Elimination Of Disease Research Articles

The impact of demography in a model of malaria with transmission‐blocking drugs

In this paper, we develop and analyze a mathematical model for spreading malaria, including treatment with transmission‐blocking drugs (TBDs). The paper's main aim is to demonstrate the impact the chosen model for demographic growth has on the disease's transmission and the effect of its treatment with TBDs. We calculate the model's control reproduction number and equilibria and perform a global stability analysis of the disease‐free equilibrium point. The mathematical analysis reveals that, depending on the model's demography, the model can exhibit forward, backward, and even some unconventional types of bifurcation, where disease elimination can occur for both small and large values of the reproduction number. We also conduct a numerical analysis to explore the short‐time behavior of the model. A key finding is that for one type of demographic growth, the population experienced a significantly higher disease burden than the others, and when exposed to high levels of treatment with TBDs, only this population succeeded in effectively eliminating the disease within a reasonable timeframe.

Optimizing Communication on HPV Vaccination to Parents of 11- to 14-Year-Old Adolescents in France: A Discrete Choice Experiment.

With the aim to optimize communication during HPV vaccination campaigns in France, we elicited parental preferences around HPV vaccination. We conducted a single-profile discrete choice experiment (DCE) among parents of 11- to 14-year-old middle-school pupils, who completed an anonymous, self-administered, internet-based questionnaire during 2020-2021. The DCE comprised five attributes (vaccine-preventable disease, justification of optimal age, information on safety, indirect protection and coverage) of vaccination against an unnamed disease that were presented to respondents in ten choice tasks, or scenarios. We use fixed effect logit models to estimate attribute weights on theoretical vaccine acceptance, and random effect linear regression to estimate attribute coefficients on vaccine eagerness (decision and decision certainty). We estimated marginal effects of attributes on expected vaccine acceptance. Vaccination scenarios were accepted by 55.6-89.2% of the 1291 participants. The largest marginal effects on expected vaccine acceptance in the full sample arose from prevention of cancer versus genital warts (+11.3 percentage points); from a "severe side effect suspicion that was not scientifically confirmed" versus a statement about "more benefits than risks" (+8.9 percentage points), and information on 80% vaccine coverage in neighbouring countries versus on "insufficient coverage" (+4.2 percentage points). Explaining the early age of vaccination by sexual debut had a strong negative impact among French monolingual parents with lower education level (vs age-independent, OR 0.48, 95% CI 0.27-0.86), but not other socio-economic groups. After removing low-quality responses (unvaried certainty and short questionnaire completion), among serial non-demanders with children not vaccinated against HPV, only disease elimination impacted vaccine eagerness positively (coefficient 0.54, 0.06-1.02). Using DCEs to elicit parents' preferences around communication messages, notably on cancer prevention, vaccine coverage and information about vaccine safety, could help to optimize HPV vaccination promotion efforts.

Synthesizing environmental, epidemiological and vector and parasite genetic data to assist decision making for disease elimination.

We present a framework for identifying when conditions are favourable for transmission of vector-borne diseases between communities by incorporating predicted disease prevalence mapping with landscape analysis of sociological, environmental and host/parasite genetic data. We explored the relationship between environmental features and gene flow of a filarial parasite of humans, Onchocerca volvulus, and its vector, blackflies in the genus Simulium. We generated a baseline microfilarial prevalence map from point estimates from 47 locations in the ecological transition separating the savannah and forest in Ghana, where transmission of O. volvulus persists despite onchocerciasis control efforts. We generated movement suitability maps based on environmental correlates with mitochondrial population structure of 164 parasites from 15 communities and 93 vectors from only four sampling sites, and compared these to the baseline prevalence map. Parasite genetic distance between sampling locations was significantly associated with elevation (r = .793, p = .005) and soil moisture (r = .507, p = .002), while vector genetic distance was associated with soil moisture (r = .788, p = .0417) and precipitation (r = .835, p = .0417). The correlation between baseline prevalence and parasite resistance surface maps was stronger than that between prevalence and vector resistance surface maps. The centre of the study area had high prevalence and suitability for parasite and vector gene flow, potentially contributing to persistent transmission and suggesting the importance of re-evaluating transmission zone boundaries. With suitably dense sampling, this framework can help delineate transmission zones for onchocerciasis and would be translatable to other vector-borne diseases.

Nonlinear dynamics and optimal control strategies of a novel fractional-order lumpy skin disease model

Fractional order differential equations are often employed to better and accurately model several natural and physical processes with memory characteristics than the integer-order models. In this work, a proposed fractional-order model is presented to simulate one of the most dangerous viral cattle diseases. The present fractional-order Lumpy Skin Disease model considers the interactions between different compartments of cattle and virus vectors. The solution of the model is examined in terms of existence, uniqueness, positivity and boundedness. Then, the stability analysis of the different equilibrium points in the model is carried out. The basic reproduction number, R0, has been obtained too. The dependence of stability regions on the values of key parameters is demonstrated and the sensitivity of R0 to different parameters in the system is also investigated. Finally, a proposed optimal control scheme is adopted to successfully diminish the disease spread. It is found that the stability of disease-free equilibrium point is verified at small values of the infection rate of cattle caused by infected cattle or insects. In addition, the disease-free equilibrium point maintains its stability in cases where the recovery rate of cattle or the vaccination rate of cattle are increased. Moreover, the high-efficiency vaccination program helps in stabilizing the disease-free equilibrium point. Also, the fractional-order parameter is found to provide additional degree of freedom in the model to represent different scenarios of evolution for solution orbits. The optimal control parameters of the model are examined in different scenarios to limit or suppress the spread of the disease. It is demonstrated that two control parameters are sufficient to achieve the goals of disease elimination and stabilization of an infection-free steady state. Numerical simulations are verified to confirm our theoretical findings and estimations.

Citizens can help to map putative transmission sites for snail-borne diseases.

Schistosomiasis and fasciolosis are snail-borne diseases of great medical and veterinary health importance. The World Health Organization recommends complementing drug treatment with snail control and community involvement for disease elimination, but there is a general lack of snail experts and hence snail distribution data. Therefore, we adopted a citizen science approach and involved citizens in the monitoring of medically and veterinary important snail taxa. Snail data was collected weekly by 25 trained citizen scientists (CSs) at 76 sites around southern Lake Albert (Uganda) for 20 months. At each site, snails were searched for 30 minutes, sorted, target snail hosts identified to genus level, counted and data submitted through a smartphone application. The quality of this data was assessed by comparing it to monthly data collected by an 'expert' malacologist using the same sampling protocol. Generalised binomial logistic and linear mixed-effects models were used to analyse the variables for agreement between the CSs and expert. The binary agreement in presence/absence of Biomphalaria, Bulinus and Radix snails reported by the expert and CSs ranged between 70% and 86% (900 reports) with an average of 17% false negatives (sites wrongly defined as snail-free). The agreement for Biomphalaria and Radix increased with snail abundance, and false negatives decreased when the number of snails collected by citizens was aggregated per month. Site type significantly predicted binary agreement, which was lowest at lake sites (55%) and highest at spring sites (99%) with variations across genera. Similar temporal trends in snail abundance were recorded despite the expert reporting higher abundance. However, the relative abundance was consistent across site types. The match between the sites with highest Biomphalaria spp. abundance identified by CSs and expert was consistently high (~84.1%) and increased over time. Our results demonstrate the potential of citizen science to map putative schistosomiasis transmission sites. We therefore argue that this inclusive, powerful and cost-effective approach can be more sustainable than top-down monitoring and intervention campaigns.

Perceived needs of disease vector control programs: A review and synthesis of (sub)national assessments from South Asia and the Middle East.

Systems for disease vector control should be effective, efficient, and flexible to be able to tackle contemporary challenges and threats in the control and elimination of vector-borne diseases. As a priority activity towards the strengthening of vector control systems, it has been advocated that countries conduct a vector-control needs assessment. A review was carried out of the perceived needs for disease vector control programs among eleven countries and subnational states in South Asia and the Middle East. In each country or state, independent teams conducted vector control needs assessment with engagement of stakeholders. Important weaknesses were described for malaria, dengue and leishmaniases regarding vector surveillance, insecticide susceptibility testing, monitoring and evaluation of operations, entomological capacity and laboratory infrastructure. In addition, community mobilization and intersectoral collaboration showed important gaps. Countries and states expressed concern about insecticide resistance that could reduce the continued effectiveness of interventions, which demands improved monitoring. Moreover, attainment of disease elimination necessitates enhanced vector surveillance. Vector control needs assessment provided a useful planning tool for systematic strengthening of vector control systems. A limitation in conducting the vector control needs assessment was that it is time- and resource-intensive. To increase the feasibility and utility of national assessments, an abridged version of the guidance should focus on operationally relevant topics of the assessment. Similar reviews are needed in other regions with different contextual conditions.

A deterministic mathematical model for quantifiable prediction of antimalarials limiting the prevalence of multidrug-resistant malaria

The malaria’s multidrug-resistant strain in Nigeria is prevalent and it poses a significant challenge for disease elimination. The testing for resistance is available but underutilized. Therefore, we develop a mathematical model incorporating the testing as a control strategy. This allows us to make quantifiable predictions about the effects of testing utilization on the malaria prevalence. By fitting the model to data on malaria and using field data reported in the literature, important parameters associated with the disease dynamics are estimated and calculated. First, we analyze the disease-free state of the malaria model and calculate the baseline control reproduction number. Sensitivity analysis is used to investigate the influence of the parameters in curtailing the disease. Numerical simulations are used to explore the behavior of the model solutions involving testing for resistance of the strain and wild strain malaria. We found that the implementation of testing would (a) prevent the increase of malaria prevalence from 30% to 35%, (b) significantly slow down the replacement of the wild strain by the resistant strain, and (c) avert about 6% of treatment failures. We also found that increasing mosquito death rate or reducing mosquito biting rate, mosquito birth rate, transmission to or from mosquitoes would contribute most significantly to the reduction of malaria prevalence in the community. In conclusion, the treatment failure is a significant component of the community malaria epidemic. Testing for multidrug resistance yields a significant reduction in cases with many implications regarding the containment of malaria in Nigeria.

A Global Perspective on Oral Vaccination of Wildlife against Rabies.

The long-term mitigation of human-domestic animal-wildlife conflicts is complex and difficult. Over the last 50 yr, the primary biomedical concepts and actualized collaborative global field applications of oral rabies vaccination to wildlife serve as one dramatic example that revolutionized the field of infectious disease management of free-ranging animals. Oral vaccination of wildlife occurred in diverse locales within Africa, Eurasia, the Middle East, and North America. Although rabies is not a candidate for eradication, over a billion doses of vaccine-laden baits distributed strategically by hand, at baiting stations, or via aircraft, resulted in widespread disease prevention, control, or local disease elimination among mesocarnivores. Pure, potent, safe, and efficacious vaccines consisted of either modified-live, highly attenuated, or recombinant viruses contained within attractive, edible baits. Since the late 1970s, major free-ranging target species have included coyotes (Canis latrans), foxes (Urocyon cinereoargenteus; Vulpes vulpes), jackals (Canis aureus; Lupulella mesomelas), raccoons (Procyon lotor), raccoon dogs (Nyctereutes procyonoides), and skunks (Mephitis mephitis). Operational progress has occurred in all but the latter species. Programmatic evaluations of oral rabies vaccination success have included: demonstration of biomarkers incorporated within vaccine-laden baits in target species as representative of bait contact; serological measurement of the induction of specific rabies virus neutralizing antibodies, indicative of an immune response to vaccine; and most importantly, the decreasing detection of rabies virus antigens in the brains of collected animals via enhanced laboratory-based surveillance, as evidence of management impact. Although often conceived mistakenly as a panacea, such cost-effective technology applied to free-ranging wildlife represents a real-world, One Health application benefiting agriculture, conservation biology, and public health. Based upon lessons learned with oral rabies vaccination of mesocarnivores, opportunities for future extension to other taxa and additional diseases will have far-reaching, transdisciplinary benefits.

National capacity strengthening within the context of an international vector control partnership: findings from a qualitative study conducted within the Ugandan ‘Tiny Targets’ programme

IntroductionThe Ugandan Tiny Target programme is an example of an international vector control partnership that held specific capacity strengthening objectives in support of a disease elimination goal. Drawing on this experience, we sought to derive transferable lessons that may inform capacity strengthening approaches within other partnership-based vector control programmes.MethodsA longitudinal qualitative study encompassing semistructured interviews conducted with Ugandan partners working on the Tiny Target programme. Data analysis was informed by a general inductive approach.ResultsCapacity strengthening priorities evolved over time initially focusing on the immediate capacities needed to perform roles and responsibilities assigned within the partnership and then shifting towards more advanced, transferable knowledge and skills. A distinction between operational and systemic priorities was observed: the former was necessary to support successful programme implementation whereas the latter reflected fundamental limitations or complexities within the Ugandan context that were bypassed by including an international partner. Systemic priorities were fewer in number than their operational counterparts, although substantially harder to resolve. The largest apparent threat to the long-term sustainability of reported capacity gains was their concentration within a small number of individuals.ConclusionOur study highlights three key lessons that may inform the design of national capacity strengthening activities conducted within the context of international vector control partnerships, including (1) Multiple approaches to strengthen capacity are needed and that can adapt to changing capacity strengthening priorities over time; (2) Balancing operational and systemic capacity strengthening priorities, the latter becoming increasingly important within longer-term partnerships and (3) Partnership members in focal country/ies should be supported to actively facilitate the transfer of newly acquired knowledge and skills to relevant colleagues/communities outside of the partnership. The generic nature of these recommendations suggests they are likely to be of benefit to many and diverse international partnerships within the wider global health space.

A Study of a Class Continuous SIR Epidemic Model with History

The SIR model, an epidemiological model, divides a population into three compartments: Susceptible (S), Infected (I), and Recovered (R). It is widely used to understand the spread of infectious diseases and predict epidemic outcomes based on factors such as transmission rates and population dynamics. A deterministic epidemic mathematical model to describe the transmission dynamics of an infectious disease was constructed and analyzed by incorporating memory term which provides information on the current and past disease states. The model revealed two key equilibria: a disease-free equilibrium and an endemic equilibrium. The calculated basic reproductive number R0, was employed to establish that when R0<1, the disease-free equilibrium is locally asymptotically stable, while the endemic equilibrium is locally asymptotically stable when R0>1. Additionally, we explored the global stability of these equilibria using Lyapunov functions and Dulac's method, respectively. To validate our analytical findings, we conducted numerical simulations of the model which show the importance of history in the dynamic spread and elimination of disease.

Eradicating gross tumor disease: a prerequisite for efficient radioimmunotherapy?

Radiotherapy may induce off-target antitumor "abscopal" immunostimulatory but also immunosuppressive effects. Several preclinical and early clinical studies revealed promising results when combining radiation therapy with immunostimulatory agents. However, most immunoradiotherapy randomized trials showed disappointing results in patients with advanced tumors. On the contrary, encouraging outcomes were suggested when immunotherapy was delivered on top of gross disease elimination with curative-intent radiotherapy. In this review, we highlight available results from randomized trials and discuss the potential impact of overall tumor burden on the observed efficacy of radioimmunotherapy.

Incorporating social vulnerability in infectious disease mathematical modelling: a scoping review

BackgroundHighlighted by the rise of COVID-19, climate change, and conflict, socially vulnerable populations are least resilient to disaster. In infectious disease management, mathematical models are a commonly used tool. Researchers should include social vulnerability in models to strengthen their utility in reflecting real-world dynamics. We conducted a scoping review to evaluate how researchers have incorporated social vulnerability into infectious disease mathematical models.MethodsThe methodology followed the Joanna Briggs Institute and updated Arksey and O'Malley frameworks, verified by the PRISMA-ScR checklist. PubMed, Clarivate Web of Science, Scopus, EBSCO Africa Wide Information, and Cochrane Library were systematically searched for peer-reviewed published articles. Screening and extracting data were done by two independent researchers.ResultsOf 4075 results, 89 articles were identified. Two-thirds of articles used a compartmental model (n = 58, 65.2%), with a quarter using agent-based models (n = 24, 27.0%). Overall, routine indicators, namely age and sex, were among the most frequently used measures (n = 42, 12.3%; n = 22, 6.4%, respectively). Only one measure related to culture and social behaviour (0.3%). For compartmental models, researchers commonly constructed distinct models for each level of a social vulnerability measure and included new parameters or influenced standard parameters in model equations (n = 30, 51.7%). For all agent-based models, characteristics were assigned to hosts (n = 24, 100.0%), with most models including age, contact behaviour, and/or sex (n = 18, 75.0%; n = 14, 53.3%; n = 10, 41.7%, respectively).ConclusionsGiven the importance of equitable and effective infectious disease management, there is potential to further the field. Our findings demonstrate that social vulnerability is not considered holistically. There is a focus on incorporating routine demographic indicators but important cultural and social behaviours that impact health outcomes are excluded. It is crucial to develop models that foreground social vulnerability to not only design more equitable interventions, but also to develop more effective infectious disease control and elimination strategies. Furthermore, this study revealed the lack of transparency around data sources, inconsistent reporting, lack of collaboration with local experts, and limited studies focused on modelling cultural indicators. These challenges are priorities for future research.

Mass drug administration for neglected tropical disease control and elimination: a systematic review of ethical reasons

BackgroundNeglected tropical diseases (NTDs) are a diverse group of debilitating diseases and conditions afflicting more than one billion people in impoverished communities. Control of these diseases is crucial to achieve...

Hepatitis C virus infection and co-infection with HIV among persons who inject drugs in 10 U.S. cities—National HIV Behavioral Surveillance, 2018

BackgroundCharacterizing acute and chronic hepatitis C virus (HCV) infection and HIV/HCV co-infection among persons who inject drugs (PWID) can inform elimination efforts. MethodsDuring 2018 National HIV Behavioral Surveillance in 10 U.S. metropolitan statistical areas (MSAs), PWID were recruited using respondent-driven sampling and offered a survey, HIV testing, and HCV antibody and RNA testing. We examined prevalence and associated characteristics of HCV infection and HIV/HCV co-infection. Associations were assessed using log-linked Poisson regression models with robust standard errors accounting for clustering by recruitment chain and adjusting for MSA and network size. ResultsOverall, 44.2% had current HCV infection (RNA detected), with 3.9% classified as acute infection (HCV antibody non-reactive/RNA detected) and 40.3% as chronic (HCV antibody reactive/RNA detected). Four percent had HIV/HCV co-infection. Current HCV infection was significantly higher among PWID who were male, White, injected >1 time/day, shared syringes in past year, and shared injection equipment in past year. PWID who were transgender, injecting >5 years, and most often injected speedball (heroin and cocaine together) or stimulants alone were more likely to have HIV/HCV co-infection. Among PWID who never previously had HCV infection, 9.9% had acute HCV infection. Among PWID who started injecting ≤5 years ago, 41.5% had already acquired HCV infection. ConclusionsAcute and chronic HCV infections were substantial among a sample of PWID in 10 U.S. MSAs. Accessibility to HCV RNA testing, promoting safer practices, and intervening early with harm reduction programs for recent injection initiates will be critical to disease elimination efforts for PWID.

Язвенная болезнь – кто виноват и что делать?

The first successes in the treatment of peptic ulcer disease (PU) using antibiotics in combination with proton pump blockers contributed to the emergence of the hypothesis that H. pylori is the main cause of PU. Moreover, it was assumed that eradication of H. pylori could lead to elimination of ulcerative disease. However, 40 years after the discovery of H. pylori, it became clear that eradication therapy reduces the time to ulcer healing, improves the quality of life and prolongs remission, but does not eliminate PU. Nevertheless, the new Maastricht VI guidelines still proclaim H. pylori eradication as the main goal of therapy for H. pylori-associated diseases. The widespread use of antibiotics has saved millions of lives. At the same time, bacterial resistance to existing antibiotics due to the ongoing escalation of antibacterial therapy has been named by the World Health Organization as one of the main threats to humanity in this century. Therefore, the infectious concept of the pathogenesis of PU and the principles of its treatment require clarification.

Iodine deficiency and modern possibilities of its prevention in adolescents

Iodine deficiency is one of the most pressing problems of modern healthcare. Currently, there are 21 countries in the world where iodine deficiency in the diet of the population has been proven, but has not yet been eliminated. Russia is one of them due to the lack of a legislative framework for mass iodine prophylaxis in our country. The strategy for the elimination of iodine deficiency diseases on the scale of the Russian Federation is based on the adoption of a federal law providing for the use of iodized salt as a medium. The strategy for the elimination of iodine deficiency diseases on the scale of the Russian Federation is based on the adoption of a federal law providing for the use of iodized salt as a means of population iodine prophylaxis. Currently, less than 30% of the population in Russia consumes iodized salt in their diet, while the target coverage in iodine-rich regions > 90% of households. In 2022, we conducted a survey of 269 adolescents aged 15–17 living in the Saratov Region and found that the share of families who regularly use YS for food was only 24,2%. Most adolescents rarely eat seafood and do not take iodine-containing drugs, which indicates the ineffectiveness of the «voluntary» model of iodine prevention. In the absence of a federal law, the most important step towards solving the problem of combating iodine deficiency diseases should be the formation of a unified nationwide preventive process based on the appropriate regulatory framework in each constituent entity of Russia – the development and implementation of targeted regional programs for the prevention of diseases caused by iodine deficiency.

In search of a ‘good number’: knowledge controversy and population estimates in the endgame of hepatitis C elimination

We explore the contentious life of a metric used to assess a country’s progress in relation to global disease elimination targets. Our topic is hepatitis C elimination, and our context...

Toward paratuberculosis control in animals: current updates and future perspectives

Paratuberculosis is a chronic non-curable disease, that affects domesticated and wild ruminants, pets and even humans. This disease causes significant economic losses worldwide. Many countries have implemented control programs to eradicate the disease. Such programs face great challenges due to the nature of the pathogen itself, the immune response, the method of pathogen shedding in susceptible animals, and the absence of accurate diagnostic tools, efficient vaccines, and curative medication. However, some control programs succeeded in eradicating the disease, others were less effective and achieved less success. The present review discusses the elements required in disease control protocols and highlights the importance of disease elimination. These control strategies include optimum application of management measures and proper use of combined diagnostic techniques to accurately identify MAP infected animals with high sensitivity and specificity. Nanotechnology has shown promising results in the diagnosis and control of paratuberculosis. All available vaccines do not completely protect the population, but they actually reduce the clinical signs, pathogen shedding and provoke cellular and humoral immune responses. Although the test and slaughter policy of paratuberculosis is considered an effective way for its control, several obstacles hinder its application.

Unveiling measles transmission dynamics: Insights from a stochastic model with nonlinear incidence

AbstractIn this paper, taking into account the inevitable impact of environmental perturbations on disease transmission, we primarily investigate a stochastic model for measles infection with nonlinear incidence. The transmission rate in this model follows a logarithmic normal distribution influenced by an Ornstein–Uhlenbeck (OU) process. To analyze the dynamic properties of the stochastic model, our first step is to establish the existence and uniqueness of a global solution for the stochastic equations. Next, by constructing appropriate Lyapunov functions and utilizing the ergodicity of the OU process, we establish sufficient conditions for the existence of a stationary distribution, indicating the prevalence of the disease. Furthermore, we provide sufficient conditions for disease elimination. These conditions are derived by considering the interplay between the model parameters and the stochastic dynamics. Finally, we validate the theoretical conclusions through numerical simulations, which allow us to assess the practical implications of the established conditions and observe the dynamics of the stochastic model in action. By combining theoretical analysis and numerical simulations, we gain a comprehensive understanding of the stochastic model's behavior, contributing to the broader understanding of measles transmission dynamics and the development of effective control strategies.

Knowledge, perceptions, and practices around zoonotic diseases among actors in the livestock trade in the Lake Victoria crescent ecosystem in East Africa.

Zoonotic diseases such as anthrax, rabies, brucellosis, and Rift Valley fever pose a direct threat to health and undercut livelihoods in the communities in which they occur. A combination of anthropogenic and animal activities like migration and interaction with wildlife and their respective parasites and vectors drives the emergence and re-emergence of zoonotic diseases. Consequently, One Health interdisciplinary approaches that incorporate social scientists can provide key insights into complex local perceptions. The approach calls for collaboration between the human and animal health sectors, including the sharing of disease surveillance data necessary to alleviate disease impacts. Livestock traders interact closely with livestock, which puts them at elevated risk of infection and creates conditions by which they may spread zoonotic disease. It is thus essential to examine practices among actors involved in the livestock trade to understand the most appropriate ways to mitigate these risks. A qualitative study was conducted among the actors in the livestock trade in Busia County on their knowledge and perceptions of zoonotic diseases and practices that may contribute to the spread, control, and prevention of zoonotic disease transmission. A thematic analysis framework was used to categorize and synthesize data from in-depth interviews (IDIs), key informant interviews (KIIs), and structured observations. Whereas participants could list livestock diseases, they could not identify which ones were zoonoses, demonstrating insufficient knowledge of zoonosis. They identify sick animals by checking for dropped ears, excess mucus production, diarrhea, bloody urinal discharge, and general animal activity levels. To prevent the spread of these diseases, they wash their animals, isolate sick animals from the rest of the stock, and vaccinate their animals. They seek help from animal health professionals for sick animals as part of curative practices. This shows that they perceive the diseases as serious and that they need to be attended to by professionals. The results also show that they perceive animals from outside the region to be more vulnerable to diseases compared to those from within. The actors in the livestock trade engage in practices like skinning dead animals before burying them; to them, this is a normal practice. Some also consume dead carcasses. These increase the risk of zoonotic disease transmission. The actors involved in the livestock trade are critical in the prevention and elimination of zoonotic diseases; hence, they need to be involved when developing intervention programs and policies for animal health extension services. Training them as a continuum of animal health workers blends lay and professional knowledge, which, alongside their intense contact with large numbers of animals, becomes a critical disease surveillance tool. Increasing awareness of zoonoses by using multi-disciplinary teams with social scientists is urgently needed so that practices like skinning dead animals before disposing of them and consumption of dead carcasses can be minimized.