I've been away a while . . .

Yes, I've been just a bit busy with my thesis. I'll try to catch up; many news stories I've meant to share and discuss.

Today's photo theme: sunrise, sunset

Well, appropriately enough for my last daily posting of Uganda photos, the dramatic skies of Karamoja. People in Kansas talk about claustrophobia in NY because they can't see the sky, whereas I feel more agoraphobia here. In Karamoja, though, the mixture of clouds and sun make the sky an interesting study for anyone.

Here, Venus makes an appearance (the slightly blurred light to the left of the tree) as we prepared to leave for the day. Earlier, we could see the Milky Way, the Southern Cross, and many other constellations. Hooray for a night sky hundreds of miles from streetlights!

And, in case you were curious, here's what I look like with a monkey on my back.

And, as I mentioned to Dad, the (artificially) zebra-striped bulls. These animals are silver-gray; traditionally, the last animal in a bride-price will be this color and will be given zebra stripes with a branding iron (as seen here).

Today's photo theme: plant life

I'm going to stop these daily posts tomorrow. First, I'm running out of good pictures to post. Second, I'm going to do something else for Lent. I'm not sure what yet, but something . . .

Anyways, here's an acacia tree beauty shot, sitting next to a washed out ravine (washed out by the daily rains we had our second week). As usual, more on flickr.

Today's photo theme: pathologies!

Ok, today is not for the faint of heart. Here's nothing exotic, really, just a big abscess. Many good abbatoir etc. photos will be going up on flickr soon.

Today's photo theme: the markets

The clothing salesmen who sold us some blankets in Kangole on market day. The boys to the left are selling brooms -- no stick, just the bristles.

Today's photo theme: the men

I said I wouldn't change a post, but I have: the essay regarding our work in Uganda has been updated and improved by suggestions, some from comments (thank you, I appreciate the correction).

And today's photos: the men of Karamoja. Here, one is butchering a goat for our welcome party.

Today's photo theme: cows (of course!)

Calves running joyfully towards the cows, who were returning for our testing procedures, while one of the herd boys tries to keep them back.

Today's photo theme: Mother and child

Okay, the photos on flickr are of human mothers with their children, but I liked this one, too!

What I did in Uganda

Zoonotic Disease Survey in Karamoja, Uganda

Background

In January-February 2007, a team of volunteers from the Kansas State University (KSU) branch of Christian Veterinary Missions (CVM) traveled to Karamoja, Uganda at the invitation of Dr. Val Shean of CVM. The trip was funded by private donations and the members.

The purpose of this project was to initiate a zoonotic disease survey. Zoonotic diseases, while important in high income countries (HIC), become critical in low income countries (LIC). In LIC’s, direct contact with livestock is more common and basic hygiene is less common (and less possible) than in HIC’s. In HIC’s, zoonotic disease surveys and control are often in the hands of the government, as, for example, in the USDA’s brucellosis control programs. In LIC’s, however, the government is unable or unwilling to pay for such expensive programs; the livestock production systems are also too decentralized for such a top-down approach. This leaves the livestock keepers of these countries to rely on private laboratories (which are too costly for subsistence farmers) or development programs for identification of zoonotic diseases in their animals. It is such a development program, Cooperative Livestock Integration and Development Enterprise (CLIDE), with which this survey is being performed, in collaboration with the Italian Cooperation and Development program (CD).

Karamoja is a semi-arid region in the northeast area of Uganda, in East Africa. It is primarily inhabited by the Karimojong tribe, semi-nomadic livestock herders. This survey is currently focused on the Moroto district, which is a central area of about 7000 square kilometers, only 48% of which is arable. 90% of the population relies on agriculture for a livelihood. According to a 1995 estimate, there are over 400,000 head of cattle and over 600,000 goats in Moroto district.

The zoonotic risk factors of the region fall into management and cultural categories. Management issues are generally related to livestock mixing and resource availability. Due to the limited water supply in the region, these livestock congregate regularly at the few water pumps or reservoirs, facilitating the spread of infectious diseases. In addition, due to inter-tribal raiding, cattle are collected into corrals within the compounds (manyattas) overnight to protect them. As the people live in huts surrounding these corrals, aerosolized disease can spread easily from cattle to people. In the dry season, the manure pack of the corrals is also aerosolized and carried in the strong winds, spreading throughout the manyatta. The lack of readily-accessible water also makes hygeine difficult; washing of hands after handling animals or before cooking meals is rare. Disease spread between cattle and people is then potentiated, as is disease spread between people. Dogs are also managed in such a way as to increase risk of some zoonotic diseases; due to a fear of rabies, dogs are rarely handled and thus almost never vaccinated or treated for disease.

Cultural risk factors for zoonotic disease are related to food safety concerns. The Karimojong rely on livestock for their main protein sources: blood and milk. Blood is collected from live animals and at slaughter to be drunk raw or cooked, primarily the former. Milk is most often drunk raw or made into sour butter, or ghee. Cow’s milk is used by adults, while goat’s milk is only drunk by the children. The boys responsible for following the herds to pasture will milk the goats into their hands and drink the milk immediately. This means they are exposed to pathogens in these food products.

Health care is in short supply; in the Moroto district, only 24% of the population has access to health care. When official diagnoses can be made, treatment is often too expensive unless highly subsidized.

Diseases Surveyed

The Matany Hospital, one of the privately-run, donor-funded health facilities in the Moroto district, provides subsidized treatments, treating over 100 cases of tuberculosis (TB) and a fair number of cases of brucellosis each month. Due to the apparent prevalence of these zoonotic diseases in the human population of the region, brucellosis and TB in cattle were chosen as the primary focus of the first survey. In addition, Echinococcus granulosus is a common finding in the small ruminants of the region at slaughter; as this is a zoonotic disease with a life cycle passing through the dog, a canine element was added to the survey.

Brucellosis is a bacterial disease transmitted to humans primarily through unpasteurized dairy products, although manure and saliva are also possible sources of disease. It produces recurrent fevers, mimicking malaria, swollen joints, and nervousness or irritability. The primary symptom in cattle is abortion. The disease is most often spread between cattle by contact with the aborted fetus and the placenta from those abortions. It may also be spread sexually; infected cows will infect a bull during coitus, which can then infect other cows in a similar manner.

TB is a mycobacterial disease also transmitted to humans through unpasteurized dairy products, although human to human transmission of the human-specific Mycobacterium tuberculosis is more common in most of the world than the zoonotic Mycobacterium bovis. Feces, saliva, and aerosolized sputum (from coughing) are all sources of disease, for people and for animals. In people and animals, the symptoms of TB are fever and inappetence, leading to a thin appearance.

Hydatid disease, caused by the tapeworm Echinococcus granulosus, generally exists in a lifecycle between dogs and small ruminants. The adult lives in the intestine of the dog, passing eggs through the feces. The small ruminant then ingests those eggs, which hatch into larvae. The larvae encyst themselves in the viscera; when those cysts are ingested by the dog, the life cycle begins anew. Humans ingesting the eggs may become infected and develop cysts in the liver, lungs, and brain, requiring surgical removal.

Procedures

The team from KSU travelled to Karamoja in order to bring testing supplies and train a local team of animal health workers and veterinarians in the skills necessary to survey the cattle of the Moroto district for brucellosis and TB. Testing supplies sufficient for 1000 head of cattle were supplied to the Karamoja Diagnostic Laboratory, a part of CD. This sample size will allow determination of the true prevalence of disease with 95% confidence intervals of +/- 2%.

Testing procedure within a manyatta was based on clinical signs and relative risk; owners were requested to identify breeding bulls, older cows, and any animals that have aborted or experienced prolonged coughing recently. For each animal, the following information was collected: name, age, sex, color, clinical history, current temperature, and treatment history. Blood was drawn from a tail vein into a red-top tube and tuberculin was injected intradermally into the caudal tail fold. The animal was then given an ear tag and a subcutaneous injection of Ivermectin, as a thanks to the owner for allowing testing. After 72 hours, the caudal tail fold was examined to determine TB reactivity. The blood was taken on ice to the Karamoja Diagnostic Laboratory, where it was centrifuged to produce serum. The serum was then used in the standard Rose Bengal card test, as provided by the USDA-NVLS Brucellosis laboratory.

Results

By the end of the week available for testing, 56 animals had been tested for brucellosis and 26 had been tested for TB. Due to the time constraints of reading TB tests within 72 hours, 30 cattle were tested for brucellosis but not TB; those animals will be TB-tested at a later date.

The Rose Bengal test showed 9 positive reactors in the 56 tested, including both bulls and cows. The director of the laboratory and the laboratory technician were trained in the performance and reading of the test.

The TB test produced one reactor, which will later be confirmed via culture of the sputum and comparative cervical test. Two field veterinarians were trained in the performance and reading of the test.

In the 9 canine fecals performed, only Ancylostomma eggs were observed. One unidentified adult tapeworm was seen; however, follow-up was not possible.

Conclusion

The zoonotic disease survey as carried out so far has established the presence of both brucellosis and TB in the cattle of the Karimojong. It is important to continue this study and establish both prevalence data and risk factor analysis; with that data, a control plan can be established to improve public health in the region. A recent meeting with the district veterinary officers of the four districts in Karamoja and the regional medical centers established the interest and support of the local veterinary and human medical community. It is to be hoped that the survey may be expanded to include other zoonotic diseases and other districts.

Other posts on this topic:I'm back!, More teasers, Today's photo theme: Mother and child, Today's photo theme: cows (of course!), Today's photo theme: the men, Today's photo theme: the markets, Today's photo theme: pathologies!, Today's photo theme: plant life, Today's photo theme: sunrise, sunset

And, of course, my flickr site.

More teasers

New plan for sharing my Uganda photos: I'll post one here and 6 on flickr on a theme each day until I get tired of doing that or run out of room on flickr. Here's today's theme: children in Karamoja.

I'm back!

Just a teaser here, more on flickr, more to come.

Just to brag

I want to brag: I have the cutest nephew/godson in the world.

Yes, isn't he adorable? And he likes to pose:
Which, given that I have a new camera and had it with me on my last visit, is very convenient.
Would you believe I took that picture in a completely unlit room? I'll have lots of fun pictures to post when I get back from Uganda.

Oh, and since I did take other pictures, here's a glimpse of WNY in December:














Isn't that depressingly non-white? Oh well, it's snowing here today!

After a long pause

Fueled by sugar/chocolate/cocktail wieners from the Dean's Office Holiday Party, I return to write all those posts I've been meaning to. The last week and a half have reminded me why research never appealed to me before I learned about epi -- who wants to spend 5 hours a day with a micropipetter? Give me a laptop any day . . .

Is hot air measured in square feet our hours?

I went to a talk yesterday by Donald Rumsfield.

Well, mostly by him. First we had to sit through a rambling introduction by General Myers. That man can blather with the best of them.

The amazing thing was that, after an hour of talking, nothing was said. Not nothing important; nothing. Ah, politics.

Some phrases/concepts that might be interesting to those without access to such things:

• communists are totalitarian, just like non-centralized terrorists
• "The enemy has brains. They do things."
• We are fighting a war against people with no home state to defend; this is why we invaded 2 countries
• we should study history to avoid repeating mistakes
  

Aren't we glad that was cleared up!

What does it say about America when . . .

I received two offers to join a book club in today's mail. One was mostly Deepak Chopra and the Dalai Lama, while the other was along the lines of James Patterson and Rachel Ray. Still, both sold Dr. Phil, Danielle Steel, and an entire page full of books on making sex better. There's a great story to draw out of this, but I'm not sure I want to go there.

The beauty of oddity

Writing a paper while at my favorite cafe, I just saw a businessman walk by with a butterfly happily sitting on his lapel, flapping its wings slowly. He watched it bemusedly. His companion, another suit, talked blithely on his cell phone.

A thousand monkeys . . .

I had a thought today, after watching the trailer for Eragon. I enjoyed the first book, but I have a feeling that anything on paper with a decent storyline and acceptable grammar would be enjoyable to me. Part of being a bibliophile and voracious reader.

Anyways, although I am enjoying the series and will most likely buy the third in hardcover, there's something . . . lacking. It's not as satisfying as a new Jordan or Martin or even Eddings. Roxann and I discussed it and decided that it seemed almost to be like fan-fic, Mary-Sue's and all.

And today, the epiphany: this is a case of the elephant painting phenomenon. Someone decided to teach elephants to paint. The elephants turn out decent, but not spectacular, modern-style paintings that sell for large amounts of money because, of course, they were painted by elephants, which is cool, right?

I'm not saying Paolini is an elephant or anything of the kind, just that he's become very popular, with a book and movie deal, in large part because, wow, a teenager writing fantasy novels! Novelty, if you'll excuse the pun. There's better writing, better stories being passed over because they don't have a hook like the 16-year-old author.

I'll still read the series. I'll watch the movie. But now, when I do, elephants are going to be dancing in my head.

Are pheremones transferred that easily?

I was reading through the archives of Rob and Elliot today and ran across this. It got me thinking: why are female vets considered (in the comics world) to be desirable, usually along the lines of booth babes et. al. Is it a holdover from the Garfield days? Is it a combination of animal taming and nurse fantasies? Do the nerdboys sense that we are all nerd girls at heart? Why?

And why is it only in comics?

The current earworm

This Is My Song
words by Lloyd Stone
to the tune of Finlandia by Jean Sibelius

This is my song, O God of all the nations,
A song of peace for lands afar and mine.
This is my home, the country where my heart is;
Here are my hopes, my dreams, my holy shrine;
But other hearts in other lands are beating
With hopes and dreams as true and high as mine.

My country's skies are bluer than the ocean,
And sunlight beams on cloverleaf and pine.
But other lands have sunlight too, and clover,
And skies are everywhere as blue as mine.
Oh hear my song, thou God of all the nations,
A song of peace for their land and for mine.

Viral annoyance

I have a cold.

2 days ago, it was a basic runny nose, slightly sore throat sort of thing. In fact, contra dancing made it feel better. No big deal.

Yesterday, I woke up unable to sing any interval above a mid G without cracking. My choir was singing the 8:30 service at my church, so I joined the baritones. I didn't have to reach for a low C. In case you're wondering why this is shocking, my normal comfort range is low F to high B. I sing tenor on occasion, but I can never use full voice on the low parts the way I was yesterday. By the end of the day yesterday, I couldn't sing at all. I was a little stuffy, but mostly it was a slightly sore/mucousy throat.

This morning, I woke up to the full-blown cold. I'm going through about 6-10 tissues an hour. I would say that sneezing hurts my throat, but really, doing nothing hurts my throat. Sneezing just makes the pain briefly agonizing. No fever, no chills, nothing serious -- just highly annoying coldish existence.

This is highly annoying to me. Yes, this would be annoying to anyone. The thing bothering me is that I'm pretty sure how I got it (spending the weekend before last with my sister (who works in a hospital as a juvenile psychologist), her husband (a high school teacher), and their son (in the hospital daycare). I spent 4 days with the ultimate virus-sharing family. I got a cold virus.

The other thing bothering me is that I'm doing everything right (well, not everything -- staying out until 1:30 for dancing wasn't smart) and it's not going away. I've doubled my vitamin B/C intake. I've been drinking cold care tea. I slept in this morning (Labor Day closing the gym helps in forcing this). I've eaten well and drunk lots of water. I'm in good shape and generally healthy. And it's not going away! It's getting worse!

Yes, I understand how this happens. I know that my immune system is picking up and will clear it out in its own time. I even know that yesterday afternoon was the beginning of the secondary bacterial infection in the nasal mucosa. Yet, knowing all this, there's nothing I can do.

It's highly annoying to know that nothing you know is going to help.