Publications from the OH network

@techreport{nokey,

title = {Mentorship of the next generation of One Health workers through experiential learning: A case of students of Makerere University},

author = {Peninah Nsamba 1 , Innocent B. Rwego 1 *, Edwina Atusingwize 2 , Sylvia Wanzala 3 , Esther Buregyeya 2 , Gabriel Tumwine 1 , Doreen

Tuhebwe 2 , Charles Drago Kato 1 , Angella Musewa 4 , Joseph M. Kungu 1 , Frank Mwiine 1 , Peter Waiswa 1 , Sarah Nitumusiima 4 ,

Irene Naigaga 1,5 , Hellen Amuguni 6 , Katherine Pelican 3 , Jeff Bender 3 , Saul Tzipori 6 , John David Kabasa 1 , and William Bazeyo 5},

url = {https://www.researchgate.net/publication/376095295_Mentorship_of_the_next_generation_of_One_Health_workers_through_experiential_learning_A_case_of_students_of_Makerere_University},

year  = {2023},

date = {2023-02-01},

urldate = {2023-02-01},

abstract = {Multiple zoonotic disease outbreaks occurred in Uganda over the past two decades and have needed operationalization of the One Health (OH) Approach to respond effectively. Between 2016 and 2018, the African One Health University Network (AFROHUN) supported 61 students (25 females, 36 males) to join multisectoral and multidisciplinary government national and district task force disease response teams. The goal of joining these teams was to build and strengthen the students’ disease investigation and response skills in real time using a One Health approach. Qualitative methods were used to collect student and partner responses on their field experiences. The AFROHUN project identified the experiential knowledge and skills that the students gained. Student project reports were reviewed by the joint technical teams from the university and the national/district task forces. These included training materials and disease outbreak investigation and response reports. Partnerships and collaboration between the university One Health networks and the government enabled 35 graduate and 26 undergraduate students to receive joint mentorship from the national or district task force outbreak response teams. Most participants were from degree programs in Public Health, Epidemiology, Environmental Health, Veterinary, Wildlife Sciences, and Infectious Disease Management, while few students were from social sciences. Students were mentored in seven competency-based areas of disease management: (1) biorisk management, (2) community engagement and coordination, (3) epidemiology, (4) leadership, (5) outbreak investigation and response, (6) risk communication, and (7) surveillance. In conclusion, zoonotic outbreaks provided real-life learning opportunities for students in disease outbreak investigation and response using a multidisciplinary and multisectoral approach. The identified skills can be incorporated into educational materials such as curricula and present an ideal opportunity to build partnerships for workforce development. One Health impact statement The next generation of One Health workers, those capable of working across sectors and disciplines to improve the health of animals, humans, plants, and the environment, need soft and technical skills to guarantee optimal preparedness, prevention, and response to disease outbreaks and understand the animal to human transmission dynamics of disease. In countries where emerging, re-emerging, and endemic zoonoses and hemorrhagic fevers are prevalent, it is crucial to provide these real-life or experiential training opportunities for university students, working closely in multidisciplinary teams. The “real-time” joint mentorship by the government’s multidisciplinary and multisectoral outbreak response teams, during disease outbreaks, provides an opportunity to build and strengthen student skills in biorisk management, community engagement and coordination, epidemiology, leadership, outbreak investigation and response, risk communication, and surveillance},

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@techreport{nokey,

title = {One Health capacity building in sub-Saharan Africa},

author = {Innocent B. Rwego, BVM, MSc, PhD,1,7,* Olutayo Olajide Babalobi, DVM, MPVM, PhD,2 Protus Musotsi, BSc,3 Serge Nzietchueng, DVM, MSc,1,4 Christian Keambo Tiambo, BSc, PhD,5,6 John David Kabasa, BVM, MSc, PhD,7 Irene Naigaga, BVM, MSc, PhD,8 Gladys Kalema-Zikusoka, BVetMed, MRCVS,9 and Katherine Pelican, DVM, PhD1},

url = {https://pmc.ncbi.nlm.nih.gov/articles/PMC5131459/},

year  = {2019},

date = {2019-11-29},

urldate = {2019-11-29},

abstract = {Background



Africa of late has been faced with challenges that require a multidisciplinary and multisectoral approach to address them, and academic and non-academic institutions have played a key role in training and conducting research that would promote the One Health approach.



Objectives



The objective of this review was to document networks and organizations conducting One Health training, research, and outreach in Africa, as one of a series of articles around the world.

Methods



Data for this review were collected from organizations through key contacts of the authors and their knowledge of networks they have worked with. Web searches were conducted using One Health, training, and research as key words for work done in Africa.



Results



Africa has major networks involved in One Health training, research, and outreach, with participation of both academic and non-academic institutions. This review highlights an effort in Africa to form networks to conduct multidisciplinary training and research. The main networks include Afrique One, Southern African Centre for Infectious Disease Surveillance (SACIDS), and One Health Central and Eastern Africa (OHCEA).



Conclusions



Both academic and non-academic institutions and organizations have shown an interest to conduct multidisciplinary training and research in Africa for managing challenges that Africa is facing currently, especially the outbreak of infectious diseases.},

howpublished = {NIH},

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@techreport{nokey,

title = {Perceptions and Practices towards Anthrax in Selected Agricultural Communities in Arua District, Uganda},

author = {Joseph M. Kungu , 1 Peninah Nsamba, 1 Alfred Wejuli, 2 John D. Kabasa, 1 and William Bazeyo 3},

url = {https://www.researchgate.net/publication/344329806_Perceptions_and_Practices_towards_Anthrax_in_Selected_Agricultural_Communities_in_Arua_District_Uganda},

year  = {2019},

date = {2019-10-18},

urldate = {2019-10-18},

abstract = {Background: Anthrax is globally recognized as an important public health and economic challenge in many agricultural communities. A cross-sectional study was conducted in three subcounties in Arua district to assess the community's awareness, cultural norm, and practices regarding anthrax. This followed a report of active cases of human cutaneous anthrax in the district. Methods: The study was conducted in subcounties of Pawor, Rigbo, and Rhino Camp, Arua district, using focus group discussion. Results: The affected communities had limited knowledge about anthrax, especially its clinical manifestation and modes of transmission both in humans and animals. The community also had no knowledge of the anthrax vaccine or treatment and where they can be accessed from. Poor practices associated with anthrax outbreaks included poor disposal of carcasses and ruminal wastes, occupational hazards (butchers, slaughter men, and herdsmen), consumption of meat from infected animals, communal herding, and cultural norms encouraging consumption of dead animals. Conclusion: This study shows that there is a knowledge gap about anthrax among the people in the affected communities. Key drivers for the anthrax outbreak such as poor cultural beliefs and practices and wildlife-livestock-human interactions were observed in all the three subcounties studied. All these findings could imply a high risk of outbreak of anthrax in Arua and Ugandan agricultural communities where the public health programs are less standardized and less effective.},

howpublished = {Research Gate},

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@techreport{nokey,

title = {Post Outbreak Evaluation Of One Health Integrated Interventions Of Rift Valley Fever And Crimean Congo Haemorrhagic Fever In Kiboga And Kiruhura Districts, Uganda},

author = {Joseph Morison Kungu, Peninah Nsamba, Alfred Wejuli, John D Kabasa, William Bazeyo},

url = {https://www.researchgate.net/publication/340204940_Post_Outbreak_Evaluation_Of_One_Health_Integrated_Interventions_Of_Rift_Valley_Fever_And_Crimean_Congo_Haemorrhagic_Fever_In_Kiboga_And_Kiruhura_Districts_Uganda},

doi = {https://doi.org/10.21203/rs.2.12617/v1},

year  = {2019},

date = {2019-08-12},

urldate = {2019-08-12},

abstract = {Objective: Following containment of Rift Valley Fever (RVF) and Crimean Congo Hemorrhagic Fever (CCHF) outbreaks, a post evaluation of the use of a one health approach in management of the reported viral haemorrhagic fevers was conducted in the affected districts of Kiboga and Kiruhura districts in Uganda. This was done through a cross sectional study using participatory epidemiology tools, mainly observation and key informant interviews. Results: The findings indicated that the interventions employed had been successful in the management of the outbreaks and multidisciplinary approach enabled containment of these hemorrhagic fever outbreaks in the districts. Although the outbreaks had been contained, delays could have been minimized by undertaking laboratory diagnosis at district level instead of transporting samples to national referral laboratories in Entebbe. Response to the RVF and CCHF challenge could have been delayed by dependence on funding of central government and non governmental organizations due to failure to plan and allocate funds for surveillance and mitigation of diseases outbreaks at district local government levels.},

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@techreport{nokey,

title = {EVALUATION OF THE ONE HEALTH APPROACH USED IN MANAGEMENT OF RVF AND CCHF IN KIBOGA AND KIRUHURA DISTRICTS, UGANDA},

author = {Dr. Joseph M. Kungu1, Peninah Nsamba2, John David Kabasa2, William Bazeyo2, and Alfred Wejuli3},

url = {https://www.researchgate.net/publication/340204940_Post_Outbreak_Evaluation_Of_One_Health_Integrated_Interventions_Of_Rift_Valley_Fever_And_Crimean_Congo_Haemorrhagic_Fever_In_Kiboga_And_Kiruhura_Districts_Uganda},

doi = {https://doi.org/10.21203/rs.2.12617/v1},

year  = {2019},

date = {2019-02-21},

urldate = {2019-02-21},

abstract = {Background: In the recent years, Uganda has suffered a number of outbreaks of public health importance, the most recent being Rift Valley Fever (RVF) and Crimean Congo hemorrhagic fever (CCHF). A post-outbreak evaluation of the one health approach in management of viral haemorrhagic fevers was conducted in Kiboga and Kiruhura districts using participatory epidemiology tools. Key Informant Interviews were held with district administrators, health and veterinary officers, community leaders to explore their collaborative involvement in management of RVF and Crimean Congo Fever during the outbreak. Observation of the cases, farms and the environment were used to understand the disease transmission dynamics. Findings: Although the use of the One Health approach in the control of RVF and CCHF was envisaged to a certain extent, especially in the planning process, active involvement of the stakeholders as a team was lacking. The high-risk groups included; Herds men, butchers and slaughter men, migrants and refugees, households near swamps and stagnant water. Practices like grazing livestock in the park, farmers rotating around neighboring districts for pasture, eating dead animals, heavy rains were important in transmission of RVF and CCHF. Conclusion: The benefits of the One health approach in control of outbreaks of zoonotic diseases can be better realized through; building the capacity of local laboratories and technicians in disease diagnosis; routine surveillance of zoonotic diseases in humans, livestock and wildlife; allocation of emergency funding to facilitate the district rapid response teams, activating vigilant teams at Sub County levels. One Health Impact: This evaluation demonstrated the need for a holistic involvement of stakeholders for successful control of diseases at the human-livestock-wildlife-environment interface.},

howpublished = {ResearchGate},

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pubstate = {published},

tppubtype = {techreport}

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@techreport{nokey,

title = {Lowland grazing and Marburg virus disease (MVD) outbreak in Kween district, Eastern Uganda},

author = {Aggrey Siya, William Bazeyo, Doreen Tuhebwe, Gabriel Tumwine, Arnold Ezama, Leonard Manirakiza, Donald R. Kugonza & Innocent B. Rwego },

url = {https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6477-y},

year  = {2019},

date = {2019-01-31},

urldate = {2019-01-31},

abstract = {Background



Uganda is one of the few countries in Africa that has been experiencing outbreaks of viral hemorrhagic fevers such as Ebola, Marburg and Crimean-Congo Hemorrhagic fevers. In 2017 Uganda experienced a Marburg Virus Disease (MVD) outbreak with case fatality rate of 100% in Kween district. Although hunting for wild meat was linked to the MVD outbreak in Kween district, less was reported on the land use changes, especially the changing animal grazing practices in Kween district.



Methods



Through Makerere University One Health graduate fellowship program with attachment to Uganda Red Cross Society, a study was conducted among the agricultural communities to elucidate the risk behaviors in Kween district that can be linked to the 2017 Marburg disease outbreak.



Results



Results show that although a few elderly participants ascribed fatal causes (disobedience to gods, ancestors, and evil spirits) to the MVD outbreak during FGDs, majority of participants linked MVD to settling in caves (inhabited by Fruit Bats) during wet season as upper belts are extensively used for crop production leaving little space for animal grazing. Members also noted side activities like hunting for wild meat during this grazing period that could have predisposed them to Marburg Virus.



Conclusions



There is need to integrate One Health concepts within agricultural extension service provision in Uganda so as to enhance the management of such infectious diseases.},

howpublished = {BMC Public Health},

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pubstate = {published},

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@techreport{nokey,

title = {Building a framework for the design and implementation of One Health curricula in East and Central Africa: OHCEAs One Health Training Modules Development Process},

author = { aTufts University, Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, USA

bOne Health Central and Eastern Africa (OHCEA), P.O. Box 7072, Kampala, Unit 4, Ekobo Avenue, Kololo, Uganda

cFinance and Administration, Makerere University and Principal Investigator, One Health Central and Eastern Africa(OHCEA) Network. P.O. Box 7072, Kampala, Unit 4, Ekobo Avenue, Kololo, Uganda},

editor = {Hellen Amuguni, Winnie Bikaako, Irene Naigaga, William Bazeyo},

url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6288412/},

year  = {2018},

date = {2018-09-08},

urldate = {2018-09-08},

abstract = {Introduction



Over the past decade, Africa and the world have faced severe public health threats, ranging from infectious disease outbreaks such as the Ebola outbreak in West Africa to environmental disruptions like the devastating effects of hurricane Matthew in Haiti. Recent outbreaks of emerging infectious diseases have captured global attention with their significant impact on health systems and economies. Boundaries between humans, animals and our environment are undergoing rapid changes [1]. Novel diseases are emerging and not just in humans. It is estimated that three out of four new infectious diseases occurring in humans are of animal origin [2]. The complexity of the issues: global movement of people, animals and disease-causing pathogens, cross border exchanges, increased human population, shrinking wildlife habitats, illegal wildlife trade, rapid globalization, pollution, loss of biodiversity, antimicrobial resistance and changes in environment and land use demand that we apply a systems thinking interdisciplinary approach to solve complex health challenges at the human animal and environmental interface.



Experiences from the fight against Ebola and the highly pathogenic avian influenza demonstrated the effectiveness of multi-sectoral, multi-agency approaches that are not limited by national or regional borders in dealing with public health threats [3]. One of the key approaches to achieve global health security is by building a multidisciplinary public health workforce that is well trained and fully equipped to counter infectious disease threats and that eliminate the current global barriers that exist because of disciplinary silos.



In response to this challenge, the One Health approach is advocated as the global framework for strengthening collaboration and capacities of the sectors and actors involved in health service delivery [4]. The One Health paradigm emerged from the recognition that the well being of humans, animals and ecosystems are interrelated and interdependent, and there is need for more systematic and cross-sectoral approaches to identifying and responding to global public health emergencies and other health threats arising at the human-animal ecosystem interface [3]. The One Health concept is a growing global strategy for expanding interdisciplinary collaborations and communications in all aspects of health care for humans, animals and the environment that calls for a paradigm shift in developing, implementing and sustaining health policies [5].



Key to the implementation of One Health strategies is the redesign of a more integrative and dynamic educational system to better match the public health needs and produce a workforce that can effectively and efficiently respond to complex health challenges. Mismatch between present siloed professional competencies and the requirements of an increasingly multidisciplinary complex world means that overhauling public health education is imperative. In 2010, the commission on education for health professionals for the 21st century was launched. This independent initiative with a global outlook sought to advance health by recommending instructional and institutional innovations to develop a new generation of health professionals who would be better equipped to handle present and future complex health challenges in an era of rapid globalization [6]. Yet many professional training programs are still very traditional, producing graduates who are ill equipped to handle current challenges. One Health is a conceptual challenge to conventional public health training and practice because it addresses public health threats from a multidisciplinary collaborative perspective.



One Health Central and Eastern Africa (OHCEA) is a network of universities in Central, West and Eastern Africa which are collaborating to build One Health capacity and academic partnerships in the region. OHCEA membership includes twenty-four Central, West and Eastern Africa Schools of Public Health, Veterinary Medicine and Environmental Science; and US partner institutions: University of Minnesota (UMN) and Tufts University. The current OHCEA membership spans eight countries: Kenya, Uganda, Tanzania, Rwanda, Ethiopia, Democratic Republic of Congo, Cameroon, and Senegal [7], working together to strengthen public health education, systems, emergency preparedness and response.



OHCEA seeks to expand the human resource base needed to detect and respond to potential pandemic disease outbreaks, and increase integration of animal, wildlife and human disease surveillance and outbreak response systems using a One Health approach [7]. To do this effectively requires engagement of multidisciplinary groups of professionals with the right intellectual competencies and knowledge, capable of collaborating with each other. What type of training and preparation will provide public health professionals with the skills and competencies needed to combat such emerging public health threats?



The OHCEA network and its partner institutions, have developed One Health Core Competencies and modules that are key to delivering knowledge and skills to a multidisciplinary workforce and building a framework on which One Health curricula can be designed and implemented. A total of sixteen modules have been developed including One Health soft skills such communication, collaboration and partnership, culture, leadership, gender, policy and advocacy, systems thinking as well as core technical skills including ecosystem health, risk analysis, infectious disease epidemiology, One Health concepts and outbreak investigation and response. These modules are being used at both preservice and in-service levels. by faculty and students across OHCEA’s eight countries and institutions in East and Central Africa, and by various government and private industry in these countries-deliberately focusing on building cross sectoral collaborative skills and technical competencies that prepare them to efficiently respond to any emerging public health threats. They are designed to fill the cross sectoral and technical skill gap caused by the changes in public health practice. The skills provided combine human and animal health sciences with the principles of ecology and environmental health while at the same time considering the social, economic, cultural and environmental impacts and effects on global health security. In this manuscript, we provide a detailed description of the module development process.},

howpublished = {NIH NLM},

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pubstate = {published},

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@techreport{nokey,

title = {Implementing One Health as an integrated approach to health in Rwanda},

author = { 1Ministry of Health, Kigali, Rwanda

2University of Minnesota, Minneapolis, Minnesota, USA

3University of California Davis, Davis, California, USA

4University of Rwanda, Butare, Rwanda

5Harvard Medical School, Boston, Massachusetts, USA

6Partners in Health, Rwanda

7USAID Preparedness and Response Project

8Rwanda Agricultural Board, Kigali, Rwanda

9Rwanda Development Board, Kigali, Rwanda

10Centers for Disease Control and Prevention (CDC), Kigali, Rwanda

11Rwanda Biomedical Center, Kigali, Rwanda

12University of Global Health Equity},

editor = { Thierry Nyatanyi 1,2, Michael Wilkes 3,4,5, Haley McDermott 3,6, Serge Nzietchueng 2,7, Isidore Gafarasi 8, Antoine Mudakikwa 9, Jean Felix Kinani 9, Joseph Rukelibuga 10, Jared Omolo 10, Denise Mupfasoni 10, Adeline Kabeja 11, Jose Nyamusore 11, Julius Nziza 4, Jean Leonard Hakizimana 11, Julius Kamugisha 11, Richard Nkunda 11, Robert Kibuuka 4, Etienne Rugigana 4, Paul Farmer 5,6,12, Philip Cotton 4, Agnes Binagwaho 5,12 },

url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5335763/ },

doi = {PMC5335763},

year  = {2017},

date = {2017-02-21},

urldate = {2017-02-21},

abstract = {It is increasingly clear that resolution of complex global health problems requires interdisciplinary, intersectoral expertise and cooperation from governmental, nongovernmental and educational agencies. ‘One Health’ refers to the collaboration of multiple disciplines and sectors working locally, nationally and globally to attain optimal health for people, animals and the environment. One Health offers the opportunity to acknowledge shared interests, set common goals, and drive toward team work to benefit the overall health of a nation. As in most countries, the health of Rwanda’s people and economy are highly dependent on the health of the environment. Recently, Rwanda has developed a One Health strategic plan to meet its human, animal and environmental health challenges.



This approach drives innovations that are important to solve both acute and chronic health problems and offers synergy across systems, resulting in improved communication, evidence-based solutions, development of a new generation of systems-thinkers, improved surveillance, decreased lag time in response, and improved health and economic savings. Several factors have enabled the One Health movement in Rwanda including an elaborate network of community health workers, existing rapid response teams, international academic partnerships willing to look more broadly than at a single disease or population, and relative equity between female and male health professionals. Barriers to implementing this strategy include competition over budget, poor communication, and the need for improved technology. Given the interconnectedness of our global community, it may be time for countries and their neighbours to follow Rwanda’s lead and consider incorporating One Health principles into their national strategic health plans.},

howpublished = {NIH NLM},

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@techreport{nokey,

title = {Producing Interdisciplinary Competent Professionals: Integrating One Health Core Competencies into the Veterinary Curriculum at the University of Rwanda},

author = {Hellen J. Amuguni n Melissa Mazan n Robert Kibuuka},

url = {https://pubmed.ncbi.nlm.nih.gov/27779918/},

isbn = {27779918},

year  = {2016},

date = {2016-10-25},

urldate = {2016-10-25},

abstract = {Infectious diseases of grave concern to human health are emerging from wildlife and livestock populations in multiple regions of the world. Responding effectively to these emerging pandemics requires engagement of multidisciplinary groups of professionals. Using a One Health approach, One Health Central and Eastern Africa (OHCEA), a network of seven schools of public health and seven veterinary schools, with the support of the United States Agency for International Development (USAID), has engaged in curriculum review with the aim of building the skills of multidisciplinary groups of professionals to improve their capacity to respond to emerging infectious diseases. Through stakeholder analysis and curriculum development workshops, the University of Rwanda’s School of Veterinary Medicine, in association with Tufts University, revised its curriculum to incorporate One Health competencies to be better prepared to respond to any infectious disease outbreak in Africa.



The revised curriculum aimed to build cross-sectoral skills and knowledge; transform students’ ways of thinking about infectious disease outbreak response; link human, veterinary, and wildlife health training opportunities; and strengthen community front-line responder training. Eight different disciplines engaged in the curriculum review process: Veterinary Medicine, Livestock Production, Wildlife and Aquatic Resources, Environmental Health and Epidemiology, Communication Technology, Engineering, Agriculture, and Public Health. One Health competencies such as communication, collaboration, leadership, and advocacy were added to the new curriculum, helping ensure that each professional be appropriately equipped with skills to recognize and respond effectively to any emerging infections.},

howpublished = {PubMed},

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@techreport{nokey,

title = {One Health Central and Eastern Africa: Historical and Future Perspectives},

author = {Japhet Killewo, William Bazeyo, Robinson Mdegela},

url = {https://www.sciencedirect.com/science/article/pii/B9780128036785005129},

year  = {2016},

date = {2016-10-24},

urldate = {2016-10-24},

abstract = {One Health Central and Eastern Africa (OHCEA) is a network of schools of public health and veterinary higher education institutions that are located in countries of the Eastern and Central Africa region, a region that includes the Congo Basin commonly considered to be one of the ‘hot spots’ for emerging and reemerging infectious diseases. The vision of the OHCEA network is to be a global leader in One Health, promoting sustainable health for prosperous communities, productive animals, and balanced ecosystems.



Keywords

• Hot spots;

• One Health Central and Eastern Africa (OHCEA);

• United States Agency for International Development (USAID);

• World Health Organization (WHO);

• Food and Agriculture Organization (FAO);

• World Organization for Animal Health (OIE);

• One Health, Emerging Pandemic Threats},

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