Towards One Health in Kenya: Challenges in Prioritizing Zoonoses in Human and Animal Health Practice

Background: Worldwide, emerging diseases in recent decades have largely been zoonotic. We analyzed available data to estimate the magnitude of zoonotic diseases in animal and human health practice and characterized the challenges faced in prioritizing them within the Kenyan public health system.

Methods: We analyzed national human morbidity data from 2005-2007, reviewed patient records for 2007-2010 at 7 district health facilities in 5 of 8 diverse regions and surveillance records from the Central Veterinary Laboratory from 2003-2009. We collated the data and used Epi Info for analysis.

Results: Of the 11,361,574 out-patient visits made to health facilities during 2005-2007, 22,005 (0.19%) were reported as PUO (Pyrexia of unknown origin). In the health facilities visited 22,124 records were reviewed, brucellosis was the commonest zoonosis (40.15%, n=8,884) and rabies the least common (0.04%, n=9). Of the brucellosis cases, 52.7% (n=4687) were reported in Marigat where an enhanced diagnostic laboratory exists. Incidence of animal bites in the 7 districts was 3.8/1000. PUO constituted 1% (218) of morbidity. Hospitals with laboratories with better diagnostic capacity reported fewer cases of PUO. Data from the Department of Veterinary Services showed brucellosis (35%, n=779) as the most common zoonosis followed by rabies (19%), rift Valley fever (18%), bovine tuberculosis (16%), anthrax (5%). No national surveillance system for zoonotic diseases exists.

Conclusion: Although Kenya lacks a singular zoonotic diseases unit, the disease pattern across the two sectors appears somewhat similar. Zoonoses are under-diagnosed and may be underlying in majority of PUO. Enhanced laboratory diagnostic capacity and joint surveillance should be enhanced. Findings of this study have helped to guide the recently formed Zoonoses Technical Working Group in formulating ways to enhance collaboration between animal and human health professionals. 

Key words: Zoonoses, health, diagnostic capacity 

Word Count: 276 

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