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Surveillance and response to zoonotic diseases in Maya communities of Guatemala: A case for One Health

English title Surveillance and response to zoonotic diseases in Maya communities of Guatemala: A case for One Health
Applicant Zinsstag Jakob
Number 160919
Funding scheme r4d (Swiss Programme for Research on Global Issues for Development)
Research institution Abt. öff. Gesundheitswesen und Epidemiologie Schweizerisches Tropen- und Public Health-Institut
Institution of higher education University of Basel - BS
Main discipline Methods of Epidemiology and Preventive Medicine
Start/End 01.03.2016 - 30.06.2019
Approved amount 500'000.00
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All Disciplines (3)

Discipline
Methods of Epidemiology and Preventive Medicine
Ethnology
Health

Keywords (8)

Response; Zoonoses; Maya medicine; One health; Biomedical; Guatemala; Surveillance; Maya

Lay Summary (German)

Lead
Gemeinsam mit den Maya gegen zoonotische Krankheiten Krankheiten, die vom Tier auf den Menschen übertragen werden (Zoonosen), kommen in Guatemala häufig vor. Die Maya leben in engem Kontakt mit Tieren und fern von staatlichen Gesundheitsdiensten. Maya-Heiler versorgen die Bevölkerung. Der Rat der Maya-Heiler in Peten, dem Studiengebiet des Projekts, möchte enger mit Experten der Human- und Veterinärmedizin zusammenarbeiten und sucht einen Dialog auf Augenhöhe.
Lay summary
 Das Projekt baut auf einem erfolgreichen Austausch zwischen Maya-Heilern und Medizinern zu Krebserkrankungen auf. Vorstudien weisen darauf hin, dass viele Maya an Zoonosen leiden, aber es ist nicht klar, welche neuen Krankheiten in den Wäldern von Peten auftreten. Mit Hilfe einer neuen Partnerschaft zwischen dem Maya-Rat der Heiler in Peten, der Universität Del Valle in Guatemala Stadt, dem Schweizerischen Tropen- und Public Health Institute, der Universität Basel und anderen Partnern wollen wir i) bereits vorkommende und neu auftretende Zoonosen mit heutigen Technologien rasch erkennen und melden (Überwachung) und ii) neue Methoden zur Vorbeugung und Heilung von Krankheiten bei Mensch und Tier entwickeln (Bekämpfung). Unser Projekt verbindet natur- und sozialwissenschaftliche Perspektiven und Herangehensweisen, schafft einen Dialog zwischen Maya-Heilern und Vertretern der Human- und Tiermedizin (One Health) und bezieht Betroffene sowie Gesundheitsanbieter und -politiker in das Schaffen von Wissen mit ein (Transdisziplinarität).
Wir erwarten, dass die Erkenntnisse dieses Projektes sich positiv auf die Gesundheitsversorgung der Maya auswirken und dazu beitragen, die Überwachung und Bekämpfung von neu auftretenden Zoonosen in abgelegenen Gebieten zu verbessern.
Direct link to Lay Summary Last update: 18.02.2016

Responsible applicant and co-applicants

Employees

Publications

Publication
Climate change and One Health
Zinsstag Jakob, Crump Lisa, Schelling Esther, Hattendorf Jan, Maidane Yahya Osman, Ali Kadra Osman, Muhummed Abdifatah, Umer Abdurezak Adem, Aliyi Ferzua, Nooh Faisal, Abdikadir Mohammed Ibrahim, Ali Seid Mohammed, Hartinger Stella, Mäusezahl Daniel, de White Monica Berger Gonzalez, Cordon-Rosales Celia, Castillo Danilo Alvarez, McCracken John, Abakar Fayiz, Cercamondi Colin, Emmenegger Sandro, Maier Edith, Karanja Simon, Bolon Isabelle, et al. (2018), Climate change and One Health, in FEMS Microbiology Letters, 365(11), 1-9.

Collaboration

Group / person Country
Types of collaboration
National School of Tropical Medicine, Houston, Texas United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Centers for Disease Control and Prevention, Atlanta, Georgia United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Ministry of Agriculture, Guatemala Guatemala (South America)
- in-depth/constructive exchanges on approaches, methods or results
- Industry/business/other use-inspired collaboration
University of del Valle, Guatemala City Guatemala (South America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
- Exchange of personnel
- Industry/business/other use-inspired collaboration
Maya Q'eqchi' Council of Elders Guatemala (South America)
- in-depth/constructive exchanges on approaches, methods or results
- Exchange of personnel
TIGO telecommunications company Guatemala (South America)
- in-depth/constructive exchanges on approaches, methods or results
- Industry/business/other use-inspired collaboration
Ministry of Health, Guatemala Guatemala (South America)
- in-depth/constructive exchanges on approaches, methods or results
- Research Infrastructure
- Exchange of personnel

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
ITD Conference 2017 - Transdisciplinary Research and Education, Intercultural Endeavors Talk given at a conference Acknoeledging Multicultural Agendas in Health Research: Transdisciplinarity as a Tool for Collective Voicing among the Maya of Guatemala (M. Berger González) 11.09.2017 Leuphana University, Germany Zinsstag Jakob;


Knowledge transfer events



Self-organised

Title Date Place
The One Health Focus in the Research of Zoonotic Disease (El Enfoque Una Salud en la Investigación de Enfermedades Zoonóticas) 09.05.2017 Universidad del Valle de Guatemala, Guatemala

Communication with the public

Communication Title Media Place Year
New media (web, blogs, podcasts, news feeds etc.) Deep Transdisciplinary exchange between Maya and Western medicine Youtube International 2018

Associated projects

Number Title Start Funding scheme
177083 Georeferenced contact sensors for analyzing the dynamics of animal and human populations in relation to disease control 01.12.2017 R'EQUIP

Abstract

Background: Zoonotic diseases continue to threaten the economies of countries worldwide due to their outbreak potential. Yet, in Guatemala, research to understand their burden is limited, especially among rural communities where vulnerability is exacerbated by the isolation from public health care providers and the close contact with ecosystems under constant developmental stress. Preliminary information is available about the prevalence of leptospirosis, salmonellosis, tuberculosis, brucellosis and cysticercosis in human and animal populations, but the importance of emerging pathogens such as Borrelia, Bartonella, Rickettsia and others in fever-related diseases are poorly understood. Surveillance of zoonoses would have the highest sensitivity if based at community level and not at the public health or animal health services level, given these are either poorly implemented or currently disconnected from prevailing cultural systems. This is especially relevant due to discrepancy between illness representations and related health practices of Maya communities and the public and animal health authorities. Disease surveillance leading to subsequent aetiological confirmation requires understanding of local explanatory models of diseases at the human-animal interface among indigenous groups.Aim and objectives: The project aims to promote a One Health approach to develop a surveillance and response proof-of-concept in the Peten region of Guatemala that can test novel methodological mechanisms for further replication in the country. In a first phase, it seeks to record the illness representation and related health practices of priority human and animal infectious diseases among Maya communities and to compare them with biomedical models. By installing a cooperative community surveillance programme that builds on the network of traditional (mobile) Maya healers of the Q’eqchi’ council area and local public health service providers, a real-time model using mobile technology will be developed, allowing for immediate response for sample collection of affected human patients and diseased or reservoir animals. Laboratory detection of pathogens to determine equivalence to Maya syndromes and explanatory models will be possible through the cooperation with Guatemalan, Swiss and US partners. Approach: A transdisciplinary (TD) process between Maya healers, community members, public health and veterinary authorities, anthropologists, microbiologists and epidemiologists, as well as a communications corporation will: 1) open a dialogue for the mutual understanding of the biomedical models (pathogens/diseases) of vector borne diseases, dog rabies, Yersinia spp. Leptospira, Rickettsia, Bartonella, Borrelia, Leishmania, Trypanosoma cruzi, hanta virus, pox virus, and match them with perception, explanatory frameworks, and practices of Maya communities and healers; 2) support the implementation of a community surveillance programme involving Maya healers/leaders and health authorities; 3) design, test and implement a culturally-appropriate mobile surveillance system for facilitating near real-time identification of febrile syndromes and coordination of sample collection in affected human patients; 4) conduct biomedical tests to determine the aetiology to enable matching emic Maya syndromes; collect samples of pathogens in animals surrounding the households for posterior laboratory testing; 5) conduct joint-analysis workshops to correlate anthropological, biomedical and epidemiological data to propose culturally-appropriate interventions to health authorities and other stakeholders in the area and implement a National Workshop on the One Health approach for relevant diseases affecting the country.Expected results: 1) A community-level syndromic surveillance programme for human and animal diseases employing culturally validated mobile technology for facilitating timely collection of human samples; 2) a better understanding of the role of Yersinia spp. Leptospira, Rickettsia, Bartonella, Borrelia and other pathogens in so far unexplained fever related diseases; 3) Comprehensive understanding of local illness representations and related health practices for culturally adapted interventions in a rural Maya context; 4) a novel methodological approach (in Guatemala and the Region) for engaging diverse stakeholders in health research and response and the promotion of young Guatemalan scientists epidemiology and microbiology. Innovation and contribution to development: The intellectual contribution and scientific value is the comparison of Maya and biomedical explanatory frameworks of these diseases that may contribute to design an adapted culturally sensitive and biologically appropriate surveillance model. A second innovation is the monitoring of the TD process to document how local communities and public authorities and scientist can work together towards societal problem solving. Implementing a One Health approach will provide hands-on experience for local authorities and other stakeholders to measure its potential for improving epidemiological surveillance and response as health interventions and disease prevention, and creating a baseline for emerging diseases whose burden was previously unknown.
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