Medical knowledge | Higher education » Preparedness to Anthrax in South-East Tajikistan

Source: http://www.doksinet Research Grant Proposal to the Centre for Development and Environment (CDE), Bern, Switzerland Preparedness to Anthrax in South–East Tajikistan. (MSc Thesis) Applicant: Rakhmatdzhonov Manuchehr MSc. Student, Tropenzentrum, Uni-Hohenheim Supervisors: Prof. Dr Reinhard Böhm Dr. Wolfgang Beyer Institute for Environmental and Animal Hygiene and Veterinary Medicine, University of Hohenheim, Germany boehm@uni-hohenheim.de beyer@uni-hohenheim.de Tel. *49 711 459 22429 Fax *49 711 459 24010 Co-Supervisors: Dr. Muzaffar Anoyatbekov Research Foot and Mouth Disease Institute, Tajikistan baytor@mail.ru Stuttgart - 2007 Source: http://www.doksinet Research Project Proposal 1. Name of applicant (LAST NAME, First name): RAKHMATDZHONOV Manuchehr 2. Current address: Benkendorffstraße 30, 70199 Stuttgart, Germany, Tel: 0711- 8885077 and e-mail: m rahmatdzhon@yahoo.com 3. Home address: 31/2 Fedina Street, Duschanbe, 734041, Tadschikistan 4. Study programme/

semester: Agricultural Sciences, Food Security and Natural Resource Management in the Tropics and Subtropics, Tropenzentrum, Uni-Hohenheim.Study programm 2005 to 2007. 5. Supervisor (Name, Institute): Prof Dr R Böhm, Institute of Animal Hygiene and Environment, Uni-Hohenheim 6. Title of Master Thesis ‘Preparedness to Athrax in the South-East Tajikistan’ 7.Summary Tajikistan has a hyper-endemic/epidemic status for the anthrax disease (WHO, 2005). Since agriculture reorganisation in 1993, within a few years private sector has gained 90% livestock in its ownership. Almost 2274 cases of anthrax in livestock and 1687 cases in human have been confirmed during 1992-2003. A significant number of these human cases (1139) have occurred in South- East Tajikistan, namely Khatlon, Rasht and Pamir areas (Navruzshoyeva, A. 2005) Preparedness in the face of intensive anthrax outbreaks still remains very weak. Therefore adequate policies and procedures must be provided to enhance anthrax

surveillance and control. The proposed research project aims to achieve the following goals: • Identify the status quo of the anthrax surveillance and control in Tajikistan. • Develop anthrax guidelines for stakeholders based on analysis of international experiences and WHO recommendations • Characterise the temporal and spatial distribution of anthrax outbreaks in the EastSouth of the country • Update the epidemiologic maps • Genetically characterise the isolates acquired in outbreak areas • Assess the population structure in the environment at sites associated with outbreaks 8. Name of partner organisation/partner institution 2 Source: http://www.doksinet The Institute of Environmental and Animal Hygiene, University of Hohenheim, Germany; Centre for Environment Development (CDE) Switzerland; Central Asian Foot and Mouth Disease Institute, Tajikistan. 9. Planned stay abroad: Tadjikistan, March 17th to September 1, Month/Week: (7 month) 10. Budget Items

Proposed amount, Euro Flight costs: Stuttgart-Duschanbe one way with United Russian Airlines. Applicant has purchased the ticket in advance Flight costs: Duschanbe – Stuttgart. 656 Personal subsistence (contributed by applicant, 4 month * 60 Euro) 240 Consumables costs for the project (bacteriologic media, plastics, 3000 vaccination against anthrax) Transport costs to distant project areas (three trips to Khatlon, 300 Rasht Velley and Pamir) Cost for transport of diagnostic specimens (to be clarified) 100 Total project costs 4296 Items proposed for the Grant Flight costs: one way Duschanbe – Stuttgart 656 Consumables costs for the project (bacteriologic media, plastics, 3000 vaccination against anthrax) Transport costs to distant project areas (three trips to Khatlon, 300 Rasht Velley and Pamir) Cost for transport of diagnostic specimens (to be clarified) 100 Grant Total 4056 11. Proposal (introduction, aim of the study, material and methods, expected results, necessity

for the stay abroad, thematic link to the objectives of the Donor Foundation, time schedule): Introduction In 1990, the share of all anthrax incidences registered in Soviet Union amounted in Tajikistan alone to 50%. (Cherkasskiy, 2002) Soon after collapse the situation got even worse which resulted in a hyper-endemic/epidemic status (WHO, 2005). Later failures in the centralised administration led to agriculture reorganisation. Since 1993 land and other production resources have been distributed among small holder farmers for private use. In a few years 90% of the livestock was already in private ownership. Apart of social and economic impacts, 3 Source: http://www.doksinet changes in livestock and land management have influenced trends of anthrax dynamics in Tajikistan. During 1992-2003, there were 2274 cases of anthrax in livestock and 1687 cases in human registered. A significant number of these human cases (1139) have occurred in South- East Tajikistan, namely Khatlon, Rasht

and Pamir areas (Navruzshoyeva, A. 2005) To address the challenging situation with anthrax, policies and procedures of the past are still prevailing. These have to be revised, reconstructed in order to develop a framework which enables a formulation and implementation of effective surveillance and control programmes. Here also specific circumstances of each afflicted outbreak zones have to be considered. The intention of this study is to identify what is the status quo of the anthrax surveillance and control in Tajikistan and what are the needs for improvements. Comparison of the legislative basis and its implementation in reality, analysis of international experiences e.g WHO model country programmes are necessary. That will make possible to come up with the design of a guideline oriented on the criteria needed for successful anthrax control and meant for use by primary stakeholders, veterinary and public health personnel. With this study a documentation of the recent anthrax

incidences is intended, too. This is necessary to update epidemiological maps and visualise the epidemiological dynamics of outbreaks in recent times. Obtained temporal and spatial data have a value for the WHO and could contribute to the completeness of the World Anthrax Map. This will then facilitate the introduction of innovative disease control strategies like fingerprinting methods used for forensic purposes, the tracing back of outbreak origins, the investigation of the routes of spread of an outbreak strain and the identification of strains- thus being able to find out whether or not different outbreaks are caused by the same strain. The prerequisite for this kind of investigation is an appropriate collection of strains of Bacillus anthraces. Research purposes. 1. Identify the status quo of the anthrax surveillance and control in Tajikistan; develop anthrax guidelines for stakeholders based on analysis of international experiences and WHO recommendations. 2. Characterise the

temporal and spatial distribution of anthrax outbreaks in the SouthEast of the country; update the epidemiologic maps 4 Source: http://www.doksinet 3. Genetically characterise the isolates acquired from contaminated samples; assess the population structure in the environment at sites assosiated with outbreaks. Project objectives: • Study the local anthrax legislation and rules, define the relevancy of their implementation and needs for improvements • Study international anthrax policies/experiences, WHO Guidelines, utilize aggregated knowledge in designing anthrax guidelines for local stakeholders • Collect epidemiological data from statistics and field sources, compare with previous epidemiological maps in order to characterise the temporal and spatial distribution of anthrax outbreaks • Collect diagnostic specimens from veterinary and field sources which have been implicated in outbreaks of Anthrax • Sort out, pack and transport contaminated specimens to the

Institute of animal Hygiene, Uni-Hohenheim • Conduct a laboratory work to obtain purified isolates ready for genetically characterization • Relate characterized strains to the geographical locations where they were acquired from Material and Method • • • • Communication tools, such as interviews, questionnaires, PRA and ZOPP techniques will be used to collect data from stakeholders, veterinary and public health authorities, statistic agencies and NGO’s Existing epidemiological maps will be utilised for site orientation and updates Sampling (collecting) of contaminated environmental specimens (soil, water and biotic) used to obtain the pathogen isolates Culture, serologic assays, molecular methods will be utilized for identification, purification and genetic characterisation of B. anthracic isolates The research base The Central Asian Foot and Mouth Diseases Institute (Dushanbe, Tajikistan) is recognized as a base for Anthrax research in Tajikistan. This Institute

will facilitate the networking with relevant veterinary and medical authorities for primary data collection and analysis. It will also provide the formal framework for acquisition of B. anthracic contaminated specimens 5 Source: http://www.doksinet The Institute of Environmental and Animal Hygiene, University of Hohenheim, Germany supervises the research flow, consults and provides the laboratory base for characterization of B. anthracic isolates Expected results: • The constraints for effective anthrax surveillance and control will be identified and the guidelines adapted to local specific circumstances will be developed in order to facilitate the primary stakeholder’s (farmers, livestock keepers) communication with veterinary or public health workers and improve cooperation within anthrax eradication programmes • The gain of knowledge about the temporal and spatial distribution of anthrax outbreaks results in updated epidemiologic maps and will thus trace the recent

history of anthrax in afflicted zones. Furthermore it will make possible a forecast of the spreading of anthrax. A better understanding of anthrax epidemiology in South- East Tajikistan, and of its socio-economic and environmental dimensions will be achieved by the analysis of data from all range of informants • A set of well characterised anthrax species will be obtained and related to their geographical locations. The collection of local B anthracic strains will be established as prerequisite for forensic investigation methods Thematic links to the objectives of the Donor Foundation Current and future research objectives of Centre for Development of the Environment (CDE) focus on mountain development and sustainable land management, biodiversity conservation and sustainable use of natural resources in Tajikistan and Tajik Pamirs in particular (CDE, 2006). The mountainous communities, who are principal livestock keepers, maintain higher number livestock in their environments.

Therefore create higher densities of animals susceptible to anthrax. They experience lack of methodological and technical potential to prevent outbreaks and sometimes lack initiative to cooperate in disease eradication programmes. These circumstances encourage anthrax to stay endemic in those areas and occur thorough the year impacting negatively on people’s economic, social and ecosystem health. Aggressive infectious agents, such as B. anthracic make the environment not safe for humans and their livestock. They bring no less harms then for instance, chemical pollutants do Friendly environment conditions provided to B. anthracic enables it to exist almost hundred years in the ground. Thus this makes the environment not safe for humans and animals (Cherkasskiy, 2002). That suggests, one should learn continuously on pathogen environment interactions to be able control pathogen in the environment and manage the environment for its sustainable safety. One of the attempts in this work is

to develop local and external knowledge based Anthrax guidelines for focal groups aimed by CDE. Modernisation of anthrax epidemiological maps which is another attempt will be a sufficient contribution of CDE to the WHO World Anthrax Map. Support from CDE will give an unique opportunity for Tajikistan to lye down the basis (purified, well characterised local strains) for domestic development of means of disease control (vaccine). 6 Source: http://www.doksinet Time schedule Activity Literature collecting and reviewing in Uni-Hohenheim Purchasing of consumables and transporting a part of that to Tajikistan Acquainting with local anthrax frameworks in Tajikistan Studying international anthrax policies/experiences, WHO Guidelines Designing guidelines for anthrax surveillance and control for primary stakeholders Collect epidemiological data from statistics and veterinary, public health and primary stakeholders Verifying epidemiologic maps and updating. Collecting contaminated specimens

from veterinary and field sources Transporting of specimens from Tajikistan to Germany Month Jan Feb x x Mar Apr May Jun Jul Aug Sep Oct Nov x x x x x x x x x x x x x Conducting a laboratory work to obtain purified isolates and genetically characterization Presenting the preliminary version of Master thesis to the supervisor Final presentation of Master thesis and presenting research paper to CDE x x x 12. Envisaged date for the completion of study Month: November /Year: 2007 13. Communication: To facilitate the research process, communication will be ongoing between the involved parties. As soon as I had defined the topic of my thesis, I had been talking to my mentor, Dr. R Böhm and to Priv.-Doz Dr W Beyer who both consider the problem to be worth to be investigated and agreed to support research at their institute. 7 Source: http://www.doksinet In March 2006 I traveled to Tadschikistan where I communicated to Dr. Muzaffar Anoyatbekov, the Director of

Central Asian FMD Institute about this research topic and he generously provided some data about Anthrax from his institute. Also did he communicate to the Chief Veterinary Department of MA to discuss the matter of the proposed research and the possibility to establish scientific collaboration with the Institute of Environmental and Animal Hygiene of the University of Hohenheim. Recently, there was a written communication between Dr. W Beyer and Dr M Anoyatbekov. The will to share knowledge and technology in the framework of the above proposed research subject was expressed. 15. Date and signature of applicant: ------------------------------------------------------------------ 16. Date and signature of supervisor:----------------------------------------------------------------- 8 Source: http://www.doksinet References 1. G Navruzschoeva, 2005 Epidemiological monitoring and upgrading of specif prophylaxis of Anthrax, Autoreferat of the dissertation work, Moscow, P.: 3-20 2.

Roberts, S Rigvava, et al, 2002 An epidemiological study of outbreaks of Bacilus anthracic in Georgia: An INTAS project. Proceedings of 5th Internatinal Conference on Anthrax, Nice, France, 2003, P.: 66 P507 3. B Cherkasskiy, 2002 Epidemiology and prevention of Anthrax Moscow P: 13-25 4. M Akhmedova, S Bobokhodjaev, 2003 Epidemiological traits of Anthrax in Uzbekistan Proceedings of 5th Internatinal Conference on Anthrax, Nice, France, 2003, P.: 66 P506 5. M Hugh-Jones, 2001 Global Anthrax Proceedings of 5th Internatinal Conference on Anthrax, Nice, France, 2003, P.: 35 O501 6. S Clegg et al, 2005 Preparedness for Anthrax Epizootics in Wildlife Areas Conference summery, Chiredzu, Zimbabwe, October 24-28, 2005. CDC Current Issue, vol 12, No7 July 2006. 7. V M Siamudaala, et al, 1999 Ecology and epidemiology of anthrax in cattle and humans in Zambia. PMID: 16786974 (PubMed – indexed for MEDLINE) wwwmedlinecom accessed 15.122006 8. PC Turnbull, ME Hugh-Jones and O Cosivi 1999 World

Health Organisation activities on anthrax surveillance and control. Journal of Applied Microbiology 1999, 87 P: 318-320 9. M Hugh-Jones, 1999 1996-97 Global Anthrax report Journal of Applied Microbiology 1999, 87. P: 189-191 10. The Pamir Alai Programme Centre for Development of Environment(CDE), 2006 http://www.cdeunibech/Regions/Pamir Rsasp (accessed on 19122006 , 18012007) 9