As part of national disease surveillance programmes, a system of monthly general disease reporting by district offices has always been recommended as a standard activity of government veterinary posts. In the classic system, each district or similar administrative unit was required to file a narrative report of disease occurrence and control activities for the month. With the introduction of computers and electronic databases, standardised formats that allow easy coding and entry of data are rapidly replacing narrative reports. For the most part, these reports consist of clinical and livestock owner information occasionally supported by autopsy results and microscopic examination of blood smears. As the reporting is routine and does not normally involve outreach for information collection, general disease surveillance is sometimes termed passive surveillance.
Veterinary delivery systems in the developing world are changing rapidly. The traditional government veterinary service is being reshaped into a smaller and more dynamic regulatory and epidemiological service. Curative and preventive service delivery is being devolved to private and community-based service providers. This is largely due to the greater efficiency, sustainability and the lower overall cost to the nation of such non-governmental delivery options. At the present time, it is largely the private veterinarians who are providing professional curative services where professional services are available. This is mainly in urban and intensive farming areas. Community-based service providers are assuming the lead in service provision in remote and marginalised pastoral areas. Most of these community-based systems are operating through the sponsorship of NGOs and national projects in collaboration with national veterinary services. The most common model of community-based animal health care utilises trained community members, the community animal health worker, as grass-roots service providers. These CAHWs are selected and supported by their communities. They are trained by professionals and operate under professional veterinary supervision. In the current environment of cost-efficiency and sustainable systems, many experts believe that CAHWs are an essential ingredient for viable veterinary services in remote areas. Some experimentation in the combination of private and community-based delivery systems for remote areas has taken place and more is expected in the future.
Direct contact between the public sector veterinarians and livestock or livestock owners has decreased over the last two decades due to the recurrent funding crises within the public services. The shift to private and community-based delivery systems will increase the gap. At some stage, public services will need to rely on non-governmental providers as a significant component of primary surveillance data. Fortunately, this is not a new issue. Strong models for mandatory reporting of OIE List A and B diseases by the private sector exist in many countries. Concerning community-based systems, recording and reporting systems are an integral part of most CAHW programmes. This data is routinely gathered by CAHW monitors and reported in detail within projects and organisations. In many cases, reporting of summary statistics to donor and collaborating organisations, such as the public veterinary services, is a routine part of project reporting.
Although models and information are extent, general disease reporting systems in the developing world have for the most part not incorporated the input of other service providers. This issue will need to be addressed in the near future. In regard to participatory or community-based systems, a few observations and suggestions on general disease reporting are appropriate to the subject of participatory epidemiology.
The CAHW networks consist of a number of trained CAHWs and professional monitors who are experienced in the EVK of the community. The CAHW networks are an extremely sensitive surveillance resource. As has been mentioned, livestock owners are experienced clinical diagnosticians in relation to traditional definitions of disease. Due to their training, CAHWs have built on their traditional skills. Part of the responsibility of programme monitors is to visit each CAHW at least once per month, de-brief the CAHW and examine his record book. Monitors are generally required to prepare monthly or quarterly reports that summarise the work and observations of the CAHWs.
Several authorities have identified a role for CAHWs in disease reporting and epidemiological intelligence (Schwabe, 1984; Schwabe 1980; Schwabe and Kuojok, 1981 and Sollod and Stem, 1991). It would seem appropriate for the monitors to complete standardised disease reporting formats using the information provided by the CAHWs for submission to the district offices. The district offices could then incorporate the data from the community animal health care programme into the district monthly report. The district office would probably wish to directly investigate and confirm unusual occurrences such as flare-ups of endemic disease or reports of new disease introductions, but the investigation of farmer reports is already a key task at district level.
An alternative solution or adjunct activity could be that CAHW monitors submit copies of a standardised disease reporting format specifically designed for community-based programmes to the national epidemiology office with a copy to the district office. The advantage of this option would be that a national database of livestock owner information could be built. A national epidemiologist with some exposure to community-based programmes and participatory epidemiology could then have access to data in a less filtered form. If copies of baseline appraisals of EVK and lexicons of local disease terms were provided to assist analysis, a very powerful active epidemiological surveillance tool would be added to the general surveillance programme at the national level.
Example of Report Form for use by Community Animal Workers/Animal Health Assistants
Name: ............................ District: ............................ Year: ................... Month: .....................
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Village: |
Disease/syndrome |
Species |
# Cases |
# Dead |
Main sign |
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No. cattle |
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No. sheep |
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No. goats |
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No. camels |
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No. poultry |
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Village: |
Disease/syndrome |
Species |
# Cases |
# Dead |
Main sign |
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No. cattle |
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No. sheep |
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No. goats |
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No. camels |
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No. poultry |
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