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Climate Change Early Warning Systems for Rift Valley Fever Pandemic Preparedness in Kenya Nanyingi M O Department of Public Health, Pharmacology and Toxicology University of Nairobi KENYA. Climate Change Impacts in Kenya.
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Climate Change Early Warning Systems for Rift Valley Fever Pandemic Preparedness in Kenya Nanyingi M O Department of Public Health, Pharmacology and Toxicology University of NairobiKENYA World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25,2012
Climate Change Impacts in Kenya In 2006 and 2007, PH Burden of RVF OB resulted in 3.4 DALYs per 1000 people and household costs of about Ksh 10,000 (USD120) 3%GDP loss $500M/(2012) $1-2 B(2030) World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25,2012
Disease Early Warning Systems (DEWS) MEWS (MODIS_NDVI) HEALTH MAPPER Are these tools available universally and utilized adequately? World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
RVF Contingency plans for EWS in Kenya (ongoing) • Linkage with communities to monitor climatic parameters. • Precipitation ,flooding and mapping of “dambos” • Remote sensing and GIS data(NDVI of 0.43-0.45/ SST by 0.5 degrees ) epidemic indicative • Community-Based Early Warning System (CB-LEWS) • DVS trains communities to capture data relevant for RVF early warning. • Monitoring of vector Dynamics and virus activity in sentinel herds? • Farmer and public awareness programmes by Veterinary Communications Officer. • Community radios ,flyers and mobile phones for preparedness. World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Stakeholders in Climate Sensitive Diseases Government Veterinary ,Public Health, Agriculture,Met ONE HEALTH COORDINATION Universities,Research Institutions Vulnerable Communities • CAPACITY BUILDING • Risk Assessment • Lab Diagnosis • Information MS • Simulation Exercise • DISEASE CONTROL • Community Sentinel Surveillance • Vaccinations and Vector Control • COMMUNICATION • System Appraisal strategy • Participatory message devt (FGD) • Media Engagement(Radio, TV) Early Warning Systems World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Research: RVF Spatiotemporal Epidemiology • Participatory Epidemiology: Rural appraisal and Community EWS to RVF investigated. • Sero-monitoring of sentinel herds and Geographical risk mapping of RVF hotspots? • Trans-boundary Surveillance for secondary foci(Neighboring country) • Disease burden Analysis and predictive modeling • Decision support tools for community utilization(Risk maps, brochures, radio and video clips) World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Community Involvement • Disease surveillance Committees (Animal health workers +Livestock keepers + Veterinary /Public health officers) • Community mapping of watering Points/Dams or “Dambos” • Training of trainers(TOT) on EWS • Information feedback mechanisms ( Schools, churches, village meetings) • Tran-sboundary security committees World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
RVF Monitoring and Surveillance -Community Model e-surveillance Aanansen et al., 2009, Madder et al., 2012 • Community sensitization/awareness by Syndromic surveillance (Mobile phones) • Dissemination of Information through community vernacular radio,SMS World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Communication tools : Risk Maps of RVF in Kenya Bett et al.,2012 • Is there Geographical restriction of the Diseases? • What other factors are involved in endemicity of RVF? World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Further secondary data analysis for RVF prediction • Precipitation and Temperature from the Kenya Meteorological Department/ECMWF for time series analysis (2000-2011) • Sero-prevalence and inter-epidemic estimates of RVF from the Department of Veterinary Services. • Disease burden analysis using demographics from Human National Census • Vegetative Index (NDVI) and Soil type cover for suitability of vector analysis. • Process based geographical risk modeling and Linear regression analysis for RVF distribution World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Outbreak Maps of RVF in Kenya –(1912-2010) • Response can be geographically targeted. • Vaccine allocation and distribution is site specific(cost saving mechanism) • Secondary foci of outbreaks in semi-urban locations. • Controlled Human and Animal migration to curb the spread of climate sensitive diseases • Post Vaccination sero-monitoring( AVID) Bett et al.,2012 World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Climate EWS Caveats in Kenya • Lack of capacity and expertise to contextualize climate change sensitive disease predictions and scenarios. • Dysfunctional communication channels (Technological inadequacies in rural communities) • Transboundary armed conflicts (Pastoral cattle rustling) • Financial Constraints in Climate Change Research(Parsimony??) • Ethno-Religious Barriers • Ineffective government policies on climate sensitive Diseases • Lack of efficient infrastructure(roads, electricity) World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Beneficiaries of Climate Early Risk Assessment • Sustainable planning and decision making tools to support the development of appropriate climate change adaptation and mitigation policies. • Simulation exercises to test response to RVF epizootic and strengthen working between veterinary, medical, and entomological sectors. World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Contributions to EWS in Kenya: Stakeholders Capacity and Networks • Zoonoses Working Group has been established (One Health concept).-CDC • Linking expert institutions through global networks within both the animal and health sectors • Improvements in governance, infrastructure and capacity building will also prove valuable to secure the livelihoods of vulnerable populations. • Participatory approaches : Farmer Field Schools and livestock owners’ training on climate change for zoonoses preparedness and prevention. • Improved surveillance, early detection and timely diagnosis, transparency of animal disease information • Rapid response to outbreaks as well as the potential use of the network approach in providing data for studies related to climate sensitive diseases. World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012
Acknowledgements Data and Financial Support Contributing Authors • Bett B, International Livestock Research Institute, Kenya • Thumbi SM, University of Edinburgh, UK Project Advisors • Kiama SG, Wangari Maathai Institute, University of Nairobi • Muchemi GM, Department of Public Health, Pharmacology and Toxicology University of Nairobi World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012