Michael Mahero, DVM
DACVBM MPH MS
Nominated From: University of Minnesota
Research Site: Uganda
Research Area: Infectious Disease
Primary Mentor: Dominic Travis
Epidemiology of Common and Emerging Infectious Disease Syndromes associated with Febrile Illness of Unknown Origin
Maintenance of natural levels of biodiversity is necessary for proper ecosystem functioning and the provision of ecosystem services to humankind. Several anthropogenic factors such as destruction of pristine wildlife habitats, biodiversity loss, displacement of populations and agricultural intensification all lead to a reduction of regulatory and supporting ecosystem services; in some cases leading to escalation of infectious disease occurrence in human and animal populations. These factors may result in increased exposure and in some cases reduced resilience to infectious diseases thus increased incidence and impact of such diseases. About 335 Emerging Infectious Diseases (EID) have been identified since 1940, several rank as leading causes of mortality worldwide, with the brunt of the burden being borne by developing nations. The majority of these identified EID have a zoonotic origin; Jones et al., 2008 placed the estimated proportion of these zoonotic diseases at about 75%.
This study would help establish the distribution of such disease syndromes and their spatial relation to human, livestock and wildlife distribution, establish the capacity of the health system to pick these diseases (diagnosis) and identify the risk factors that drive the transmission these syndromes.
1. Evaluate human and animal health services – include a descriptive summary of ‘syndromes’ and capacity to effectively diagnose, potential pathogen causing organisms among malaria and typhoid negative febrile patients.
2. Map the spatial distribution of disease syndromes in relation to human, livestock and wildlife populations.
3. Identify livelihood practices that influence exposure to potential zoonotic diseases.
This preliminary work will help develop a longitudinal population based infectious disease surveillance targeting humans, livestock and wildlife. This will determine prevalence, incidence and community transmission of diseases behind some of the observed syndromes.
Communities located in border regions, which often coincide with marginal zones between protected environments and human settlements, have poorer health outcomes than the majority of the country’s population living in other rural areas. Such communities also have fragile health systems that cannot cope with the possible health challenges that arise from the dynamic interactions between humans, animals (both domestic and wild) and their environment. This is further complicated by the possibility of mobile populations due to political instability in neighboring countries/regions, given that 3% of the world’s population (n = 214 million people) has crossed international borders for various reasons. Many of these health challenges may present as febrile illness and go untreated due to misdiagnosis or failure to diagnose a root cause leading to further health complications and increased community transmission. Therefore characterizing the burden and epidemiology of such infectious disease syndromes in Africa is important for optimum resource utilization that would ensure optimal curative and preventive services and for research and development of novel strategies and interventions.