Antimicrobial resistance (AMR) is a global public health threat responsible for 700,000 deaths per year worldwide. There is scientific evidence of the causal relationship between antimicrobial use ...(AMU) along the food chain and AMR. Improving AMU in livestock is therefore a key component in the fight against AMR. To improve AMU in livestock, there is no one-size-fits-all solution and strategies must be context-adapted and socially acceptable for actors in order to increase AMU sustainability. AMU decision-making is based on an interdependent set of economic, behavioral, ethical, and cultural factors that need to be assessed to advise on the potential impacts of measures. We hypothesized that a participatory strategic planning approach may increase the plausibility and the efficacy of the strategies formulated by facilitating the dialogue between actors of diverse backgrounds, stimulating innovative thinking and constant considerations of contextual factors, actors and impacts. We adapted and applied the ImpresS ex ante approach (IMPact in reSearch in the South, https://impress-impact-recherche.cirad.fr/) within a Living Lab engaging actors from the French pig and poultry sectors in co-creation of innovative strategies towards improved AMU. We conducted semi-structured interviews and participatory workshops between April 2021 and March 2022. The results describe 1) an initial diagnosis of the current AMU situation in the pig and poultry sectors in France; 2) a common vision of the future to which participants would like to contribute through the intervention; 3) an identification of the current problems opposed to this vision of the future; 4) a defined scope of the intervention; 5) a typology of actors protagonist or impacted by those issues and 6) outcome maps to solve a priority problem related to indicators and monitoring. This study provides recommendations for decision-makers on plausible and innovative strategies to sustainably improve AMU in pig and poultry sectors in France and evidence of the benefits of participatory strategic planning approaches.
Although currently available data indicate that Africa has the lowest usage of antimicrobials in animals in the world (adjusted by animal biomass), data show a high prevalence of antimicrobial ...resistance in foodborne pathogens isolated from animals and animal products. Apart from the lack of solid data on antimicrobial use in many countries in Africa, different hypotheses could explain this situation. Qualitative interviews of farmers show a lack of knowledge and uninformed use of antimicrobials. Considering the development of animal farming to meet an increasing demand for proteins, this deficiency represents a serious public health issue. We advocate for policies that consider the specific challenges faced by family farmers in Africa, to simultaneously improve access to veterinary drugs while strengthening the regulation of their use. We propose a global approach targeting the agri-food system, offering innovative social and technical interventions on antimicrobial usage, adapted to family farmers.
Understanding where and how fast an infectious disease will spread during an epidemic is critical for its control. However, the task is a challenging one as numerous factors may interact and drive ...the spread of a disease, specifically when vector-borne diseases are involved. We advocate the use of simultaneous autoregressive models to identify environmental features that significantly impact the velocity of disease spread. We illustrate this approach by exploring several environmental factors influencing the velocity of bluetongue (BT) spread in France during the 2007-2008 epizootic wave to determine which ones were the most important drivers. We used velocities of BT spread estimated in 4,495 municipalities and tested sixteen covariates defining five thematic groups of related variables: elevation, meteorological-related variables, landscape-related variables, host availability, and vaccination. We found that ecological factors associated with vector abundance and activity (elevation and meteorological-related variables), as well as with host availability, were important drivers of the spread of the disease. Specifically, the disease spread more slowly in areas with high elevation and when heavy rainfall associated with extreme temperature events occurred one or two months prior to the first clinical case. Moreover, the density of dairy cattle was correlated negatively with the velocity of BT spread. These findings add substantially to our understanding of BT spread in a temperate climate. Finally, the approach presented in this paper can be used with other infectious diseases, and provides a powerful tool to identify environmental features driving the velocity of disease spread.
A matched case-control study (95 cases and 220 controls) was designed to study risk factors for atypical scrapie in sheep in France. We analyzed contacts with animals from other flocks, lambing and ...feeding practices, and exposure to toxic substances. Data on the prnp genotype were collected for some case and control animals and included in a complementary analysis. Sheep dairy farms had a higher risk for scrapie (odds ratio OR 15.1, 95% confidence interval CI 3.3-69.7). Lower risk was associated with organic farms (OR 0.15, 95% CI 0.02-1.26), feeding corn silage (OR 0.16, 95% CI 0.05-0.53), and feeding vitamin and mineral supplements (OR 0.6, 95% CI 0.32-1.14). Genetic effects were quantitatively important but only marginally changed estimates of other variables. We did not find any risk factor associated with an infectious origin of scrapie. Atypical scrapie could be a spontaneous disease influenced by genetic and metabolic factors.
Reducing antimicrobial use (AMU) on farms is key for controlling the rise of resistant bacteria that have the potential capacity to infect humans via direct animal contact or via the food chain or ...the environment. To reduce AMU, antimicrobials must be used in a prudent and rational manner. Extensive efforts have been made recently to identify the cognitive and behavioral barriers to the appropriate use of antimicrobials by various livestock sector stakeholders. However, most studies carried out thus far have only partly captured the dynamic and systemic dimension of the processes involved in changes of practices related to AMU on farms. To shed light on the transition pathways implemented to reduce AMU, a qualitative study was conducted in France based on 28 semi-structured interviews with farmers, technicians and veterinarians from the free-range broiler production sector. Based on the thematic analysis of verbatims, we identified technical improvements which are key contributors to reduced AMU. We also highlighted some gaps in knowledge regarding AMU and antimicrobial resistance. We found that, rather than individual motivations alone, the extent to which farmers are embedded in collective organizations is decisive for changes in practices, and downstream operators (distributors and slaughterers) play a key role in the beginning of AMU transition pathways. As a result, we show that change in AMU requires a global rethinking of the overall socio-technical system rather than modifications of a single element in a farming system. Our results also highlight that transition pathways toward reduced AMU cannot just rely on trigger events, but also involves medium or long-term processes, with actors' experiences and practices being modified on an incremental basis over time. Our study sheds light on the need for multi and trans-disciplinary research involving the social sciences to analyze interactions between stakeholders and the collective actions implemented to tackle the challenge of AMU reduction.
We performed a simulation study to evaluate the performances of an anomaly detection algorithm considered in the frame of an automated surveillance system of cattle mortality. The method consisted in ...a combination of temporal regression and spatial cluster detection which allows identifying, for a given week, clusters of spatial units showing an excess of deaths in comparison with their own historical fluctuations. First, we simulated 1,000 outbreaks of a disease causing extra deaths in the French cattle population (about 200,000 herds and 20 million cattle) according to a model mimicking the spreading patterns of an infectious disease and injected these disease-related extra deaths in an authentic mortality dataset, spanning from January 2005 to January 2010. Second, we applied our algorithm on each of the 1,000 semi-synthetic datasets to identify clusters of spatial units showing an excess of deaths considering their own historical fluctuations. Third, we verified if the clusters identified by the algorithm did contain simulated extra deaths in order to evaluate the ability of the algorithm to identify unusual mortality clusters caused by an outbreak. Among the 1,000 simulations, the median duration of simulated outbreaks was 8 weeks, with a median number of 5,627 simulated deaths and 441 infected herds. Within the 12-week trial period, 73% of the simulated outbreaks were detected, with a median timeliness of 1 week, and a mean of 1.4 weeks. The proportion of outbreak weeks flagged by an alarm was 61% (i.e. sensitivity) whereas one in three alarms was a true alarm (i.e. positive predictive value). The performances of the detection algorithm were evaluated for alternative combination of epidemiologic parameters. The results of our study confirmed that in certain conditions automated algorithms could help identifying abnormal cattle mortality increases possibly related to unidentified health events.
Vaccination is one of the most efficient ways to control the spread of infectious diseases. Simulations are now widely used to assess how vaccination can limit disease spread as well as mitigate ...morbidity or mortality in susceptible populations. However, field studies investigating how much vaccines decrease the velocity of epizootic wave-fronts during outbreaks are rare. This study aimed at investigating the effect of vaccination on the propagation of bluetongue, a vector-borne disease of ruminants. We used data from the 2008 bluetongue virus serotype 1 (BTV-1) epizootic of southwest France. As the virus was newly introduced in this area, natural immunity of livestock was absent. This allowed determination of the role of vaccination in changing the velocity of bluetongue spread while accounting for environmental factors that possibly influenced it. The average estimated velocity across the country despite restriction on animal movements was 5.4 km/day, which is very similar to the velocity of spread of the bluetongue virus serotype 8 epizootic in France also estimated in a context of restrictions on animal movements. Vaccination significantly reduced the propagation velocity of BTV-1. In comparison to municipalities with no vaccine coverage, the velocity of BTV-1 spread decreased by 1.7 km/day in municipalities with immunized animals. For the first time, the effect of vaccination has been quantified using data from a real epizootic whilst accounting for environmental factors known to modify the velocity of bluetongue spread. Our findings emphasize the importance of vaccination in limiting disease spread across natural landscape. Finally, environmental factors, specifically those related to vector abundance and activity, were found to be good predictors of the velocity of BTV-1 spread, indicating that these variables need to be adequately accounted for when evaluating the role of vaccination on bluetongue spread.
Although the poultry sector accounts for a major portion of global antimicrobial consumption, few studies have explored the factors which influence antimicrobial use (AMU) in poultry farms in Europe. ...We performed a matched case-control study in traditional free-range broiler farms in France during 2016 to evaluate the effect of technical factors and farmers' perceptions of health problems on the probability of AMU. In total, 52 cases (defined as flocks treated with antimicrobials when chickens were between 1 and 42 days old), were included. Another 208 controls (untreated flocks the same ages as the case flocks), were randomly selected and paired with a matching case (same farmer organization and placement date). On-farm questionnaires were administered. Multivariable logistic regression modeling was conducted; seven variables were significant in the final model.
Two factors were associated with a lower probability of AMU: the use of chicken paper topped with starter feed (OR = 0.3; 95% CI = 0.1; 0.9) and the use of herbal drugs as a prophylaxis (OR = 0.1; 95% CI = 0.01; 0.5). A higher probability of AMU was associated with farmers perceiving the cumulative mortality of chicks between 1 and 10 days old as normal (OR = 10.1; 95% CI = 1.7; 59) or high (OR = 58.7; 95% CI = 9.6; 372.3). A higher probability of AMU also was associated with farmers detecting a health problem (OR = 12.5, 95% CI = 4.2; 36.9) and phone calls between farmers and their technicians (OR = 5.9; 95% CI = 2.3; 14.8) when chicks are between 11 to 42 days old. Two additional factors (litter thickness and cleaning/disinfecting) were significant and highlighted the importance of technical factors such as biosecurity.
Our results suggest that to reduce AMU, technical training should be provided to farmers to improve how farms are monitored and to reinforce preventive health measures. Training also should address how farmers assess warning criteria like daily mortality rates, which when overestimated often lead to antimicrobial treatment.