Risk factors for human cutaneous anthrax and an enhanced surveillance program of anthrax in livestock, North-West of Bangladesh Regional Training in Animal and Human Health Epidemiology in South Asia

Objectives To obtain the socio-demographic information of human cutaneous anthrax cases To assess risk factors associated with human cutaneous anthrax cases To evaluate reporting of animal anthrax cases through the enhanced program compared with the existing system To assess the effectiveness of village volunteers in overall animal disease surveillance and anthrax detection

Low income and below primary education were major socio-demographic characteristics of human cutaneous anthrax cases Major risk factors for anthrax were  Contact with sick or dead animals or animal products  Living in an earth floor or mud walls house As a reflection of poor economic condition of people  Cutting grass from wet or dry land As an environmental factor for exposure due to disposal of carcasses in open places Results

One Health surveillance network for anthrax investigation was practised in real life. Reporting of suspected cases increased in enhanced program as compared to the existing system Using village volunteers (vaccinators & village doctors in particular) increased reporting of suspected cases in enhanced program areas Proportionately more confirmed anthrax cases were reported in goats as compared to cattle in enhanced program areas Because of the awareness created by village volunteers farmer’s communication with the VET/ULO was higher in program areas (24%) than in non-program areas (15%). Results

Suggestions for policy makers Strict enforcement of slaughter act through the veterinary regulatory body Establish a combined monitoring system to prevent sick animal slaughtering and disposal of carcases in open place Develop and implement an awareness programme especially for low income and less educated people on –Handling and slaughtering of infected animals –Proper disposal of carcases –Personal hygiene to prevent the disease Considering a compensation scheme for anthrax infected animal cases to prevent slaughtering of infected animals

Suggestions for policy makers Implementation of the enhanced surveillance programme at least in outbreak prone/high risk areas for control of zoonotic diseases Recruitment of village volunteers for implementation of the enhanced surveillance program Implementation of “one health approach” at all levels for control and prevention of zoonotic diseases including anthrax

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