Abstract
BackgroundEfficient A(H5N1) control is unlikely to be based on epidemiological data alone. Such control depends on a thorough understanding and appreciation of the interconnectedness of epidemiological, social, and economic factors that contribute to A(H5N1) vulnerability. To date, the control of A(H5N1) in Egypt has been challenging. The disease has been endemic for more than 10 years with a dramatic increase in human cases between December 2014 and March 2015. Part of the problem has been a lack of understanding of the inter-play of drivers, conditions and motives that influence preventive behaviours at the household level.MethodsTo address this issue, the authors developed a Composite Risk Index (CRI) to inform decision-makers of critical epidemiological, livelihood, food security and risk perception factors that were found to contribute to A(H5N1) vulnerability at the community level. The CRI consists of seven constructs that were individually scored for each community. The seven constructs included poultry sales, previous flock exposure to A(H5N1), human risk probability, sense of control over the disease, preventative actions taken, level of household food insecurity and community norms toward certain handling and disposal practices. One hundred forty female poultry keepers across four governorates were interviewed in 2010 using a mix of random and purposive sampling techniques. A mixed method approach underpinned the analysis. The study used wealth ranking in order to help decision-makers in understanding the specific constraints of different wealth groups and aid better targeting of A(H5N1) control and prevention strategies.ResultsPoverty, widowhood and lack of education were among the factors associated with high risk scores. CRI scores in those villages where awareness raising had taken place were not significantly different compared to those villages where awareness raising had not taken place.ConclusionsThe aim of the tool is to enable targeting those communities that are likely to be highly vulnerable to A(H5N1) outbreaks and where control and awareness-raising efforts are expected to be most effective. In this manner, policy makers and practitioners will be able to better allocate limited resources to those communities most vulnerable to the negative impact of A(H5N1).
Highlights
Efficient A(H5N1) control is unlikely to be based on epidemiological data alone
The sample frame The Composite Risk Index (CRI) was underpinned by data from 140 household interviews and 24 group discussions among female poultry keepers from lower socio-economic strata residing across four governorates of Egypt: Fayoum, Assuit, Menia and Sohag
An One-way ANOVA test indicated that these differences were not statistically significant, p = 0.155, the findings do show a trend of higher vulnerability to A(H5N1) flock infection among widowed or divorced women with little or no education or agricultural land
Summary
Efficient A(H5N1) control is unlikely to be based on epidemiological data alone. Such control depends on a thorough understanding and appreciation of the interconnectedness of epidemiological, social, and economic factors that contribute to A(H5N1) vulnerability. Poultry meat is the most consumed animal protein source, it supplies roughly 53% of daily protein intake compared to bovine, mutton and goat meat [5, 7]. This share is likely higher among the poor as poultry meat is relatively cheap compared to other meats. A flock of 73 birds (mixed species) provides an average annual net income of approximately US $397 [6]. This is significantly more than a government widower’s pension of approximately US $140 annually
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