As part of the animal health component of the Pacific Regional Influenza and Pandemic Preparedness Project (PRIPPP), a team of animal health specialists from the Secretariat of the Pacific Community (SPC) conducted training on animal disease surveillance and field diagnostic techniques in Samoa on 12–17 July, and more recently in Vanuatu on 9–13 August. The Samoa training was attended by 20 participants from Samoa and three from Tokelau. The trainees (eight of whom were female) were mainly paravets and field livestock officers or equivalent. Dr Sina Moala, the Ministry of Agriculture Veterinarian was responsible for the local organisation and coordination of the programme in Samoa. Sixteen trainees, including two females, participated in the Vanuatu training. They were mainly trained paravets, quarantine officers, meat inspectors, agriculture extension officers, agriculture teachers and livestock officers from secondary and agriculture institutes throughout Vanuatu. Mr Nambo Moses, the Senior Livestock Officer, was responsible for much of the local organisation and coordination of the training there.
The SPC trainers included of Dr Kenneth Cokanasiga, SPC Animal Health Adviser and the team leader; Dr Ilagi Puana, Course Coordinator/Instructor and PRIPPP Regional Veterinarian; and Andrew Tukana, PRIPPP Animal Health Technical Officer. The local trainers who assisted the SPC team included Dr Sina Moala and Dr Roger Philips, the Livestock and Quarantine Department Veterinarian in Vanuatu.
The purpose of these training sessions was two-fold: to trial the newly developed draft Animal Disease Surveillance and Field Diagnostic Training Manual for Pacific Island Countries and Territories and, equally importantly, to train the paravet or equivalent field officers from the ministries of agriculture and line agencies in these countries in basic epidemiology principles, how to use these principles in carrying out epidemiological investigation of potential disease incursions, and how to apply epidemiological control strategy in disease control programmes with a special emphasis on active early warning disease surveillance systems for transboundary animal diseases. The training was also designed to introduce to the trainees the concept of syndromic surveillance (surveillance based on disease symptoms) as an alternative to conventional active surveillance, which involves collection of representative specimens from selected animals.
The rationale for the training and the training manual
The method of collecting information on livestock diseases that is currently used in most Pacific Island countries and territories (PICTs) is a passive disease reporting system. When the owner of an animal notices it is sick, the owner may contact the livestock authorities, who will carry out a disease investigation and may then either submit a disease report or send a specimen to a diagnostic laboratory. This system is called a passive reporting or passive surveillance system because the main users of the information (the livestock services) take no action to initiate the collection of the information. The livestock owner initiates the report, and the central livestock or animal health authorities wait (passively) for the report to arrive.
The most important problem in this system is under-reporting, and the weakest link in the reporting chain is usually the livestock owner, who may not recognise the disease, or may fail to report it for other reasons. The result is that not all cases of disease are reported. Passive disease reports are not a reliable basis on which to base sound decision-making. A better alternative is provided by active surveillance, where the main users of the information (usually the animal health and livestock authorities) make active efforts to collect the information needed. The main reason for collecting the information is surveillance. The most practical way to achieve this is through the use of properly structured disease surveys. Surveys have two further advantages: they are quick to conduct, and are relatively inexpensive (compared with the cost of running an effective passive reporting system).
The role of national animal health or livestock authorities is to control animal diseases to improve the health and productivity of the nation's livestock population, and thereby, the well-being of the people. To achieve this, information is required to:
• identify what diseases exist in the country;
• determine the level and location of the diseases;
• determine the importance of different diseases;
• set priorities for the use of resources for disease control activities;
• plan, implement and monitor disease control programmes;
• respond to disease outbreaks;
• meet reporting requirements of international organisations (eg. World Organisation for Animal Health – OIE); and
• demonstrate disease status to trading partners.
One way to control disease more efficiently is to use a ‘smart’ or strategic approach. However, in order to achieve this control, it is first necessary to understand the distribution of disease in a given population and the behaviour of the disease agent(s) within a population, because each disease agent(s) will interact differently with a particular population. This is why an understanding of epidemiology is important in disease control. It is important to identify what information is needed before carrying out the actual surveys in the field. The training was designed to show trainees how to collect the appropriate and relevant information to plan, design and carry out a disease survey based on the resources available in PICTs. The emphasis in the training was on applying active surveillance as a lower cost option than the passive surveillance system that is more common in PICTs.
Following the pilot training, the manual will be further improved as an advanced regional training manual for paravets and equivalents in basic epidemiology; disease recognition; survey planning and design; disease investigation and field diagnostic techniques; and collection, handling and transportation of samples for laboratory diagnosis. When finalised (including translation into French), it is intended that this training manual be used in all PICTs. In its current format, the training manual is designed for delivery of one week of training in two components. The first component consists of a one-day session, intended for managers involved in decision-making, covering the epidemiological concepts and principles behind a good, sustainable animal health surveillance programme with respect to early warning and animal disease control strategies. The second component is a four-day session intended for paravets and equivalent field personnel who are/will be responsible for carrying out pest and disease surveillance activities in their countries. This component includes classroom sessions on syndromic surveillance concepts and disease outbreak investigation and Standard reporting procedures (Standard Operating Procedure), basic epidemiology and principles of planning and designing a field survey. The field session involves carrying out a real field survey exercise in a village or a farm situation, including field and laboratory preparation and processing of specimens. Hence, this component of training is designed largely for hands-on practical and very field oriented training. The aim is to get the trainees to be actively involved to gain knowledge and skills in planning, designing and carrying out a disease survey. The trainees also receive instruction in proper animal restraint and specimen collection techniques.
Dr Puana, who is responsible for the development of the manual and the coordination of the training, said he was very pleased with the outcome of the trainings, especially the great enthusiasm shown by the trainees. He noted that the trainees took charge of the survey planning and field activities with very little assistance from the trainers. He said that parts of the manual had been identified for further improvement, and he hope to make these improvements in the coming weeks. With the PRIPPP project ending at the end of the year, he said he planned to complete the manual, including the consultation process and editing, by end of October.
Because laboratory diagnostic capabilities are often inadequate in the region and may continue to be for some time, the surveillance manual takes into consideration the significance of field diagnostic techniques as an alternative for laboratory investigation procedures for disease incursions. Field diagnostic techniques emphasised in the manual include: (a) collection and interpretation of good case history information and applying the ‘trigger point’ concept; (b) use and proper interpretation of rapid test kits for H5N1 and Newcastle disease in poultry; (c) performing and interpreting post-mortem examinations; and (d) proper preparation, processing, handling and transportation of specimens for laboratory diagnosis.
For the purpose of this training manual initiative, it is hoped that SPC will maintain training support in the post-PRIPPP period to enable PICTs to establish an effective active surveillance capacity, in particular the larger and high risk countries that may have some resource capacity. The smaller and lesser resourced countries will no doubt continue to rely on SPC to meet their disease surveillance requirements.