Public Health (VPH), Faculty of Veterinary Medicine,
Freie Universität Berlin, Germany; [email protected] 6
Sidai Africa (Kenya) Limited
*Corresponding author email: [email protected]
Abstract The camel disease terminology of pastoralists in northern Kenya differentiates between two respiratory disease complexes of camels. Participatory epidemiology data were collected in 2011 in three camel keeping communities (Gabra, Garri, and Somali) and analysed to assess the validity of this differentiation. Further queries assessed recurrence of the disease in the 1
2 same animal, most affected age group, relative frequency of occurrence, morbidity rates, mortality rates and response to antibiotic treatment. Based on matrix scoring the cardinal symptom nasal discharge was significantly correlated with Respiratory Disease Complex 1 (RDC1; Somali Hergeb, Gabra & Garri Furri) while cough was correlated with Respiratory Disease Complex 2 (RDC2; Somali Dhuguta, Gabra Qufa, Garri Dhugud). RDC1 appears to occur regularly every year and does not respond to antibiotic treatments while outbreaks of RDC2 are only observed at intervals of several years and treated cases do generally respond to antibiotics. While RDC1 is more severe in calves, RDC 2 is mostly associated with respiratory disease in adults. Elements of this differentiation appear to be in agreement with other authors who differentiate between camel influenza (PI3 virus) and bacterial camel pneumonia, respectively.
Keywords Respiratory Disease Complex 1 and 2; Camel, Participatory Epidemiology; Indigenous Knowledge; Northern Kenya
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Introduction Camelus dromedarius is an essential livestock species distinctively adapted to hot and arid environments (Schwartz and Dioli, 1992). In the face of increased global warming and desertification, the camel would perhaps be the most favoured animal to develop (Ahmad et al., 2010). It produces more milk and for longer periods than any other livestock species, hence playing a central role in providing nutrition for the pastoralists living in the arid zones of East Africa (Farah et al., 2007). According to Schwartz and Dioli (1992), camel production provides significant contributions to national economies in Eastern Africa. In Kenya, the northern part of the country is the most important camel producing area constituting 95% of the total national population (Census, 2009). Kuria et al. (2011) describe camel rearing in this region as a highly rational adaptation of human life to a harsh environment. In spite of their enormous ability to thrive in this arid and semi-arid land, there are a number of constraints to the production of camels in this area. According to Dirie and Abdurahman (2003) even though camels are comparatively hardy and less susceptible to common diseases affecting other animals, they do contract many other diseases some of which are still unknown. According to Bekele (1999) aetiological and epidemiological details for many camel diseases are not well documented. Outbreaks of mass respiratory disease in camels have been reported from Afghanistan, Ethiopia, Iran, Pakistan, Somalia and Sudan (Yigezu et al., 1997; Bekele, 1999; Roger et al., 2000; Alhendi, 2000; Younan and Bornstein, 2007; Kakar, 2011; Khan, 2012; Wernery and Kinne, 2012); causing and/or contributing agents include a.o. parainfluenza 3 virus, Pasteurella multocida, paramyxoviridae. Studies on the causes of respiratory diseases of camels in the East African region are still at a preliminary stage and the precise aetiological role of most pathogens identified in the respiratory tract of camels is yet to be corroborated (Yigezu et al, 1997; Bekele, 1999; Younan and Bornstein, 2007; 3
4 Bekele, 2008: Kebede and Gelaye, 2010; Wareth et al., 2014). In Ethiopia, which borders Kenya to the north, respiratory disease is considered an emerging disease in camel and a major threat to camel production (Bekele, 1999; Bekele, 2008; Awol et al., 2011). Gross, histopathological and microbiological studies carried out on the lungs of camels in Ethiopia and Jordan highlight the occurrence of different types of pneumonia (Bekele, 2008; AlTarazi, 2001). The need to distinguish between different specific respiratory diseases in camels is further highlighted by recent findings on Rhodococcus equi in United Arab Emirates’camels (Kinne et al., 2011). A comprehensive overview of current knowledge on respiratory diseases in camels is provided by Wernery et al. (2014) who also stress the importance of pre-disposing factors such as stress due to transportation and movement, feeding resources and/or other concurrent infections. This study was conducted to gain insight into pastoralist’s traditional clinical and epidemiological differentiation of respiratory diseases in camels in northern Kenya.
Materials and Methods
Study area
Field work for the study was carried out from June to September 2011 in three neighbouring Districts in northern Kenya, namely Marsabit North, Mandera West and Wajir East. These districts are mainly inhabited by the Gabra, the Somali and the Garri pastoralists, respectively (Fig. 1).
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5 Fig. 1. Map of Kenya showing the three study districts and study locations (in maroon colour) (Source: Ojwang, G. O, Chief Natural Resource Scientist, Department of Resource Surveys and Remote Sensing, Kenya, 2011).
Study Design The districts were purposively selected based on concentration of camels. The locations within the districts were also chosen purposively based again on the concentration of camel herds and accessibility of the area. The informants in a specific location were selected by the village elders and the chief based on their knowledge of camel herding. A total of 11 informant groups consisting of 6 to 10 individuals were enrolled for the study. Four groups were selected from Marsabit North and Mandera West each, while three were selected from Wajir East. Our considerations regarding sample size - - methodological guidelines for this research question lacking - - were mainly guided by the attempt to use resources in terms of transport, knowledgeable individuals and logistics most efficiently within the given time for field work (limited by course curriculum and schedule). As the study did not involve animal experiments nor being involved in human diseases ethical approval was not required.
Data collection and analysis The research team composed of a researcher and a translator/guide received practical field training in Wajir East ahead of the participatory epidemiology (PE) exercise. A set of PE tools were selected and tested in the field during the training exercise. Based on the test, necessary adjustments were made before the tools were applied in the study.
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6 The data were collected by participatory rural appraisal which included focused group discussion (FGD), semi-structured interviews, proportional piling and matrix scoring. These tools were adapted from Catley and Mariner (2002), Catley (2005), Swai and Neselle (2010) and Kipronoh et al. (2011): After each exercise, the result was recorded in a note book. A total of 11 informant groups consisting of 6 to 10 individuals were involved in the study numbers being based on recommendations given by Catley (2005): (i.) Identifying and priority ranking of camel diseases Focused group discussion (FGD) was used to identify and rank the ten most important camel diseases in the area. The meeting was held at a neutral site easily accessible by the members. The facilitator then introduced the team and provided a friendly and relaxed environment for ease of exchange of information. The informants were asked to list important camel diseases in the area.. They were asked to rank the diseases in order of importance and then prompted to explain why a disease is more important than another. Thus, the definition of the “importance” of a disease was left to the pastoralists to decide. Fifty stones were used to score the diseases: the stones were piled in order of importance, i.e. the disease which is considered most important gets the highest score and the least important of the ten gets the lowest score. After scoring, the informants were also asked to describe the main clinical signs and post-mortem lesions of those diseases. (ii.) Relationship between the local disease terminologies, veterinary disease names and veterinary clinical terms for respiratory diseases In their camel disease terminology pastoralists of northern Kenya separate between two respiratory disease complexes based on clinical lead symptoms: Respiratory Disease Complex 1 (RDC1) is defined by the lead symptom nasal discharge while Respiratory Disease Complex 2 (RDC 2) is defined by the lead symptom coughing. According to the 6
7 herders in this study, RDC 1 is referred to as Hergeb by the Somali while the Gabra and the Garri call it Furri. RDC 2 is known as Dhuguta among the Somali herders. The Garri and the Gabra refer to it as Dhugud and Qufa respectively. The term Hergeb used by Somalis for RDC 1 is the same term used to describe common cold in humans while Furri which is used by Gabra herders for the same camel disease means nasal discharge. Qufa, the term used by Gabra herders for RDC 2 means cough. – Pronunciation of the Somali language varies strongly between regions. In the context of this study it is important to note that the phonetic transcripts Hergeb, Hargab and Erghib used by different authors refer to one and the same clinical disease term in Somali. This is equally true for Dhuguta and Dhugato, with the pronunciation Dhuguta commonly used in the study region of this paper while Dhugato is used by camel herdsmen in other parts of Northern Kenya as well as in Northern Somalia. RDC 1 and RDC 2 together with two other diseases, haemorrhagic septicaemia/swollen gland syndrome (HS/SGS) and wry neck, were subjected to matrix scoring to establish the relationship between the local disease terminologies and veterinary clinical terms for selected diseases. HS/SGS was included in the matrix because it is one of the diseases of interest in the broader context of the study and shares a number of clinical signs with RDC 1 and RDC 2. Wry Neck (torticollis) was considered as kind of a `control´ since it has a unique clinical expression. Wry Neck syndrome is a disease condition of camels that is characterized by twisting of the neck into an S-shape. It is well known by the pastoralists of northern Kenya and described by various local names e.g. Shimbir, Simpiro, Dahasi etc. This kind of a `control´ is to serve the researcher in assessing whether the informants have understood the exercise or not. From the clinical signs which were described by the informants in identifying the diseases, ten were drawn on cards and placed on the y-axis of the matrix. The diseases were represented by familiar objects and placed on the x-axis. The informants were then asked to score each of the signs by dividing 20 stones against the 4 diseases according to the 7
8 relative prominence of a sign of a disease. It was ensured that all the stones were used. After the stones had been allocated to each sign, the scoring was checked with the informants. They were given time to alter the scores if they wanted to do so. The final scores were recorded and the informants were asked open-ended questions designed to prompt further discussion. (iii.) Seasonality of priority camel diseases Seasonal calendars were used to study seasonality of priority camel diseases (RDC1, RDC2, HS/SGS and Camel Pox). HS/SGS and respiratory diseases were of interest to the researcher and were considered the most important diseases throughout nearly all groups; camel pox also one of the most important diseases in all groups was introduced as a `control´. The informants were asked to name seasons in their own language. Various objects were placed on the ground representing the seasons in order of occurrence. A matrix was constructed with the seasons on the x-axis and indicators such as rainfall, pasture, ticks and diseases drawn on cards on the y-axis. Twenty stones were used to score the amount of rainfall; the season with the highest amount of rain got the highest score followed by the second highest, the third highest and the least, in that order. Pasture availability, tick population and disease incidence were also scored using the same number of stones. One indicator was scored at a time until all indicators were completed. Then, the matrix was discussed and recorded. (iv.) Relative frequency of occurrence of priority camel diseases and their relative response to treatment The informants were asked to list the treatment options for six camel diseases including Haemorrhagic Septicaemia/ “Swollen Gland Syndrome” (HS/SGS), RDC 1, RDC 2, camel pox, wry neck and trypanosomosis. These were priority camel diseases according to nearly all the informant groups except trypanosomosis which was introduced as a `control´ again
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9 because its treatment is well known. Each disease represented by its major clinical signs drawn on a card was placed on the x-axis of a matrix on the ground. Frequency of occurrence of the diseases and their relative response to treatment were determined by scoring using 30 stones. One indicator was scored at a time. The most frequently occurring disease was given highest score and the least frequent was given lowest score. Relative response to treatment was determined the same way; the disease that responds best to treatment compared to the other five was given the highest score and the ones with relatively poor response to treatment was given low scores. (v.) Clinical course, outbreak length, morbidity and case fatality estimates of priority camel diseases The informants were asked to give the clinical course in an individual animal and duration of an outbreak within a herd of the 6 priority camel diseases (as described above). From the answers given in 11 groups, mean clinical course for an animal and length of outbreak in a herd of each of the six diseases were calculated and recorded. Thereafter, the informants were asked to define herd age structures as understood by their community. Then proportional piling technique was used to estimate morbidity and case fatality rates of RDC 1 and RDC 2 with two other diseases according to age groups. Piles of 100 stones represented different age groups. Beginning with one disease, the informants were asked to divide each pile into two piles representing the number of camels in this age group that become sick and those that remain healthy once the disease attacks the herd. The proportion that became sick represented the morbidity rate of the disease in each age group. To estimate the case fatality rate of the disease, the piles representing the sick were further divided into two representing those that die due to the disease and those that recover. Scores
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10 were counted and recorded. This was repeated for the four diseases RDC1, RDC2, HS/SGS and camel pox.
Data collected were entered into Microsoft Excel worksheets and some descriptive statistics such as mean, median and range were calculated. Data then were imported into SPSS version 18.0 and Kendall’s coefficient of concordance was estimated to assess agreement between the results of different informants (Catley et al., 2002b; Catley, 2005). Guidelines given by Siegel and Castellan (1994), cited by Kipronoh et al. (2011), were used to classify the agreement as weak for values less than 0.26, as moderate for values between 0.26 and 0.38 at p-values < 0.05 and as good agreement for values over 0.38 at p-values < 0.01 to < 0.001. Qualitative data was quantified by calculating the number of groups mentioning it out of the eleven informant groups; answers were then expressed in percentage.
Results HS/SGS was ranked the most important camel disease in the area. Other priority camel diseases included respiratory disease complexes (RDC) which were described as two different entities by the informants hence referred to as RDC 1 and RDC 2 in this study, camel pox, wry neck, abscesses and trypanosomosis (Table 1). Overall, 88 camel keeper were involved in the scoring exercises. Table 1: Ten most important camel diseases as scored by 11 herder groups using 50 stones in each group, Northern Kenya, 2011
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Based on the clinical terminology for respiratory camel diseases as used by pastoralists in Northern Kenya, a differentiation into RDC1 (Somali Hergeb, Gabra and Garri Furri) and RDC2 (Somali Dhuguta, Gabra Qufa and Garri Dhugud) was applied for analysing participatory epidemiological data on camel diseases. The defining clinical signs for RDC1 (nasal discharge) and RDC 2 (cough) were confirmed also statistically by matrix scoring (Table 2).
Table 2: Scoring of clinical signs of camel diseases in the study area by 11 herder groups using 20 stones, Northern Kenya, 2011
Kendall’s coefficient of concordance showed moderate to perfect agreement for all the clinical signs except for emaciation where there was no significant agreement (Table 2). RDC 1 was mainly associated with nasal discharge while the major clinical signs of RDC 2 were coughing and emaciation. Almost all other clinical signs of RDC 1 and RDC 2 are shared but at varying degrees. RDC 2 is said to confer permanent immunity to animals that recover while RDC 1 does not. RDC 1 affects all age groups, but is more severe in young animals and kills mainly older calves (0.5-2 years) while RDC 2 is mostly associated with adults and does not cause mortality in calves younger than 6 months. In fact, according to a number of herders especially among the Somali, calves younger than 6 months do not contract RDC 2. RDC 2 also runs a longer clinical course compared to RDC 1. If left untreated, animals suffering from RDC 2 can become extremely emaciated and rest in sternal recumbence for prolonged 11
12 periods during daytime. However, RDC 2 does not cause the same mortality as RDC 1 but predators often attack and kill these weak animals. Because of this the Somali herders have a proverb that says “Dhuguta does not kill, so do not let the hyena kill”. RDC 2 is less frequent than RDC 1; most of the Somali and Garri herders said that they had not seen RDC 2 for a long time until an outbreak occurred in 2011 while RDC 1 is said to occur every year. RDC 2 is said to respond to antibiotic treatments quite well while the response of RDC 1 to the same is fairly low.
Both RDC 1 and RDC 2 are associated with the cold dry period between June and August (Fig. 2).
Fig. 2. Graphical presentation of matrix scoring for seasonal patterns of rain, pasture ticks and 4 diseases according to 11 informant groups in northern Kenya, 2011
RDC 1 with 27% occurs more frequently than RDC 2 with 10% (Fig. 3).
Fig. 3. Relative frequency of occurrence of camel diseases as scored by 11 informant groups in northern Kenya, 2011.
RDC 2 responds relatively well to antibiotics treatment, particularly amoxicillin compared to RDC 1 (Fig. 4).
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Fig. 4. Relative response of 6 priority camel diseases to treatment according to 11 informant groups in northern Kenya, 2011.
An outbreak of RDC 2 in a herd takes about 9 weeks to resolve while RDC 1 outbreaks last on average 4.5 weeks (Fig. 5).
Fig. 5. Average clinical course in a sick animal and outbreak length in a herd of priority camel diseases according to 11 herder informant groups in northern Kenya, 2011..
RDC 1 has higher morbidity and case fatality rates among the calves (83% and 21% respectively) and young adults (71% and 15% respectively) while RDC 2 shows more morbidity and case fatality among young adults (67% and 14% respectively) and adults (56% and 9% respectively) (Table 3).
Table 3: Expected morbidity and case fatality rates of priority camel diseases by age group according to 8 informant groups using 100 stones for each age group and each disease, Northern Kenya, 2011
In Table 4 Respiratory Disease Complex 1 is contrasted with Respiratory Disease Complex 2 and their characteristics listed and summarized.
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Table 4: Difference between RDC 1 and RDC 2 according to 11 herder groups, Northern Kenya, 2011
Discussion The herders participating in this study clearly differentiated between two complexes of respiratory diseases in camels, based on clinical symptoms and epidemiology. Other relevant criteria used by camel pastoralists to differentiate between RDC1 and RDC2 were the recurrence of disease in the same animals, the age-group most affected, the relative frequency of occurrence, morbidity rates, mortality rates and the clinical response to antibiotic treatments. For respiratory disease of camels in North Somalia, Catley and Mohammed (1995) differentiate between Hargab, a mild respiratory disease, and Dhugato, a respiratory disease characterized by prolonged debilitation and long recovery. The differentiation of these two Somali clinical terms recorded by Catley and Mohammed (1995) agrees with the use of the two terms Hergeb and Dhuguta documented for camel herdsmen from northern Kenya in this study. Moallin (2009) is also in general agreement with the clinical terminology of camel pastoralists described in this paper, by using the terms Hergeb and Dhuguta to differentiate between camel influenza and camel pneumonia, respectively. Moallin (2009) also mentions that Dhuguta responds to antibiotic treatment such as oxytetracycline, procaine penicillin and gentamicin while Hergeb is refractory to treatments with antibiotics. This statement is in full agreement with the information from camel pastoralists on RDC 1 and RDC 2 presented in
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15 this paper. Schwartz and Dioli (1992) and Dioli (2013) summarise all respiratory disease conditions of Kenyan camels under one major `Respiratory Disease Complex´ equated in the 1992 publication with the Somali term Erghib. Koehler-Rollefson et al. (2001) summarize respiratory disease conditions of camels as “coughs, colds and pneumonia”. According to Shiferaw et al. (2011), the aetiology of pulmonary disease in camels is complex and involves several factors. Kebede and Gelaye (2010) state that the primary cause of camel respiratory disease is Parainfluenza-3 which predisposes the animal to secondary bacterial infection; the main one being Mannheimia haemolytica, emphasising the multi-factorial nature of camel respiratory diseases. Roger et al. (2010) and Yigezu (1997) suspect PPR to play a primary role in triggering mass respiratory disease in camels. The participatory epidemiological data presented in this paper provide clinical and statistical evidence for the presence of two different clinical respiratory disease complexes amongst camels in North Kenya, as recognised by the clinical terminology of Kenyan pastoralists. These results clearly emphasise the value of detailed participatory epidemiology studies in animal disease investigations and surveillance. Nonetheless, the participatory epidemiology methods applied are by virtue prone to a number of biases; (i) to recall bias since the informants generally rely on memory to give information on the diseases under investigation (Catley and Admassu, 2003), (i) to selection bias as the respondents though based on knowledge and skills, were selected by village elders and chiefs, and (iii) to information bias in terms of misclassification of disease sign and symptoms. Future efforts should be directed towards pathogen isolation. Identifying the etiological factors underlying Respiratory Disease Complexes 1 and 2 in the camel keeping districts of Kenya and other camel husbandry regions should allow further differentiation into two
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16 respiratory disease complexes yet in the study design; besides a case-control study approach randomised clinical trials would be expected to assist here,though being aware of its pitfalls (Sargeant et al., 2009) . .
Conclusions In tapping on the indigenous knowledge of camel pastoralists in northern Kenya the toolbox of participatory epidemiology offered suitable instruments in scoring and ranking camel diseases, and in particular focussing on the differentiation of the two camel respiratory disease complexes RDC 1 and RDC 2. The criteria identified, assessed and attributed in the local languages of the Somali, Gabra and Garri communities now allow a much more targeted disease prevention and control approach in the field.
Acknowledgement Kenya Arid and Semi-Arid Lands/Kenya Agricultural Research Institute (KASAL/KARI) sponsored the field work of the first author, Deutscher Akademischer Austausch Dienst (DAAD) (German Academic Exchange Service) provided the stipend through the Joint Master in Transboundary Animal Disease Management Course (MTADM), EDULINK (African Caribbean and Pacific group of states-European Union Cooperation programme in Higher Education) paid the tuition fees and travel expenses throughout the study period and VSF-Suisse, Kenya provided substantial logistical support in the field.
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References
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18 Contagious Bovine Pleuropneumonia in Africa, 12-14 November, 2003, Rome, Italy. Pp 4. Catley, A., Mariner, J., 2002. Where there is no data: participatory approaches to veterinary epidemiology in pastoral areas of the horn of Africa. International Initiative for Environment and Development Dry Land Programmes. Issue Paper no.110. Pp 10-16. Catley A., Mohammed A.A. (1995). – Ethnoveterinary knowledge in Sanaag region, Somaliland: notes on local descriptions of livestock diseases and parasites. Nomadic Peoples, 36/37, 3-16. Catley, A., Osman, J., Mawien, C., Jones, B.A., Leyland, T.J., 2002. Participatory analysis of seasonal incidences of diseases of cattle, disease vectors and rainfall in southern Sudan. Prev. Vet. Med. 53, 275–284. Census, 2009. Vol II Q 11: Livestock population by type and District. https://www.opendata.go.ke/Agriculture/Census-Vol-II-Q-11-Livestock-populationby-type-an/qbvv-8bjk 1/5/2016 Dioli, M., 2010. Clinical observations on the “wry-neck” syndrome or torticollis in the camel (Camelus dromedarius) population of Kenya and Sudan; https://www.researchgate.net/publication/250615241_Clinical_observations_on_the_ wryneck_syndrome_or_torticollis_in_the_camel_Camelus_dromedarius_population_ of_Kenya_and_Sudan accessed on April 29, 2016. Dioli, M., 2013. Pictorial Guide to Traditional Management, Husbandry and Disease of the One-Humped Camel. 2nd edition, ISBN 978-82-303-2367-0. Farah, Z., Mollet, M., Younan, M., Dahir, R., 2007. Camel dairy in Somalia: Limiting factors and development potential. Lvstck. Sci. 110 (2007), 187–191. 18
19 Intisar, K.S., Ali, Y.H., Khalafalla, A.I., Rahmana, M. E.A., Amin, A.S., 2010. Respiratory infection of camels associated with parainfluenza virus 3 in Sudan. J. Virol. Meth. 163, 82–86. Jenberie, S., Awol, N., Ayelet, G., Gelaye, E., Negussie, H., and Abie, G., 2011. Gross and histopathological studies on pulmonary lesions of camel (Camelus dromedarius) slaughtered at Addis Ababa abattoir, Ethiopia. Trop Anim Health Prod. 44(4):849-54. Kakar R., 2011. A fatal respiratory camel disease. http://camel4all.blogspot.com/2011/02/fatal-respiratory-camel-disease.html accessed on Dec 20, 2015. Kebede, F., Gelaye, E., 2010. Studies on major respiratory diseases of Camel (Camelus dromedarius) in North Eastern Ethiopia. Afr. J. Microbiol. Res. 4 (14), 1560-1564. Khan, F.M., 2012.: Field Epidemiology of an Outbreak of Hemorrhagic Septicemia in Dromedary Population of Greater Cholistan Desert (Pakistan). Pak. Vet. J. 32(1), 3134. http://pvj.com.pk/pdf-files/32_1/31-34.pdf accessed on Dec 20, 2015. Kinne J., Madarame H., Takai S., Jose S., Wernery U. (2011). Disseminated Rhodococcus equi infection in dromedary camels (Camelus dromedarius). Vet Microbiol. 149 (12): 269-72. Koehler-Rollefson, I., Munday, P., Mathias, E., 2001.. A field manual of camel diseases, traditional and modern health care for the dromedary, ITDG. Pp 156-158. Moallin, A.S.M., 2009. Observations on diseases of the dromedary in Central Somalia. http://somalivetforum.org/Observations%20on%20diseases%20of%20the%20dromed ary%20pdf.pdf, accessed on Dec 20, 2015.
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20 Roger, F., Diallo, A., Yigezu, L.M., Hurard, C., Libeau, G., Mebratu, G.Y., Faye, B., 2000. Investigation of a new pathological condition of camels in Ethiopia. J Camel Pract Res. 7, 163-166. Sargeant, J.M., Elgie, R., Valcour,J.,,. Saint-Ongea J., Thompson, A.. Marcynuk, P. Snedeker K , 2009. Methodological quality and completeness of reporting in clinical trials conducted in livestock species. Prev. Vet. Med. 91, 107-115. Schwartz, H. J., Dioli, M., 1992. The One Humped Camel (Camelus dromedarius) in Eastern Africa: a Pictorial Guide to Diseases, Health Care and Management. Verlag Josef Margraf. Pp. 1-3, 159-160. Swai, E.S., Neselle, M.O., 2010. Using Participatory Epidemiology Tools to Investigate Contagious Caprine Pleuropneumonia (CCPP) in Maasai Flocks, Northern Tanzania. Int. J. Anim. Vet. Advances, 2 (4), 141-147. Wareth, G., Murugaiyan, J., Khater, D. F., Moustafa, S.A., 2014. Subclinical pulmonary pathogenic infection in camels slaughtered in Cairo, Egypt. J. Infect. Dev. Ctries. 8(7): 909-913. doi:10.3855/jidc.4810 Wernery, U., Kinne, J., 2012. Mycoplasmosis - A new Disease in Camelids. Proceedings of the 3rd Conference of the International Society of Camelid Research and Development, 29th Jan-1st Feb 2012, Muscat, Sultanate of Oman. Wernery, U., Kinne, J., Schuster, R.K., 2014. 1.3 Respiratory System & 2.2.2 Respiratory Viruses. In: Camelid Infectious Disorders, World Organisation for Animal Health OIE, Paris, France 2014, pp 113-134 and pp 305-308. Yigezu, L. M., Roger, F., Kiredjian, M., and Tariku, S., 1997. Isolation of Streptococcus equi subspecies equi (strangles agent) from an Ethiopian camel. Vet. Rec. 140, 608.
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21 Younan, M., Bornstein, S., 2007. Lancefield Group B and C streptococci, important opportunistic pathogens in East African camels (Camelus dromedarius). Vet Rec. 160, 330-335.
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22 Table 1: Ten most important camel diseases as scored by 11 herder groups using 50 stones in each group, northern Kenya, 2011 Disease
Total Score*
Average score
HS/SGS
Number of herder groups 11
102
9.27
Overall Rank 1
RDC 1
11
73
6.64
2
Camel Pox
11
66
6.00
3
Wry Neck
10
39
3.55
4
RDC 2
9
36
3.27
5
Abscess
6
27
2.45
6
Trypanosomosis
5
28
2.55
7
Lesa/Butal (diarrhoea)
3
32
2.91
8
Iddi (plant poisoning)
3
24
2.18
9
Mange
4
16
1.45
10
*This is the total score from 11 groups; each group used 50 stones to score against 10 diseases. However, these diseases differ from group to group, i.e. not all groups mentioned all diseases.
22
23 Table 2: Scoring of clinical signs of camel diseases in the study area by 11 herder groups using 20 stones, northern Kenya, 2011 Clinical signs
Kendall’s W*
P value
Median score (range)
Bent/kinked neck 1.00
RDC1 <0.000 0 (0-0)
RDC2 0 (0-0)
HS/SGS 0 (0-0)
Wry Neck 20 (20-20)
Lachrymation
0.592
<0.000 4 (2-7)
5 (2-12)
9 (3-14)
0.5 (0-5)
Enlarged lymph nodes Recumbency
0.857
<0.000 4 (0-8)
3 (0-7)
12.5 (11-20)
0 (0-0)
0.34
0.017
2 (0-5)
4 (1-10)
7 (3-13)
5.5 (0-10)
Emaciation
0.257ns
0.053
3 (0-7)
6.5 (0-9)
7 (2-11)
4.5 (0-9)
Coughing
0.916
<0.000 5 (1-7)
3.5 (2-6)
0 (0-0)
Fever
0.734
<0.000 4.5 (2-7)
11.5 (1015) 4.5 (0-11)
10 (6-14)
0 (0-6)
Bad odour
0.773
<0.000 6 (2-11)
1.5 (0-7)
11 (7-18)
0 (0-2)
Nasal discharge
0.865
<0.000 13.5 (9-20)
1 (0-6)
4.5 (0-7)
(0-1)
Mortality
0.765
<0.000 5 (2-7)
2 (0-4)
9 (8-14)
3.5 (1-7)
Key: *Kendall’s coefficient of concordance (W); ns = not significant; Respiratory Disease complex 1 (RDC 1), Respiratory Disease complex 2 (RDC 2), Haemorrhagic Septicaemia/ “Swollen Gland Syndrome” (HS/SGS)
23
24 Table 3: Expected morbidity and case fatality rates of priority camel diseases by age group according to 8 informant groups using 100 stones for each age group and each disease, northern Kenya, 2011
Diseases Morbidity/ Kendall’s P case
W*
value
Age groups Mean (min-max)
fatality Young calves
Older
Young adults
Adults
(3-5 yrs)
(>5yrs)
63 (0-97)
19 (0-19)
40 (12-71)
29 (0-84)
1 (0-7)
83 (63-
71 (44-97)
44 (11-86)
(<0.25-0.5yrs) calves (0.5-2yrs) Pox
Morbidity
0.678
<0.000 21(0-53)
79 (59100)
Case
0.629
0.001
30 (0-64)
0.687
<0.000 49 (23-100)
fatality RDC 1
Morbidity
100) Case
0.604
<0.000 20 (8-33)
21 (5-35)
15 (0-32)
6 (0-26)
Morbidity
0.700
0.001
5 (0-43)
38 (10-72)
67 (48-90)
56 (10-92)
Case
0.421
0.018
0 (0-0)
5 (0-19)
14 (0-48)
9 (0-26)
Morbidity
0.894
<0.000 0 (0-0)
49 (29-79)
67 (50-94)
18 (0-45)
Case
0.894
<0.000 0 (0-0)
36 (24-50)
51 (43-72)
19 (0-51)
fatality RDC 2
fatality HS/SGS
fatality Key: *Kendall’s coefficient of concordance (W); Respiratory Disease complex 1 (RDC 1), Respiratory Disease complex 2 (RDC 2), Haemorrhagic Septicaemia/ “Swollen Gland Syndrome” (HS/SGS)
24
25 Table 4: Difference between Respiratory Disease complex 1 (RDC 1) and Respiratory Disease complex 2 (RDC 2) according to 11 herder groups, northern Kenya, 2011
RDC 1
RDC 2
1. Mainly associated with nasal discharge
1. Mainly associated with cough, emaciation and recumbency
2. Does not confer permanent immunity
2. Confers permanent immunity
3. Affects all age groups but mostly kills
3. Mostly associated with adults over three
claves between 0.5 and 2 years of
years of age and does not affects calves less
age.
than 6 months according to most herders 4. Less frequent outbreaks compared to RDC 1
4. Frequent outbreaks
5. Responds well to antibiotic therapy particularly amoxicillin
5. Shows poor response to antibiotic 6. Longer clinical course compared to RDC 1 therapy 6. Shorter clinical course compared to RDC 2
25
26
36
37
38
39
40
41
Madera Marsabit
4
4
Wajir
3
3
N
0.001
0
0.001 Kilometers
2
2
1
1
N
0.0003
36
37
0
38
0.0003 Kilometers
39
40
41
Fig. 1. Map of Kenya showing the three study districts and study locations (in maroon colour) (Source: Ojwang, G. O, Chief Natural Resource Scientist, Department of Resource Surveys and Remote Sensing, Kenya, 2011).
26
27
Seasonal Calendar 12
ticks, W=0.351, P=0.009
Median score
10
8
RDC1, W=0.441, P=0.002
6
HS/SGS, W=0.187, P=0.104
4
POX, W=0.490, P=0.001
2
0
RDC2, W=0.319, P=0.015 amount of rain, W=0.938, P=0.000 pasture, W=0.822, P=0.000
Key: Kendall’s coefficient of concordance (W), Asymptotic significance (P); Respiratory Disease complex 1 (RDC 1), Respiratory Disease complex 2 (RDC 2), Haemorrhagic Septicaemia/ “Swollen Gland Syndrome” (HS/SGS)
Fig. 2. Graphical presentation of matrix scoring results for seasonal patterns of rain, pasture ticks and 4 diseases according to 11 informant groups in northern Kenya, 2011
27
28
Tryps 3% Wry neck 13%
Camel pox 17%
RDC1 27%
HS/SGS 30% RDC2 10%
W=0.636 P=<0.000
Key: Kendall’s coefficient of concordance (W), Asymptotic Significance (P); Haemorrhagic Septicaemia/Swollen Gland Syndrome (HS/SGS), Respiratory Disease Complex 1 (RDC1), Respiratory Disease Complex 2 (RDC2), Trypanosomosis (Tryps)
Fig. 3. Relative frequency of occurrence of camel diseases as scored by 11 informant groups in northern Kenya, 2011
28
29
Tryps 29%
Camel pox 16% RDC1 16%
Wry neck 6% HS/SGS 7%
RDC2 26%
W=0.636 P=<0.000
Key: Kendall’s coefficient of concordance (W), Asymptotic significance (P); Haemorrhagic Septicaemia/Swollen Gland Syndrome (HS/SGS), Respiratory Disease Complex 1 (RDC1), Respiratory Disease Complex 2 (RDC2), Trypanosomosis (Tryps)
Fig. 4. Relative response of 6 priority camel diseases to treatment according to 11 informant groups in northern Kenya, 2011
29
30
16.0 14.0 12.0
Average clinical course in an individual
weeks
10.0 8.0
Average length of outbreak in a herd
6.0 4.0
W= 0.635
2.0
P=<0.000
0.0 Camel pox
RDC1
RDC2
HS/SGS
Key: Kendall’s coefficient of concordance (W), Asymptotic significance (P); Haemorrhagic Septicaemia/Swollen Gland Syndrome (HS/SGS), Respiratory Disease Complex 1 (RDC1), Respiratory Disease Complex 2 (RDC2)
Fig. 5. Average clinical course in a sick animal and outbreak length in a herd of priority camel diseases according to 11 herder informant groups in northern Kenya, 2011.
30
S0167-5877(16)30138-6 http://dx.doi.org/doi:10.1016/j.prevetmed.2016.05.008 PREVET 4033
To appear in:
PREVET
Received date: Revised date: Accepted date:
22-12-2015 6-5-2016 13-5-2016
Please cite this article as: Wako, D.D., Younan, M., Tessema, T.S., Glucks, ¨ I.V., Baumann, M.P.O., INDIGENOUS KNOWLEDGE OF PASTORALISTS ON RESPIRATORY DISEASES OF CAMELS IN NORTHERN KENYA.Preventive Veterinary Medicine http://dx.doi.org/10.1016/j.prevetmed.2016.05.008 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
1 INDIGENOUS KNOWLEDGE OF PASTORALISTS ON RESPIRATORY DISEASES OF CAMELS IN NORTHERN KENYA D.D. Wako1,2,6, M. Younan1, T.S. Tessema2,3, I.V. Glücks4 and M.P.O. Baumann2, 5*
1
Kenya Arid & Semi-Arid Lands (KASAL) Research Programme, Kenya Agricultural
Research Institute, Kenya; [email protected]; [email protected] 2
Joint Master Programme in Transboundary Animal Disease Management (MTADM),
Addis Ababa University, Ethiopia and Freie Universität Berlin, Addis Ababa, Ethiopia [email protected] 3
Addis Ababa University, Institute of Biotechnology; Addis Ababa, Ethiopia;
[email protected] 4
Vétérinaires sans Frontières (VSF) Suisse, Kenya Programme, VSF-Suisse Regional Office
Nairobi, Kenya ; [email protected] 5
FAO Reference Centre for Veterinary Public Health (VPH), Faculty of Veterinary Medicine,
Freie Universität Berlin, Germany; [email protected] 6
Sidai Africa (Kenya) Limited
*Corresponding author email: [email protected]
Abstract The camel disease terminology of pastoralists in northern Kenya differentiates between two respiratory disease complexes of camels. Participatory epidemiology data were collected in 2011 in three camel keeping communities (Gabra, Garri, and Somali) and analysed to assess the validity of this differentiation. Further queries assessed recurrence of the disease in the 1
2 same animal, most affected age group, relative frequency of occurrence, morbidity rates, mortality rates and response to antibiotic treatment. Based on matrix scoring the cardinal symptom nasal discharge was significantly correlated with Respiratory Disease Complex 1 (RDC1; Somali Hergeb, Gabra & Garri Furri) while cough was correlated with Respiratory Disease Complex 2 (RDC2; Somali Dhuguta, Gabra Qufa, Garri Dhugud). RDC1 appears to occur regularly every year and does not respond to antibiotic treatments while outbreaks of RDC2 are only observed at intervals of several years and treated cases do generally respond to antibiotics. While RDC1 is more severe in calves, RDC 2 is mostly associated with respiratory disease in adults. Elements of this differentiation appear to be in agreement with other authors who differentiate between camel influenza (PI3 virus) and bacterial camel pneumonia, respectively.
Keywords Respiratory Disease Complex 1 and 2; Camel, Participatory Epidemiology; Indigenous Knowledge; Northern Kenya
2
3
Introduction Camelus dromedarius is an essential livestock species distinctively adapted to hot and arid environments (Schwartz and Dioli, 1992). In the face of increased global warming and desertification, the camel would perhaps be the most favoured animal to develop (Ahmad et al., 2010). It produces more milk and for longer periods than any other livestock species, hence playing a central role in providing nutrition for the pastoralists living in the arid zones of East Africa (Farah et al., 2007). According to Schwartz and Dioli (1992), camel production provides significant contributions to national economies in Eastern Africa. In Kenya, the northern part of the country is the most important camel producing area constituting 95% of the total national population (Census, 2009). Kuria et al. (2011) describe camel rearing in this region as a highly rational adaptation of human life to a harsh environment. In spite of their enormous ability to thrive in this arid and semi-arid land, there are a number of constraints to the production of camels in this area. According to Dirie and Abdurahman (2003) even though camels are comparatively hardy and less susceptible to common diseases affecting other animals, they do contract many other diseases some of which are still unknown. According to Bekele (1999) aetiological and epidemiological details for many camel diseases are not well documented. Outbreaks of mass respiratory disease in camels have been reported from Afghanistan, Ethiopia, Iran, Pakistan, Somalia and Sudan (Yigezu et al., 1997; Bekele, 1999; Roger et al., 2000; Alhendi, 2000; Younan and Bornstein, 2007; Kakar, 2011; Khan, 2012; Wernery and Kinne, 2012); causing and/or contributing agents include a.o. parainfluenza 3 virus, Pasteurella multocida, paramyxoviridae. Studies on the causes of respiratory diseases of camels in the East African region are still at a preliminary stage and the precise aetiological role of most pathogens identified in the respiratory tract of camels is yet to be corroborated (Yigezu et al, 1997; Bekele, 1999; Younan and Bornstein, 2007; 3
4 Bekele, 2008: Kebede and Gelaye, 2010; Wareth et al., 2014). In Ethiopia, which borders Kenya to the north, respiratory disease is considered an emerging disease in camel and a major threat to camel production (Bekele, 1999; Bekele, 2008; Awol et al., 2011). Gross, histopathological and microbiological studies carried out on the lungs of camels in Ethiopia and Jordan highlight the occurrence of different types of pneumonia (Bekele, 2008; AlTarazi, 2001). The need to distinguish between different specific respiratory diseases in camels is further highlighted by recent findings on Rhodococcus equi in United Arab Emirates’camels (Kinne et al., 2011). A comprehensive overview of current knowledge on respiratory diseases in camels is provided by Wernery et al. (2014) who also stress the importance of pre-disposing factors such as stress due to transportation and movement, feeding resources and/or other concurrent infections. This study was conducted to gain insight into pastoralist’s traditional clinical and epidemiological differentiation of respiratory diseases in camels in northern Kenya.
Materials and Methods
Study area
Field work for the study was carried out from June to September 2011 in three neighbouring Districts in northern Kenya, namely Marsabit North, Mandera West and Wajir East. These districts are mainly inhabited by the Gabra, the Somali and the Garri pastoralists, respectively (Fig. 1).
4
5 Fig. 1. Map of Kenya showing the three study districts and study locations (in maroon colour) (Source: Ojwang, G. O, Chief Natural Resource Scientist, Department of Resource Surveys and Remote Sensing, Kenya, 2011).
Study Design The districts were purposively selected based on concentration of camels. The locations within the districts were also chosen purposively based again on the concentration of camel herds and accessibility of the area. The informants in a specific location were selected by the village elders and the chief based on their knowledge of camel herding. A total of 11 informant groups consisting of 6 to 10 individuals were enrolled for the study. Four groups were selected from Marsabit North and Mandera West each, while three were selected from Wajir East. Our considerations regarding sample size - - methodological guidelines for this research question lacking - - were mainly guided by the attempt to use resources in terms of transport, knowledgeable individuals and logistics most efficiently within the given time for field work (limited by course curriculum and schedule). As the study did not involve animal experiments nor being involved in human diseases ethical approval was not required.
Data collection and analysis The research team composed of a researcher and a translator/guide received practical field training in Wajir East ahead of the participatory epidemiology (PE) exercise. A set of PE tools were selected and tested in the field during the training exercise. Based on the test, necessary adjustments were made before the tools were applied in the study.
5
6 The data were collected by participatory rural appraisal which included focused group discussion (FGD), semi-structured interviews, proportional piling and matrix scoring. These tools were adapted from Catley and Mariner (2002), Catley (2005), Swai and Neselle (2010) and Kipronoh et al. (2011): After each exercise, the result was recorded in a note book. A total of 11 informant groups consisting of 6 to 10 individuals were involved in the study numbers being based on recommendations given by Catley (2005): (i.) Identifying and priority ranking of camel diseases Focused group discussion (FGD) was used to identify and rank the ten most important camel diseases in the area. The meeting was held at a neutral site easily accessible by the members. The facilitator then introduced the team and provided a friendly and relaxed environment for ease of exchange of information. The informants were asked to list important camel diseases in the area.. They were asked to rank the diseases in order of importance and then prompted to explain why a disease is more important than another. Thus, the definition of the “importance” of a disease was left to the pastoralists to decide. Fifty stones were used to score the diseases: the stones were piled in order of importance, i.e. the disease which is considered most important gets the highest score and the least important of the ten gets the lowest score. After scoring, the informants were also asked to describe the main clinical signs and post-mortem lesions of those diseases. (ii.) Relationship between the local disease terminologies, veterinary disease names and veterinary clinical terms for respiratory diseases In their camel disease terminology pastoralists of northern Kenya separate between two respiratory disease complexes based on clinical lead symptoms: Respiratory Disease Complex 1 (RDC1) is defined by the lead symptom nasal discharge while Respiratory Disease Complex 2 (RDC 2) is defined by the lead symptom coughing. According to the 6
7 herders in this study, RDC 1 is referred to as Hergeb by the Somali while the Gabra and the Garri call it Furri. RDC 2 is known as Dhuguta among the Somali herders. The Garri and the Gabra refer to it as Dhugud and Qufa respectively. The term Hergeb used by Somalis for RDC 1 is the same term used to describe common cold in humans while Furri which is used by Gabra herders for the same camel disease means nasal discharge. Qufa, the term used by Gabra herders for RDC 2 means cough. – Pronunciation of the Somali language varies strongly between regions. In the context of this study it is important to note that the phonetic transcripts Hergeb, Hargab and Erghib used by different authors refer to one and the same clinical disease term in Somali. This is equally true for Dhuguta and Dhugato, with the pronunciation Dhuguta commonly used in the study region of this paper while Dhugato is used by camel herdsmen in other parts of Northern Kenya as well as in Northern Somalia. RDC 1 and RDC 2 together with two other diseases, haemorrhagic septicaemia/swollen gland syndrome (HS/SGS) and wry neck, were subjected to matrix scoring to establish the relationship between the local disease terminologies and veterinary clinical terms for selected diseases. HS/SGS was included in the matrix because it is one of the diseases of interest in the broader context of the study and shares a number of clinical signs with RDC 1 and RDC 2. Wry Neck (torticollis) was considered as kind of a `control´ since it has a unique clinical expression. Wry Neck syndrome is a disease condition of camels that is characterized by twisting of the neck into an S-shape. It is well known by the pastoralists of northern Kenya and described by various local names e.g. Shimbir, Simpiro, Dahasi etc. This kind of a `control´ is to serve the researcher in assessing whether the informants have understood the exercise or not. From the clinical signs which were described by the informants in identifying the diseases, ten were drawn on cards and placed on the y-axis of the matrix. The diseases were represented by familiar objects and placed on the x-axis. The informants were then asked to score each of the signs by dividing 20 stones against the 4 diseases according to the 7
8 relative prominence of a sign of a disease. It was ensured that all the stones were used. After the stones had been allocated to each sign, the scoring was checked with the informants. They were given time to alter the scores if they wanted to do so. The final scores were recorded and the informants were asked open-ended questions designed to prompt further discussion. (iii.) Seasonality of priority camel diseases Seasonal calendars were used to study seasonality of priority camel diseases (RDC1, RDC2, HS/SGS and Camel Pox). HS/SGS and respiratory diseases were of interest to the researcher and were considered the most important diseases throughout nearly all groups; camel pox also one of the most important diseases in all groups was introduced as a `control´. The informants were asked to name seasons in their own language. Various objects were placed on the ground representing the seasons in order of occurrence. A matrix was constructed with the seasons on the x-axis and indicators such as rainfall, pasture, ticks and diseases drawn on cards on the y-axis. Twenty stones were used to score the amount of rainfall; the season with the highest amount of rain got the highest score followed by the second highest, the third highest and the least, in that order. Pasture availability, tick population and disease incidence were also scored using the same number of stones. One indicator was scored at a time until all indicators were completed. Then, the matrix was discussed and recorded. (iv.) Relative frequency of occurrence of priority camel diseases and their relative response to treatment The informants were asked to list the treatment options for six camel diseases including Haemorrhagic Septicaemia/ “Swollen Gland Syndrome” (HS/SGS), RDC 1, RDC 2, camel pox, wry neck and trypanosomosis. These were priority camel diseases according to nearly all the informant groups except trypanosomosis which was introduced as a `control´ again
8
9 because its treatment is well known. Each disease represented by its major clinical signs drawn on a card was placed on the x-axis of a matrix on the ground. Frequency of occurrence of the diseases and their relative response to treatment were determined by scoring using 30 stones. One indicator was scored at a time. The most frequently occurring disease was given highest score and the least frequent was given lowest score. Relative response to treatment was determined the same way; the disease that responds best to treatment compared to the other five was given the highest score and the ones with relatively poor response to treatment was given low scores. (v.) Clinical course, outbreak length, morbidity and case fatality estimates of priority camel diseases The informants were asked to give the clinical course in an individual animal and duration of an outbreak within a herd of the 6 priority camel diseases (as described above). From the answers given in 11 groups, mean clinical course for an animal and length of outbreak in a herd of each of the six diseases were calculated and recorded. Thereafter, the informants were asked to define herd age structures as understood by their community. Then proportional piling technique was used to estimate morbidity and case fatality rates of RDC 1 and RDC 2 with two other diseases according to age groups. Piles of 100 stones represented different age groups. Beginning with one disease, the informants were asked to divide each pile into two piles representing the number of camels in this age group that become sick and those that remain healthy once the disease attacks the herd. The proportion that became sick represented the morbidity rate of the disease in each age group. To estimate the case fatality rate of the disease, the piles representing the sick were further divided into two representing those that die due to the disease and those that recover. Scores
9
10 were counted and recorded. This was repeated for the four diseases RDC1, RDC2, HS/SGS and camel pox.
Data collected were entered into Microsoft Excel worksheets and some descriptive statistics such as mean, median and range were calculated. Data then were imported into SPSS version 18.0 and Kendall’s coefficient of concordance was estimated to assess agreement between the results of different informants (Catley et al., 2002b; Catley, 2005). Guidelines given by Siegel and Castellan (1994), cited by Kipronoh et al. (2011), were used to classify the agreement as weak for values less than 0.26, as moderate for values between 0.26 and 0.38 at p-values < 0.05 and as good agreement for values over 0.38 at p-values < 0.01 to < 0.001. Qualitative data was quantified by calculating the number of groups mentioning it out of the eleven informant groups; answers were then expressed in percentage.
Results HS/SGS was ranked the most important camel disease in the area. Other priority camel diseases included respiratory disease complexes (RDC) which were described as two different entities by the informants hence referred to as RDC 1 and RDC 2 in this study, camel pox, wry neck, abscesses and trypanosomosis (Table 1). Overall, 88 camel keeper were involved in the scoring exercises. Table 1: Ten most important camel diseases as scored by 11 herder groups using 50 stones in each group, Northern Kenya, 2011
10
11
Based on the clinical terminology for respiratory camel diseases as used by pastoralists in Northern Kenya, a differentiation into RDC1 (Somali Hergeb, Gabra and Garri Furri) and RDC2 (Somali Dhuguta, Gabra Qufa and Garri Dhugud) was applied for analysing participatory epidemiological data on camel diseases. The defining clinical signs for RDC1 (nasal discharge) and RDC 2 (cough) were confirmed also statistically by matrix scoring (Table 2).
Table 2: Scoring of clinical signs of camel diseases in the study area by 11 herder groups using 20 stones, Northern Kenya, 2011
Kendall’s coefficient of concordance showed moderate to perfect agreement for all the clinical signs except for emaciation where there was no significant agreement (Table 2). RDC 1 was mainly associated with nasal discharge while the major clinical signs of RDC 2 were coughing and emaciation. Almost all other clinical signs of RDC 1 and RDC 2 are shared but at varying degrees. RDC 2 is said to confer permanent immunity to animals that recover while RDC 1 does not. RDC 1 affects all age groups, but is more severe in young animals and kills mainly older calves (0.5-2 years) while RDC 2 is mostly associated with adults and does not cause mortality in calves younger than 6 months. In fact, according to a number of herders especially among the Somali, calves younger than 6 months do not contract RDC 2. RDC 2 also runs a longer clinical course compared to RDC 1. If left untreated, animals suffering from RDC 2 can become extremely emaciated and rest in sternal recumbence for prolonged 11
12 periods during daytime. However, RDC 2 does not cause the same mortality as RDC 1 but predators often attack and kill these weak animals. Because of this the Somali herders have a proverb that says “Dhuguta does not kill, so do not let the hyena kill”. RDC 2 is less frequent than RDC 1; most of the Somali and Garri herders said that they had not seen RDC 2 for a long time until an outbreak occurred in 2011 while RDC 1 is said to occur every year. RDC 2 is said to respond to antibiotic treatments quite well while the response of RDC 1 to the same is fairly low.
Both RDC 1 and RDC 2 are associated with the cold dry period between June and August (Fig. 2).
Fig. 2. Graphical presentation of matrix scoring for seasonal patterns of rain, pasture ticks and 4 diseases according to 11 informant groups in northern Kenya, 2011
RDC 1 with 27% occurs more frequently than RDC 2 with 10% (Fig. 3).
Fig. 3. Relative frequency of occurrence of camel diseases as scored by 11 informant groups in northern Kenya, 2011.
RDC 2 responds relatively well to antibiotics treatment, particularly amoxicillin compared to RDC 1 (Fig. 4).
12
13
Fig. 4. Relative response of 6 priority camel diseases to treatment according to 11 informant groups in northern Kenya, 2011.
An outbreak of RDC 2 in a herd takes about 9 weeks to resolve while RDC 1 outbreaks last on average 4.5 weeks (Fig. 5).
Fig. 5. Average clinical course in a sick animal and outbreak length in a herd of priority camel diseases according to 11 herder informant groups in northern Kenya, 2011..
RDC 1 has higher morbidity and case fatality rates among the calves (83% and 21% respectively) and young adults (71% and 15% respectively) while RDC 2 shows more morbidity and case fatality among young adults (67% and 14% respectively) and adults (56% and 9% respectively) (Table 3).
Table 3: Expected morbidity and case fatality rates of priority camel diseases by age group according to 8 informant groups using 100 stones for each age group and each disease, Northern Kenya, 2011
In Table 4 Respiratory Disease Complex 1 is contrasted with Respiratory Disease Complex 2 and their characteristics listed and summarized.
13
14
Table 4: Difference between RDC 1 and RDC 2 according to 11 herder groups, Northern Kenya, 2011
Discussion The herders participating in this study clearly differentiated between two complexes of respiratory diseases in camels, based on clinical symptoms and epidemiology. Other relevant criteria used by camel pastoralists to differentiate between RDC1 and RDC2 were the recurrence of disease in the same animals, the age-group most affected, the relative frequency of occurrence, morbidity rates, mortality rates and the clinical response to antibiotic treatments. For respiratory disease of camels in North Somalia, Catley and Mohammed (1995) differentiate between Hargab, a mild respiratory disease, and Dhugato, a respiratory disease characterized by prolonged debilitation and long recovery. The differentiation of these two Somali clinical terms recorded by Catley and Mohammed (1995) agrees with the use of the two terms Hergeb and Dhuguta documented for camel herdsmen from northern Kenya in this study. Moallin (2009) is also in general agreement with the clinical terminology of camel pastoralists described in this paper, by using the terms Hergeb and Dhuguta to differentiate between camel influenza and camel pneumonia, respectively. Moallin (2009) also mentions that Dhuguta responds to antibiotic treatment such as oxytetracycline, procaine penicillin and gentamicin while Hergeb is refractory to treatments with antibiotics. This statement is in full agreement with the information from camel pastoralists on RDC 1 and RDC 2 presented in
14
15 this paper. Schwartz and Dioli (1992) and Dioli (2013) summarise all respiratory disease conditions of Kenyan camels under one major `Respiratory Disease Complex´ equated in the 1992 publication with the Somali term Erghib. Koehler-Rollefson et al. (2001) summarize respiratory disease conditions of camels as “coughs, colds and pneumonia”. According to Shiferaw et al. (2011), the aetiology of pulmonary disease in camels is complex and involves several factors. Kebede and Gelaye (2010) state that the primary cause of camel respiratory disease is Parainfluenza-3 which predisposes the animal to secondary bacterial infection; the main one being Mannheimia haemolytica, emphasising the multi-factorial nature of camel respiratory diseases. Roger et al. (2010) and Yigezu (1997) suspect PPR to play a primary role in triggering mass respiratory disease in camels. The participatory epidemiological data presented in this paper provide clinical and statistical evidence for the presence of two different clinical respiratory disease complexes amongst camels in North Kenya, as recognised by the clinical terminology of Kenyan pastoralists. These results clearly emphasise the value of detailed participatory epidemiology studies in animal disease investigations and surveillance. Nonetheless, the participatory epidemiology methods applied are by virtue prone to a number of biases; (i) to recall bias since the informants generally rely on memory to give information on the diseases under investigation (Catley and Admassu, 2003), (i) to selection bias as the respondents though based on knowledge and skills, were selected by village elders and chiefs, and (iii) to information bias in terms of misclassification of disease sign and symptoms. Future efforts should be directed towards pathogen isolation. Identifying the etiological factors underlying Respiratory Disease Complexes 1 and 2 in the camel keeping districts of Kenya and other camel husbandry regions should allow further differentiation into two
15
16 respiratory disease complexes yet in the study design; besides a case-control study approach randomised clinical trials would be expected to assist here,though being aware of its pitfalls (Sargeant et al., 2009) . .
Conclusions In tapping on the indigenous knowledge of camel pastoralists in northern Kenya the toolbox of participatory epidemiology offered suitable instruments in scoring and ranking camel diseases, and in particular focussing on the differentiation of the two camel respiratory disease complexes RDC 1 and RDC 2. The criteria identified, assessed and attributed in the local languages of the Somali, Gabra and Garri communities now allow a much more targeted disease prevention and control approach in the field.
Acknowledgement Kenya Arid and Semi-Arid Lands/Kenya Agricultural Research Institute (KASAL/KARI) sponsored the field work of the first author, Deutscher Akademischer Austausch Dienst (DAAD) (German Academic Exchange Service) provided the stipend through the Joint Master in Transboundary Animal Disease Management Course (MTADM), EDULINK (African Caribbean and Pacific group of states-European Union Cooperation programme in Higher Education) paid the tuition fees and travel expenses throughout the study period and VSF-Suisse, Kenya provided substantial logistical support in the field.
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References
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18 Contagious Bovine Pleuropneumonia in Africa, 12-14 November, 2003, Rome, Italy. Pp 4. Catley, A., Mariner, J., 2002. Where there is no data: participatory approaches to veterinary epidemiology in pastoral areas of the horn of Africa. International Initiative for Environment and Development Dry Land Programmes. Issue Paper no.110. Pp 10-16. Catley A., Mohammed A.A. (1995). – Ethnoveterinary knowledge in Sanaag region, Somaliland: notes on local descriptions of livestock diseases and parasites. Nomadic Peoples, 36/37, 3-16. Catley, A., Osman, J., Mawien, C., Jones, B.A., Leyland, T.J., 2002. Participatory analysis of seasonal incidences of diseases of cattle, disease vectors and rainfall in southern Sudan. Prev. Vet. Med. 53, 275–284. Census, 2009. Vol II Q 11: Livestock population by type and District. https://www.opendata.go.ke/Agriculture/Census-Vol-II-Q-11-Livestock-populationby-type-an/qbvv-8bjk 1/5/2016 Dioli, M., 2010. Clinical observations on the “wry-neck” syndrome or torticollis in the camel (Camelus dromedarius) population of Kenya and Sudan; https://www.researchgate.net/publication/250615241_Clinical_observations_on_the_ wryneck_syndrome_or_torticollis_in_the_camel_Camelus_dromedarius_population_ of_Kenya_and_Sudan accessed on April 29, 2016. Dioli, M., 2013. Pictorial Guide to Traditional Management, Husbandry and Disease of the One-Humped Camel. 2nd edition, ISBN 978-82-303-2367-0. Farah, Z., Mollet, M., Younan, M., Dahir, R., 2007. Camel dairy in Somalia: Limiting factors and development potential. Lvstck. Sci. 110 (2007), 187–191. 18
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20 Roger, F., Diallo, A., Yigezu, L.M., Hurard, C., Libeau, G., Mebratu, G.Y., Faye, B., 2000. Investigation of a new pathological condition of camels in Ethiopia. J Camel Pract Res. 7, 163-166. Sargeant, J.M., Elgie, R., Valcour,J.,,. Saint-Ongea J., Thompson, A.. Marcynuk, P. Snedeker K , 2009. Methodological quality and completeness of reporting in clinical trials conducted in livestock species. Prev. Vet. Med. 91, 107-115. Schwartz, H. J., Dioli, M., 1992. The One Humped Camel (Camelus dromedarius) in Eastern Africa: a Pictorial Guide to Diseases, Health Care and Management. Verlag Josef Margraf. Pp. 1-3, 159-160. Swai, E.S., Neselle, M.O., 2010. Using Participatory Epidemiology Tools to Investigate Contagious Caprine Pleuropneumonia (CCPP) in Maasai Flocks, Northern Tanzania. Int. J. Anim. Vet. Advances, 2 (4), 141-147. Wareth, G., Murugaiyan, J., Khater, D. F., Moustafa, S.A., 2014. Subclinical pulmonary pathogenic infection in camels slaughtered in Cairo, Egypt. J. Infect. Dev. Ctries. 8(7): 909-913. doi:10.3855/jidc.4810 Wernery, U., Kinne, J., 2012. Mycoplasmosis - A new Disease in Camelids. Proceedings of the 3rd Conference of the International Society of Camelid Research and Development, 29th Jan-1st Feb 2012, Muscat, Sultanate of Oman. Wernery, U., Kinne, J., Schuster, R.K., 2014. 1.3 Respiratory System & 2.2.2 Respiratory Viruses. In: Camelid Infectious Disorders, World Organisation for Animal Health OIE, Paris, France 2014, pp 113-134 and pp 305-308. Yigezu, L. M., Roger, F., Kiredjian, M., and Tariku, S., 1997. Isolation of Streptococcus equi subspecies equi (strangles agent) from an Ethiopian camel. Vet. Rec. 140, 608.
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21 Younan, M., Bornstein, S., 2007. Lancefield Group B and C streptococci, important opportunistic pathogens in East African camels (Camelus dromedarius). Vet Rec. 160, 330-335.
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22 Table 1: Ten most important camel diseases as scored by 11 herder groups using 50 stones in each group, northern Kenya, 2011 Disease
Total Score*
Average score
HS/SGS
Number of herder groups 11
102
9.27
Overall Rank 1
RDC 1
11
73
6.64
2
Camel Pox
11
66
6.00
3
Wry Neck
10
39
3.55
4
RDC 2
9
36
3.27
5
Abscess
6
27
2.45
6
Trypanosomosis
5
28
2.55
7
Lesa/Butal (diarrhoea)
3
32
2.91
8
Iddi (plant poisoning)
3
24
2.18
9
Mange
4
16
1.45
10
*This is the total score from 11 groups; each group used 50 stones to score against 10 diseases. However, these diseases differ from group to group, i.e. not all groups mentioned all diseases.
22
23 Table 2: Scoring of clinical signs of camel diseases in the study area by 11 herder groups using 20 stones, northern Kenya, 2011 Clinical signs
Kendall’s W*
P value
Median score (range)
Bent/kinked neck 1.00
RDC1 <0.000 0 (0-0)
RDC2 0 (0-0)
HS/SGS 0 (0-0)
Wry Neck 20 (20-20)
Lachrymation
0.592
<0.000 4 (2-7)
5 (2-12)
9 (3-14)
0.5 (0-5)
Enlarged lymph nodes Recumbency
0.857
<0.000 4 (0-8)
3 (0-7)
12.5 (11-20)
0 (0-0)
0.34
0.017
2 (0-5)
4 (1-10)
7 (3-13)
5.5 (0-10)
Emaciation
0.257ns
0.053
3 (0-7)
6.5 (0-9)
7 (2-11)
4.5 (0-9)
Coughing
0.916
<0.000 5 (1-7)
3.5 (2-6)
0 (0-0)
Fever
0.734
<0.000 4.5 (2-7)
11.5 (1015) 4.5 (0-11)
10 (6-14)
0 (0-6)
Bad odour
0.773
<0.000 6 (2-11)
1.5 (0-7)
11 (7-18)
0 (0-2)
Nasal discharge
0.865
<0.000 13.5 (9-20)
1 (0-6)
4.5 (0-7)
(0-1)
Mortality
0.765
<0.000 5 (2-7)
2 (0-4)
9 (8-14)
3.5 (1-7)
Key: *Kendall’s coefficient of concordance (W); ns = not significant; Respiratory Disease complex 1 (RDC 1), Respiratory Disease complex 2 (RDC 2), Haemorrhagic Septicaemia/ “Swollen Gland Syndrome” (HS/SGS)
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24 Table 3: Expected morbidity and case fatality rates of priority camel diseases by age group according to 8 informant groups using 100 stones for each age group and each disease, northern Kenya, 2011
Diseases Morbidity/ Kendall’s P case
W*
value
Age groups Mean (min-max)
fatality Young calves
Older
Young adults
Adults
(3-5 yrs)
(>5yrs)
63 (0-97)
19 (0-19)
40 (12-71)
29 (0-84)
1 (0-7)
83 (63-
71 (44-97)
44 (11-86)
(<0.25-0.5yrs) calves (0.5-2yrs) Pox
Morbidity
0.678
<0.000 21(0-53)
79 (59100)
Case
0.629
0.001
30 (0-64)
0.687
<0.000 49 (23-100)
fatality RDC 1
Morbidity
100) Case
0.604
<0.000 20 (8-33)
21 (5-35)
15 (0-32)
6 (0-26)
Morbidity
0.700
0.001
5 (0-43)
38 (10-72)
67 (48-90)
56 (10-92)
Case
0.421
0.018
0 (0-0)
5 (0-19)
14 (0-48)
9 (0-26)
Morbidity
0.894
<0.000 0 (0-0)
49 (29-79)
67 (50-94)
18 (0-45)
Case
0.894
<0.000 0 (0-0)
36 (24-50)
51 (43-72)
19 (0-51)
fatality RDC 2
fatality HS/SGS
fatality Key: *Kendall’s coefficient of concordance (W); Respiratory Disease complex 1 (RDC 1), Respiratory Disease complex 2 (RDC 2), Haemorrhagic Septicaemia/ “Swollen Gland Syndrome” (HS/SGS)
24
25 Table 4: Difference between Respiratory Disease complex 1 (RDC 1) and Respiratory Disease complex 2 (RDC 2) according to 11 herder groups, northern Kenya, 2011
RDC 1
RDC 2
1. Mainly associated with nasal discharge
1. Mainly associated with cough, emaciation and recumbency
2. Does not confer permanent immunity
2. Confers permanent immunity
3. Affects all age groups but mostly kills
3. Mostly associated with adults over three
claves between 0.5 and 2 years of
years of age and does not affects calves less
age.
than 6 months according to most herders 4. Less frequent outbreaks compared to RDC 1
4. Frequent outbreaks
5. Responds well to antibiotic therapy particularly amoxicillin
5. Shows poor response to antibiotic 6. Longer clinical course compared to RDC 1 therapy 6. Shorter clinical course compared to RDC 2
25
26
36
37
38
39
40
41
Madera Marsabit
4
4
Wajir
3
3
N
0.001
0
0.001 Kilometers
2
2
1
1
N
0.0003
36
37
0
38
0.0003 Kilometers
39
40
41
Fig. 1. Map of Kenya showing the three study districts and study locations (in maroon colour) (Source: Ojwang, G. O, Chief Natural Resource Scientist, Department of Resource Surveys and Remote Sensing, Kenya, 2011).
26
27
Seasonal Calendar 12
ticks, W=0.351, P=0.009
Median score
10
8
RDC1, W=0.441, P=0.002
6
HS/SGS, W=0.187, P=0.104
4
POX, W=0.490, P=0.001
2
0
RDC2, W=0.319, P=0.015 amount of rain, W=0.938, P=0.000 pasture, W=0.822, P=0.000
Key: Kendall’s coefficient of concordance (W), Asymptotic significance (P); Respiratory Disease complex 1 (RDC 1), Respiratory Disease complex 2 (RDC 2), Haemorrhagic Septicaemia/ “Swollen Gland Syndrome” (HS/SGS)
Fig. 2. Graphical presentation of matrix scoring results for seasonal patterns of rain, pasture ticks and 4 diseases according to 11 informant groups in northern Kenya, 2011
27
28
Tryps 3% Wry neck 13%
Camel pox 17%
RDC1 27%
HS/SGS 30% RDC2 10%
W=0.636 P=<0.000
Key: Kendall’s coefficient of concordance (W), Asymptotic Significance (P); Haemorrhagic Septicaemia/Swollen Gland Syndrome (HS/SGS), Respiratory Disease Complex 1 (RDC1), Respiratory Disease Complex 2 (RDC2), Trypanosomosis (Tryps)
Fig. 3. Relative frequency of occurrence of camel diseases as scored by 11 informant groups in northern Kenya, 2011
28
29
Tryps 29%
Camel pox 16% RDC1 16%
Wry neck 6% HS/SGS 7%
RDC2 26%
W=0.636 P=<0.000
Key: Kendall’s coefficient of concordance (W), Asymptotic significance (P); Haemorrhagic Septicaemia/Swollen Gland Syndrome (HS/SGS), Respiratory Disease Complex 1 (RDC1), Respiratory Disease Complex 2 (RDC2), Trypanosomosis (Tryps)
Fig. 4. Relative response of 6 priority camel diseases to treatment according to 11 informant groups in northern Kenya, 2011
29
30
16.0 14.0 12.0
Average clinical course in an individual
weeks
10.0 8.0
Average length of outbreak in a herd
6.0 4.0
W= 0.635
2.0
P=<0.000
0.0 Camel pox
RDC1
RDC2
HS/SGS
Key: Kendall’s coefficient of concordance (W), Asymptotic significance (P); Haemorrhagic Septicaemia/Swollen Gland Syndrome (HS/SGS), Respiratory Disease Complex 1 (RDC1), Respiratory Disease Complex 2 (RDC2)
Fig. 5. Average clinical course in a sick animal and outbreak length in a herd of priority camel diseases according to 11 herder informant groups in northern Kenya, 2011.
30