In rural Kenyan villages where few families have electricity or indoor plumbing, a surprising technology helps researchers study the health of animals and people: the cell phone.
Families who are part of the population-based animal syndromic surveillance project, or PBASS, use their cell phones to call a veterinarian toll free when an animal is sick. More than 70 percent of families participating in the survey have cell phones; only three percent are connected to the electricity grid.
“Mobile telephony is actually very well developed in most of Africa, especially in Kenya,” says Thumbi Mwangi, clinical assistant professor in the Paul G. Allen School for Global Animal Health, who has been collecting data since the survey began in February 2013.
Unlike electricity and water infrastructure, cell phone infrastructure is relatively cheap to build. There is cell network coverage in almost every rural village, and where there isn’t electricity the towers are “off-the-grid” getting their power from diesel generators, says Mwangi. Families who are using firewood to cook or gathering water from streams or Lake Victoria are also going to local shopping centers to charge their energy-efficient phones for a very small fee. One charge could last for many days. And that makes it ideal for communicating with survey families.
Once every two weeks, community interviewers, usually traveling by bicycle, visit the families. During the first year of the study, researchers visited 1,500 households. They collected data on humans such as fever, diarrhea, and respiratory illnesses and similar disease data for animals. For animals, researchers also recorded reproductive illnesses, nervous system illnesses, mastitis, and death. And they collected socioeconomic data for the families including age of family members, household income, and number of children. If an animal gets sick, the families can call the toll free number and a veterinarian will come out within 24 hours so the family doesn’t have to wait until the next scheduled visit.
“One of the big things is that we have been able to simultaneously monitor health in people and the animals they live with,” said Mwangi. “This is not the standard approach in the surveillance of infectious diseases.” Living with livestock is part of everyday life for these families. It is a source of nutrition, but also a source of income. More than 90 percent of families own some type of livestock. Of those, nearly 90 percent have chickens, more than 50 percent have cattle, roughly 40 percent own goats, and about 20 percent of families have sheep.
“Farm products are the main source of cash for most families,” says Mwangi. “Milk and eggs are a rich source of protein and easy to sell, but if they only have small quantities, families are likely to struggle between eating them or selling them to buy other items.”
From the study researchers have found that families who owned more livestock were also more likely to eat eggs and milk, meaning they are keeping eggs and milk for their families rather than selling it all for other needed items. And that could improve their nutrition. Victoria Olsen-Mikitowicz (’15 DVM), a student in the Allen School’s Global Animal Health Professional Certificate Program who spent a month in Kenya collecting data, experienced firsthand how animal health affects human health.
“It was easy to visualize the concept of ‘one health’,” says Olsen-Mikitowicz. “Seeing the connection between human, animal, and environmental health, through infections such as malaria, East Coast Fever, and helminths [parasitic worms]—and, all too common, malnutrition.”
As a WSU veterinary student, she has mastered the technical skills, such as analyzing samples or quantifying data, to be a top-notch researcher. But what she learned during her time in Africa was that building relationships with fellow researchers, community interviewers, veterinarians, and community members is key to successful research.
“I learned the importance of developing trust within the community and team to accomplish research,” says Olsen-Mikitowicz. “Because of those relationships, I was better able to collect samples, gather survey information, and help ensure people get the information they need.”
“One of the greatest benefit of this research is that we will be able to determine which animal diseases have the greatest impact on human health and welfare,” says Mwangi. “From there we will be able to conduct intervention studies to reduce disease in animals and improve human health and wellbeing.”
Newcastle disease is thought to be the main cause of chicken mortality. Future vaccination campaigns against Newcastle are predicted to result in increased survival for chickens, more egg production per household, and access to eggs for children under 5 years of age, which has significant nutritional benefits, says Mwangi. “There is a strong correlation between cases of human disease and animal disease in the same households,” said Mwangi. “We need to conduct more diagnostic work to know if they are driven by the same pathogens, but the finding shows that surveillance of animal diseases is useful for understanding the health problems of people.”
Population-based animal syndromic surveillance and the socioeconomic survey are conducted by the Allen School for Global Animal Health in collaboration with the Kenya Medical Research Institute – Center for Global Health Research, and the Centers for Disease Control.