Use of lay vaccinators in animal vaccination programmes: A scoping review

Background The human resource gap in veterinary sectors, particularly in low-income countries, imposes limitations on the delivery of animal healthcare in hard-to-reach populations. Lay animal health workers have been deployed in these settings to fill the gap though there are mixed views about the benefits of doing this and whether they can deliver services safely. We mapped evidence on the nature and extent of roles assigned to lay animal vaccinators, and identified lessons useful for their future deployment. Methodology/Principal findings Following the PRISMA Extension for Scoping Reviews guidelines, we searched seven bibliographic databases for articles published between 1980 and 2021, with the search terms lay OR community-based OR volunteer AND "animal health worker" OR vaccinator*, and applied an a priori exclusion criteria to select studies. From 30 identified studies, lay vaccinators were used by non-government developmental (n = 12, 40%), research (n = 10, 33%) and government (n = 5, 17%) programmes to vaccinate domestic animals. The main reason for using lay vaccinators was to provide access to animal vaccination in the absence of professional veterinarians (n = 12, 40%). Reported positive outcomes of programmes included increased flock and herd sizes and farmer knowledge of best practice (n = 13, 43%); decreased disease transmission, outbreaks and mortality (n = 11, 37%); higher vaccination coverage (10, 33%); non-inferior seroconversion and birth rates among vaccinated herds (n = 3, 10%). The most frequently reported facilitating factor of lay vaccinator programmes was community participation (n = 14, 47%), whilst opposition from professional veterinarians (n = 8, 27%), stakeholders seeking financial gains to detriment of programmes goals (n = 8, 27%) and programming issues (n = 8, 27%) were the most frequently reported barriers. No study reported on cost-effectiveness and we found no record from a low and middle-income country of lay vaccinator programmes being integrated into national veterinary services. Conclusion Although the majority of included studies reported more benefits and positive perceptions of lay vaccinator programmes than problems and challenges, regularization will ensure the programmes can be designed and implemented to meet the needs of all stakeholders.

Evaluation of the feasibility and sustainability of the joint human and animal vaccination and its integration to the public health system in the Danamadji health district, Chad

Background One Health approaches such as the Joint human and animal vaccination programmes (JHAVP) are shown to be feasible and to increase health care access to hard-to-reach communities such as mobile pastoralists. However, the financial sustainability and the integration into the public health systems at the district level of such programmes are still challenging. The main objective of the present study was to give insight to the feasibility and financial sustainability of JHAVP integrated as part of the public health system in Chad. Methods We conducted a mixed methods study using semi-structured key informant interviews, focus group discussions and budget impact analysis. Strengths, weaknesses, opportunities, and threats were analysed regarding the feasibility and sustainability of the implementation of JHAVP in Danamadji health district in Chad. Feasibility was further analysed using three dimensions: acceptability, implementation, and adaptation. Financial sustainability of JHAVP was analysed through budget impact analysis of implementation of the programme at district level. Results The acceptability of this approach was regularly assessed by immunization campaign teams through evaluation meetings which included pastoralists. The presence of authorities in the meetings and workshops of the programme had an incentive effect since they represent a mark of consideration these populations generally declared to be lacking. The coordination between the public health and veterinary services at central and decentralized level seemed to be a key element in the success of the implementation of the programme. Regarding financial sustainability, the total incremental budget impact was 27% slightly decreasing to 26% after five years, which accounts for up to one third of the total budget of the district health office. Also, given that most of the costs for each round are recurrent costs, efficiency gains from scale effects over time are limited. Conclusion Based on these findings, we conclude that for JHAVP to be routinely delivered at the district health level, a considerable increase in financial resources would be required. The district could benefit from joint immunization to maintain contact with mobile pastoralists to promote the use of available immunization services at district level.

Occupational infection to Brucella abortus B19 vaccine despite antimicrobial prophylaxis

The authors report the case of a veterinarian who acquired brucellosis infection by accidental exposure to Brucella abortus vaccine (BRUCEL-VET B19) while performing animal vaccination. Antibiotic prophylaxis with doxycycline and rifampin for six weeks was indicated, but rifampin was discontinued after 10 days due to gastrointestinal intolerance. Despite prophylaxis, the patient seroconverted after 30 days, but was asymptomatic and did not require additional antibiotic therapy. Post-exposure prophylaxis of Brucella is not free from side effects and asymptomatic seroconversion can occur despite prophylaxis.

Evaluation of the Feasibility and Sustainability of the Joint Human and Animal Vaccination and Its Integration to the Public Health System in the Danamadji Health District, Chad

BackgroundOne Health approaches such as the Joint human and animal vaccination programmes (JHAVP) are shown to be feasible and to increase health care access to hard-to-reach communities such as mobile pastoralists. However, the financial sustainability and the integration into the public health systems at the district level of such programmes are still challenging. The main objective of the present study was to give insight to the feasibility and financial sustainability of JHAVP integrated as part of the public health system in Chad.MethodsWe conducted a mixed methods study using semi-structured key informant interviews, focus group discussions and budget impact analysis. Strengths, weaknesses, opportunities, and threats were analysed regarding the feasibility and sustainability of the implementation of JHAVP in Danamadji health district in Chad. Feasibility was further analysed using three dimensions: acceptability, implementation, and adaptation. Financial sustainability of JHAVP was analysed through budget impact analysis of implementation of the programme at district level.ResultsThe acceptability of this approach was regularly assessed by immunization campaign teams through evaluation meetings which included pastoralists. The presence of authorities in the meetings and workshops of the programme had an incentive effect since they represent a mark of consideration these populations generally declared to be lacking. The coordination between the public health and veterinary services at central and decentralized level seemed to be a key element in the success of the implementation of the programme. Regarding financial sustainability, the total incremental budget impact was 27% slightly decreasing to 26% after five years, which accounts for up to one third of the total budget of the district health office. Also, given that most of the costs for each round are recurrent costs, efficiency gains from scale effects over time are limited.ConclusionBased on these findings, we conclude that for JHAVP to be routinely delivered at the district health level, a considerable increase in financial resources would be required. The district could benefit from joint immunization to maintain contact with mobile pastoralists to promote the use of available immunization services at district level.

Design and validation of brucellosis prevention questionnaire focused on animal vaccination

Background The inadequate awareness of livestock breeders on brucellosis transmission, as well as their improper knowledge about preventing brucellosis is considered as one of the important barriers to animal vaccination against brucellosis. The present study aimed to design and validate a brucellosis prevention questionnaire focused on animal vaccination. The valid questionnaire was used to design, implement, and evaluate an interventional training program. Method A brucellosis prevention questionnaire (BPQ) was developed in the exploratory psychometric study. In addition, face-to-face interviews were conducted to formulate its initial items, the results of which were merged with those obtained from literature review. Further, the face, content, and construct validity of the questionnaire were assessed by co-operating livestock breeders, veterinarians, and health educationists. The impact score (IS), and content validity ratio (CVR) and index (CVI) of the items were calculated, and the construct validity of the questionnaire was evaluated through factor analysis. Furthermore, the reliability of the results related to the questionnaire was measured by using Cronbach’s alpha, intra-class correlation coefficient (ICC), and composite reliability, as well as the standard error of measurement (SEM). Results The questionnaire was finalized with 53 items and its validity was confirmed by CVI (0.90), CVR (0.74), and IS (4.30). Additionally, the items were loaded into three constructs of awareness, attitude, and practice. Further, the predictive power of awareness, attitude, and practice was determined as 43.43, 15.81, and 15.78%, respectively. Furthermore, the fitness of the proposed model among the constructs was confirmed by the root mean square error of approximation (RMSEA) < 0.08, as well as normed chi-square (× 2/ df) < 5.0, comparative fit index (CFI) ≥ 0.90, and Tucker- Lewis index (TLI) ≥ 0.9. Conclusion The brucellosis prevention questionnaire represented acceptable psychometric properties. The factors influencing the preventive behavior of livestock breeders can be identified by applying the questionnaire, and co-operating veterinarians and educational planners.

Design and validation of Brucellosis prevention questionnaire focused on animal vaccination

Background: The inadequate awareness of livestock breeders on brucellosis transmission, as well as their improper knowledge about preventing brucellosis is considered as one of the important barriers to animal vaccination against brucellosis. The present study aimed to design and validate a brucellosis prevention questionnaire focused on animal vaccination. The valid questionnaire was used to design, implement, and evaluate an interventional training program.Method: A brucellosis prevention questionnaire (BPQ) was developed in the exploratory psychometric study. In addition, face-to-face interviews were conducted to formulate its initial items, the results of which were merged with those obtained from literature review. Further, the face, content, and construct validity of the questionnaire were assessed by co-operating livestock breeders, veterinarians, and health educationists. The impact score (IS), and content validity ratio (CVR) and index (CVI) of the items were calculated, and the construct validity of the questionnaire was evaluated through factor analysis. Furthermore, the reliability of the results related to the questionnaire was measured by using Cronbach’s alpha, intra-class correlation coefficient (ICC), and composite reliability, as well as the standard error of measurement (SEM).Results: The questionnaire was finalized with 53 items and its validity was confirmed by CVI (0.90), CVR (0.74), and IS (4.30). Additionally, the items were loaded into three constructs of awareness, attitude, and practice. Further, the predictive power of awareness, attitude, and practice was determined as 43.43, 15.81, and 15.78%, respectively. Furthermore, the fitness of the proposed model among the constructs was confirmed by the root mean square error of approximation (RMSEA) <0.08, as well as normed chi-square (x 2/ df) < 5.0, comparative fit index (CFI) ≥ 0.90, and Tucker- Lewis index (TLI) ≥ 0.9. Conclusion: The brucellosis prevention questionnaire represented acceptable psychometric properties. The factors influencing the preventive behavior of livestock breeders can be identified by applying the questionnaire, and co-operating veterinarians and educational planners.

Assessment of Seroprevalence and the Risk Factors of Sheep Brucellosis in Basrah (Southern Iraq): A Challenge to Prospectively Control Brucellosis

Brucellosis is one of the most important foodborne infectious diseases distributed widely in low- and middle-income countries. The current study was carried out to investigate the prevalence and risk factors that influence the distribution of Brucella in sheep. A structured questionnaire was prepared and introduced to a total of 60 resident owners from five counties, and 400 sheep blood samples were randomly collected from the selected herds. The sera of isolated sheep were tested for Brucella spp. using the Rose Bengal Test (RBT). A univariable and multivariable logistic regression analysis was used to evaluate the risk factors linked to animal management and husbandry practices at the farm level. The overall prevalence estimated for brucellosis was 31% (95% confidence interval [Cl]: 26.5–35.8). The odds of seroprevalence in sheep >1 year were significantly higher than those in sheep ≤1 year (odds ratio [OR]: 2.2, 95% Cl: 1.41–3.44). The logistic regression outcomes revealed that two variables related to the management and practices at the farm level were significantly associated with the seroprevalence of brucellosis. These variables were sheep sheep grazing with other flocks (OR: 5.8, 95 Cl% Cl: 1.53–22.67) and the practice of lending ram among sheep owners (OR: 9.3, 95% Cl: 1.05–83.82). Unconfined domesticated dogs, improper handling of aborted ewes, introduction of new animals in a herd, (purchased), and lack of knowledge about brucellosis among owners were underlined to be further important factors that could influence the spread of brucellosis. This study concluded that brucellosis is an endemic disease in Basrah, and the animal vaccination control program with an integrated health education program for sheep owners are obligatory elements of the prevention measures needed to be established to minimize the risk of brucellosis in Basrah.

Design and validation of Brucellosis prevention questionnaire focused on animal vaccination

Background: Inadequate awareness of livestock breeders concerning the transmission of brucellosis and their improper knowledge with regard to the prevention of brucellosis are among important barriers to vaccinate animals against brucellosis. The aim of this study is design and validation of a Brucellosis prevention questionnaire focused on animal vaccination. This valid questionnaire is used to design, implement and evaluate an interventional training program.Methods: In this exploratory psychometric study, a brucellosis prevention questionnaire (BPQ) was developed. Face-to-face interviews were conducted to develop the initial items of BPQ. The findings from interviews were merged with those of literature review. Face, content and construct validity of BPQ were assessed by participation of livestock breeders, veterinarians and health educationists. Impact Score (IS), Content Validity Ratio (CVR) and Content Validity Index (CVI) of the items were calculated. Construct validity of BPQ was evaluated through factor analysis. Cronbach’s alpha, Intra-class correlation coefficient (ICC), composite reliability and standard error of measurement (SEM) were measured to assess the reliability of the findings by BPQ.Results: BPQ was finalized by 53 items and its validity was confirmed by CVI, CVR, and IS of 0.90, 0.74 and 4.30, respectively. The items were loaded into three constructs of awareness, attitude and practice. The predictive power of the awareness, attitude and practice was 43.43%, 15.81% and 15.78%, respectively. The fitness of the proposed model among those constructs was confirmed by Root Mean Square Error of Approximation (RMSEA) <0.08, Normed chi-square (x 2/ df) < 5.0, Comparative Fit Index (CFI) ≥ 0.90, Tucker- Lewis Index (TLI) ≥ 0.9. Conclusion: The brucellosis prevention questionnaire has acceptable psychometric properties. Applying BPQ, veterinarians and educational planners can identify factors influencing preventive behavior of livestock breeders.

Design and validation of Brucellosis prevention questionnaire focused on animal vaccination

Background: Inadequate awareness of livestock breeders concerning the transmission of brucellosis and their improper knowledge with regard to the prevention of brucellosis are among important barriers to vaccinate animals against brucellosis. The aim of this study is design and validation of a Brucellosis prevention questionnaire focused on animal vaccination . This valid questionnaire is used to design, implement and evaluate an interventional training program. Methods: In this exploratory psychometric study, a brucellosis prevention questionnaire (BPQ) was developed. Face-to-face interviews were conducted to develop the initial items of BPQ. The findings from interviews were merged with those of literature review. Face, content and construct validity of BPQ were assessed by participation of livestock breeders, veterinarians and health educationists. Impact Score (IS), Content Validity Ratio (CVR) and Content Validity Index (CVI) of the items were calculated. Construct validity of BPQ was evaluated through factor analysis. Cronbach’s alpha, Intra-class correlation coefficient (ICC), composite reliability and standard error of measurement (SEM) were measured to assess the reliability of the findings by BPQ. Results: BPQ was finalized by 53 items and its validity was confirmed by CVI, CVR, and IS of 0.90, 0.74 and 4.30, respectively. The items were loaded into three constructs of awareness, attitude and practice. The predictive power of the awareness, attitude and practice was 43.43%, 15.81% and 15.78%, respectively. The fitness of the proposed model among those constructs was confirmed by Root Mean Square Error of Approximation (RMSEA) <0.08, Normed chi-square (x 2/ df) < 5.0, Comparative Fit Index (CFI) ≥ 0.90, Tucker- Lewis Index (TLI) ≥ 0.9. Conclusion: The brucellosis prevention questionnaire has acceptable psychometric properties. Applying BPQ, veterinarians and educational planners can identify factors influencing preventive behavior of livestock breeders.

Michael Joseph Day

A teacher, mentor, coworker, volunteer and friend who worked tirelessly to transform companion animal vaccination practice around the world and to champion companion animals within One Health.