Identifying Sources, Pathways and Risk Drivers in Ecosystems of JE in an Epidemic-Prone North Indian District in 2011-13: An EcoHealth Perspective to Studying JE

Japanese Encephalitis is one of nine priority diseases that the Roadmap to Combat Zoonoses Initiative in India (RCZI) is currently working on. “Identifying Sources, Pathways and Risk Drivers in Ecosystems of JE in an Epidemic-Prone North Indian District” was a study that spanned three years from July 2011-October 2014 with strong components that were aligned to RCZI’s thrust areas, namely Collaborative Research, Capacity Building, Health Communication and Advocacy.

The Public Health Foundation of India (PHFI) along with partners embarked on this study in three blocks of Padrauna, Kaptanganj and Khadda of Kushinagar District in the state of Uttar Pradesh. These blocks were chosen in accordance with the Reports JE/AES disease burden. A total of 12 villages were taken up (4 per block) with a strong a quantitative and qualitative arm. The study followed a multidisciplinary, EcoHealth approach to study vector-animal-human interactions along with other environmental, economic, cultural and social factors that influence transmission of JE.

The study aimed at understanding epidemiology of JE and drivers of JE virus transmission between different host systems of an endemic district with the objective of identifying key drivers amenable to interventions. It looked at community and health systems perspectives as they relate to JEV transmission and JE health outcomes. Specifically, the objectives of the study were to:

  • Contribute to improving health and livelihoods of rural populations residing in areas at risk of JE through research on animal-vector-human interactions and the social and environmental factors that influence disease transmission.
  • Improve existing knowledge on relevance of animal-vector-human interactions that influence JEV transmission in selected domestic biotopes
  • Characterise JE vector ecology and bionomics of JE mosquito species in peri-domestic biotopes
  • Determine knowledge, perceptions and practices of different stakeholders in project communities that influence risks of JE transmission and health-seeking behaviour
  • Create multi-dimensional profile and model of domestic and peri-domestic biotopes to help examine risk drivers and key associations for JE transmission in Kushinagar
  • Synthesise and disseminate comprehensive risk profile for JE transmission and implications for prevention and control to promote and inform micro-ecosystem approaches to zoonotic diseases

Accordingly, different disciplines (entomology, public health, animal health, social research) were involved in helping develop a more holistic understanding of the disease and disease outcomes.

Important outcomes and outputs from the study
On one hand,the findings from the study increased the knowledge of JE ecosystems in a high burden district. On the other hand the holistic design of the study, that followed the core principles of EcoHealth research, allowed promotion of an ecosystem approach to zoonoses research and control and ensured context specific planning through involvement of communities. Improved research skills, institutional capacity and organisational practices of Indian partners in JE related and EcoHealth research were other significant outcomes from the study.

The study also resulted in a number of creative outputs that emerged based on findings and interactions that the study team had on the field. These ranged from technical documents, peer reviewed publications to easy-to-comprehend and yet impactful communication tools that could be used by health workers, householders and school teachers providing basic information on JE.

Disease Outbreak News

JE outbreaks are being reported from previously unknown foci. Further, encephalitis outbreaks of other aetiologies in endemic areas have only added to their complexity. For programme managers, researchers and community health professionals, access to accurate and updated information is key to planning interventions and other relief measures.

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