Knowledge gaps exist regarding foodborne zoonotic diseases in migrant populations. We assessed the seroprevalence of Campylobacter, Salmonella, Yersinia, Brucella, hepatitis E virus (HEV), and Trichinella, and identified potential exposure risks in populations with and without migration backgrounds. In a cross-sectional study (2014–2016), adults with Turkish, Russian, Vietnamese, or German backgrounds residing in Berlin, Germany, were recruited via convenience sampling. Sera were screened for anti-IgG antibodies, and risk factors were assessed via a structured questionnaire. Logistic regression was used for analysis. We included 1180 participants: 497 Germans and 215, 273, and 195 individuals with Russian, Turkish, and Vietnamese backgrounds, respectively. Salmonella seroprevalence was highest among Vietnamese (47–50%) and lowest among Turks (18–20%). Campylobacter seroprevalence ranged from 17% to 23%. Yersinia seroprevalence was highest among Germans (64–70%) and associated with raw pork consumption. HEV seropositivity was highest among Vietnamese (27–28%) and lowest among Russians (5%). No samples were positive for Brucella; two were positive for Trichinella. High seroprevalence of Campylobacter, Salmonella, Yersinia, and HEV suggests substantial exposure and frequent asymptomatic or mild infections. While Yersinia seropositivity was associated with raw pork consumption, high seroprevalence in Turks—who rarely consume pork—suggests other food sources or transmission routes.

Goat’s milk production is an important activity in France. Gastrointestinal nematodes (GIN) remain a main threat for grazing goats, usually controlled using anthelmintic drugs (AH). However, 1) eprinomectin (EPN) is the sole molecule yet available without withdrawal time for milk in France; 2) nematodes AH resistances increase dramatically. First, a survey was performed on 13 farms in the Auvergne-Rhône-Alpes (AURA) region to evaluate the efficacy of 2 AH authorized for dairy goats: a benzimidazole (BZ) and a macrocyclic lactone (EPN pour-on). Fecal Egg Count Reduction Tests (FECRT) were carried out using 3 groups of 10 goats per farm: a control group, one treated with BZ (oxfendazole) and one treated with EPN. The results indicate a resistance to BZ in 11 out of 13 farms (84.6%) and a lack of efficacy for EPN pour-on in at least 10 farms (76.9%). Secondly, EPN was given orally or subcutaneously in 4 farms of the previous trial showing a lack of efficacy to EPN pour-on. A resistance to EPN was confirmed in 3 out of 4 farms. Although based on a few farms, these results confirm the high prevalence of resistance of GIN to BZ in dairy goat farms. They also highlight a high level of resistance to EPN and the lack of efficacy of EPN when used pour-on. Given the level of resistance to marketed drugs, there is an urgent need to explore alternative options to AH to prepare integrated, sustainable control of GIN.

Caseous lymphadenitis is an infectious disease that has a significant economic impact on sheep breeding. The objectives of this study were to evaluate the effect of season, animals’ age, sex, body score and shearing on the clinical incidence of caseous lymphadenitis, relapses and abscess location in sheep from Settat province, Morocco. In this longitudinal study, 274 clinically healthy sheep were recruited in six flocks among 1451 inspected sheep and followed during 12 months to cover four seasons. The animals involved in this study were assigned to different age categories at continuous recruitment from February to July 2021 (lambs younger than 6 months, young sheep between 6 and 24 months and old sheep more than 24 months) and to sex categories. Selected animals were clinically examined every 2 months to detect superficial abscesses by palpation of superficial lymph nodes. Information about the number of abscesses and their locations was recorded and analyzed in multivariable statistical models. The results showed that 185/274 (67.5%) of the monitored animals developed superficial CL abscesses. The risk ratio (RR) of superficial CL was significantly higher between April and September compared to between January and March (RR~4.4; p < 0.0001). No significant difference was found between October and December compared to between January and March (RR = 1.2; p = 0.64). Regarding the effect of age, the results revealed that the RR was significantly lower in old sheep compared to lambs (RR = 0.45, p < 0.0001). No significant difference was detected between lambs and young sheep (RR = 0.7, p = 0.07). The prevalence of caudally located abscesses (prefemoral and popliteal lymph nodes, as well as in testicles, scrotum and mammary glands) was significantly higher in old sheep than in lambs (20% versus 3%; odds ratio = 7.8, p = 0.02). The sex, body score and shearing since the last examination did not show any significant effect on CL incidence (p > 0.1). Abscess relapse was significantly lower in old sheep than in lambs (IRR = 0.4, p = 0.003). The highest clinical CL incidence was observed in young animals between April and September and was likely due to indoor intensive rearing management. To conclude, both season and age had significant effects on superficial CL incidence. Farmers, veterinarians and technicians should focus attention and preventive measures against CL on young animals during spring and summer.

Two surveys were conducted to assess the prevalence and risk factors of ovine caseous lymphadenitis (CL) and explore the association between its superficial and visceral forms in Sardi sheep in Settat province, Morocco. A total of 1521 sheep, including 318 lambs < 6 months, 572 young sheep aged 6-24 months, and 631 adult sheep > 24 months, were examined from 57 flocks. Superficial CL prevalence levels were as follows: 69/318 in lambs, 292/572 in young sheep, and 114/631 in adult sheep. Additionally, 2124 sheep, including 1813 young and 311 adult sheep, were inspected in slaughterhouses ante- and post-mortem. Among all infected animals, the prevalence of visceral abscesses was notably higher in adult sheep (83%, OR = 9.8, 95% CI = 5.5-17.2) compared to young sheep (35%). Data on flock size, sex, age, body condition score, rearing methods, and hygienic measures were collected. Suspected CL cases were confirmed using quadruplex-PCR. Poor barn ventilation, lack of abscess control, and younger age were identified as key risk factors for CL. Additionally, a high percentage (89%) of animals with thoracic abscesses did not display superficial lesions. While age and abscess control have been reported in previous studies, barn ventilation appears to be a new, but important, risk factor. In conclusion, the identified risk factors in Settat province are linked to breeding management practices. Implementing regular abscess control measures and improving barn ventilation are essential for CL prevention.

Cystic echinococcosis (CE) is a major zoonosis in Morocco, common in most livestock including sheep. The objectives of this study, performed in sheep of different ages in the Middle Atlas in Morocco, were (1) to compare CE detection, CE count and cysts classification into viable and calcified by ante-mortem hepatic ultrasound (US) scanning and post-mortem macroscopic hepatic inspection and (2) to investigate post-mortem the hydatid cysts present in the liver and lungs to determine in as far hepatic US scanning would fail to detect sheep with exclusive location of CE in the lungs that are not detected on ultrasound. Among 126 examined sheep, 106 were considered as infected by CE by US scanning, whereas 108 were detected at necropsy. Whatever the diagnostic method used; the total number of cysts increased significantly in function of age (p < 0.001). Differentiation capacity between viable and calcified cysts was similar for US scanning and necropsy. Sheep considered as negative by US scanning (n = 32) were confirmed negative by necropsy, leading to a specificity of US scanning of 100% (95% CI: 90-100%) and sensitivity of 98% (IC: 92-99%). Part 2 of the study evidenced that among 97 infected sheep, 78% (IC 95%: 72-83%) presented hepatics cysts, whereas 22% (IC 95%: 17-28%) presented exclusively pulmonary cysts. 56% (IC 95%: 54-59%) of total cysts were located in the liver. Animals showing exclusively pulmonary cysts were lightly infected in comparison to sheep with liver or with liver and pulmonary cysts. Under the conditions of the Middle Atlas sheep farm, the US scan was able to detect 98% of sheep with liver cysts. The US scan therefore allows easy monitoring of the progress of the control measures and provides data on the infestation of animals without the need for autopsy.

Cystic echinococcosis (CE) or hydatidosis is a common parasitic disease worldwide, especially in poor and developing countries. In Morocco, CE is a major zoonosis, despite the implementation of a national control program since 2007. Therefore, in 2016, a field trial that associates the EG95 vaccine (lambs) and anthelmintic treatment (dogs) was started in the Mid Atlas, the most endemic region in Morocco, with preliminary positive results. Here, a qualitative approach was used to analyze the feasibility and social acceptability of this strategy. Fifteen focus group discussions were separately conducted with breeders and with their wives, and forty-two individual interviews were performed with private-sector veterinarians and officers from structures responsible for the CE control program. Recordings were transcribed and analyzed with the R software, using the RQDA package. This qualitative research was validated using the credibility, transferability, dependability and confirmability criteria. This study showed that the professionals' views on sheep vaccination and anthelmintic treatment were divided between acceptability and concerns. Conversely, breeders and their wives highlighted the issue of the costs of procedures the utility of which was not immediately clear to them. All participants proposed solutions to improve this strategy, and also stressed the lack of education on CE. By bringing together the views of the communities and the professionals, this study traced the main lines (targeting the different aspects of CE and taking into account the local socio-cultural beliefs) that must be taken into account to ensure the short- and long-term CE control in Morocco.

BackgroundCystic echinococcosis (CE) is an important cause of human morbidity and mortality worldwide, particularly in Morocco and other North African countries.Methodology/Principal findingsWe investigated the potential of three strategies to reduceEchinococcus granulosustransmission: (1) 4-monthly treatment of dogs with praziquantel, (2) vaccination of sheep with the EG95 vaccine and (3) a combination of both measures. These measures were implemented during four consecutive years in different areas of the Middle Atlas Mountains in Morocco. The outcome of the interventions was assessed through hydatid cyst (viable and non-viable) counts in liver and lungs using necropsy orin vivoultrasound examination of the liver. A total of 402 lambs were recruited for annual vaccination with the EG95 anti-E.granulosusvaccine and 395 similar lambs were selected as non-vaccinated controls.At approximately four years of age the relative risk (estimated as odds ratio) for vaccinated sheep to have viable hydatid cysts compared with non-vaccinated controls was 3% (9.37% of the vaccinated sheep were found infected while 72.82% of the controls were infected; p = 0.002). The number of viable cysts in vaccinated animals was reduced by approximately 97% (mean counts were 0.28 and 9.18 respectively; p<0.001). An average of 595 owned dogs received 4-monthly treatment during the 44 months trial, corresponding to 91% of the owned dog population. Approximately, 5% of them were examined forE.granulosusadult worms by arecoline purge or eggs in feces (confirmed by PCR). The proportion of infected dogs significantly decreased after treatment (12% versus 35%; p<0.001). Post-treatment incidence of re-infestation corresponded to a monthly risk of 4% (95% CI: 3–6%). Treatment of owned dogs on a 4-monthly basis did not reduce the level of transmission ofE.granulosusto sheep, nor did it enhance the level of control generated by vaccination of sheep with EG95, possibly because of unowned dogs and wild canids were not treated.Conclusions/SignificanceThese data suggest that vaccination of sheep with EG95 has the potential to reduce the level of CE in Morocco and in other parts of the world with similar transmission dynamics. Under the epidemiological circumstances existing in the trial area, 4-monthly treatment of owned dogs with praziquantel was insufficient to have a major impact ofE.granulosustransmission to sheep.

ABSTRACT Rabies is efficiently controlled through mass vaccination of dogs. In an area of South Africa where free vaccination campaigns were implemented following rabies re-emergence, the required 70% vaccination coverage was challenging to reach. Understanding the factors affecting the efficiency of mass vaccination is helpful in guiding long-term rabies control efforts. This study aimed to assess the communities’ knowledge and perceptions of dogs, rabies and the related risk, and control behaviors in a rural rabies-endemic interface area. Combined with informal discussions and participative observations, we organized 18 focus group discussions with men, women, and children – stratified by dog ownership status – in three villages in the Mnisi community in the Mpumalanga Province in north-east South Africa. This community highly valued hunting dogs despite hunting of wildlife being illegal. Although people did not have a clear idea of how dogs acquire rabies, they were aware of the presence of the disease and its zoonotic nature. A dog bite was always associated with rabies risk but was also a source of conflict between dog owners and bite victims, hampering bite health care management. Dog vaccination was perceived as a means to prevent diseases from spreading to humans and other animals, not only to protect dogs from diseases but also to cure disease. Lack of awareness, misinterpretation of health promotion messages, and specific beliefs among adults seemed to hinder participation in rabies vaccination campaigns. Involving and educating staff from clinics and wildlife reserves during vaccination campaigns would tackle rumors, clarify dog bite and dog vaccination procedures, and improve the relationship among stakeholders. Further anthropological studies, focusing on people owning dogs for hunting, may provide a better understanding of rabies transmission patterns and risk factors in this community.

The traditional rabies control strategy based on annual mass vaccination of dogs appears to be costly and cumbersome. Given the existence of different risk zones for rabies transmission, the present study aimed at proposing risk-based vaccination schemes by considering canine population dynamics as well as vaccine efficacy and duration of immunity (DOI). The capital of the Democratic Republic of the Congo (RDC), Kinshasa, was chosen as study site. The turnover rate of dogs was used to assess their population dynamics in two low-roaming (<25 % of dogs are roaming) and in two high-roaming zones (>75 % of dogs are roaming). The sero-conversion rate was assessed in response to primo-vaccination in three age groups: 24 puppies (≤3months), 37 juveniles (4-12 months) and 22 adult dogs. The DOI was evaluated serologically by revaccinating dogs previously vaccinated since 1-2 years (n = 31), 2-3 years (n = 12) or 3-7.5 years (n = 4). Rapid Fluorescent Focus Inhibition Test was used to quantify antibodies. These data were used to implement vaccination outcome models.The turnover rate was twice as high in high-roaming zones (36 %) as that in lowroaming zones (17 %). Irrespective of roaming level, 75 % of dogs were less than 3 years old. The vaccine was equally effective in puppies (96 %), juvenile (97 %) and adult dogs (100 %, p = 0.24). The vaccine was effective in 93 % (11/12) of puppies without pre-vaccinal protective titers (≥0.5 IU/mL). The anamnestic response was strong within 5-8 days upon the booster vaccination, in 96 % (45/47) of dogs reported vaccinated 1-7.5 years before. This suggests that the vaccine provided a long-term protection (≥3 years) which is likely to occur in 75 % of dogs in Kinshasa.Hypothesizing a vaccination stop, the vaccination outcome model allowed to estimate the time point after which vaccination coverage would drop below 40 % in function of dog population turnover rate. The systematic vaccination of puppies as well as annual vaccination of dogs aged between 3 and 15 months or annual vaccination of all unvaccinated dogs aged more than 3 months of age appeared as valuable alternative to systematic annual mass vaccination.In conclusion, this study developed a vaccination outcome model pointing out the impact of dog population dynamics and of effective duration of immunity. It appears as a promising tool for designing cost-effective rabies vaccination campaigns.

This study aimed to consolidate current knowledge of wildlife brucellosis in Africa and to analyse available predictors of infection. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Information on species, test used, test results, area, rainfall, livestock and wildlife contact and year of study were extracted. This systematic review revealed 42 prevalence studies, nine disease control articles and six articles on epidemiology. Brucella abortus, Brucella melitensis, Brucella inopinata and Brucella suis were reported in wildlife. The prevalence studies revealed serological evidence of brucellosis in buffalo, antelope (positive in 14/28 species), carnivores (4/12) and other species (7/20) over the last five decades. Buffalo populations were more likely to be infected and had a higher seroprevalence than other species; the pooled seroprevalence was 13.7% (95% CI 10.3–17.3%) in buffalo, 7.1% (95% CI 1.1–15.5%) in carnivores and 2.1% (95% CI 0.1–4.9%) in antelope. Wildlife in high rainfall areas (≥ 800 mm) were more likely to be infected, and infected populations showed higher seroprevalence in high rainfall areas and in studies published after 2000. Domestic animal contact was associated with increased seroprevalence in antelope and carnivore species, but not in buffalo, supporting the hypothesis that buffalo may be a reservoir species.

Avec l’avènement de la médecine vétérinaire moderne, les pratiques traditionnelles vétérinaires sont reléguées au second plan dans la gestion zoosanitaire des animaux d’élevage. Toutefois, la médecine vétérinaire moderne n’a pas pu faire face à tous les problèmes sanitaires des exploitations d’élevage, surtout dans les milieux ruraux où l’accès aux médicaments et services vétérinaires pose un problème. A cela s’ajoute le faible pouvoir d’achat des éleveurs. Ces derniers sont obligés de recourir aux pratiques et connaissances traditionnelles pour traiter leurs animaux. La médecine ethnovétérinaire a joué un rôle primordial dans la gestion des exploitations d’élevage depuis la domestication jusqu’à nos jours. Les auteurs retracent l’évolution des pratiques ethnovétérinaires puis examinent la contribution de la recherche scientifique à la connaissance et l’amélioration de la médecine traditionnelle vétérinaire. Les raisons qui expliquent aujourd’hui l’engouement autour des pratiques traditionnelles vétérinaires sont discutées. Des mesures sont proposées sous forme de perspectives pour pérenniser la médecine ethnovétérinaire. Il s’agit principalement d’oeuvrer pour la disponibilité des plantes médicinales et autres ressources naturelles utilisées dans les pratiques ethnovétérinaires, mais aussi de prouver scientifiquement l’efficacité de ces plantes et de transmettre aux éleveurs les informations les plus pertinentes. L’intégration des pratiques et des connaissances traditionnelles dans la médecine vétérinaire moderne apparait comme une alternative prometteuse pour une meilleure gestion de la santé des animaux d’élevage. Les conditions de cette intégration sont évoquées. La recherche scientifique a encore un grand rôle à jouer dans la vérification de l’efficacité des traitements ethnovétérinaires.

Cystic echinococcosis, rabies and bovine tuberculosis are major neglected zoonoses in many developing countries, including Morocco. A common step in their control strategies is the management of slaughterhouses and/or the control of dog populations. This study used a qualitative approach to identify the barriers to the implementation of the cystic echinococcosis control programme in Morocco that focused on slaughterhouses and dog control. This approach could be used to understand the causes leading to the defective management of other zoonoses, and to go beyond the often-invoked 'lack of means' reason to explain failure in disease control in the Global South. Specifically, slaughterhouse observation and in-depth individual interviews with stakeholders involved in the cystic echinococcosis control programme were carried out in five Moroccan regions (Rabat-Sale-Kenitra, Mellal-Khenifra, Sous-Masaa, Laayoune-Sakia El Hamra and Guelmim-Oued Noun) for 3 years (from 2014 to 2016). Interviews (n = 81) were with agents responsible of the services managing slaughterhouses and dog population control, and also with slaughterers. Recordings were fully transcribed and narratives were analysed with the RQDA package and the R software. Triangulations and the criteria proposed by Guba and Lincon were used to assess the approach validity. This analysis revealed that in addition to 'lack of means', zoonosis control programmes can be hindered by overlapping authority/functions among the involved authorities, conflicts of interest, lack of proper training and professional practices. Zoonosis control requires the commitment of all structures, the establishment of a national and inter-regional strategy, and the updating of the legislative arsenal.

East Coast fever (ECF) is an often fatal, economically important cattle disease that predominantly affects eastern, central, and southern Africa. ECF is controlled through vaccination by means of simultaneous injection of oxytetracycline and cryogenically preserved stabilate containing live, disease-causing parasites. Storage and transportation of the stabilate requires liquid nitrogen, a commodity that is commonly unreliable in low-resource settings. Here we show that storage of conventionally prepared stabilate at -80 °C for up to 30 days does not significantly affect its ability to infect cultured peripheral blood mononucleated cells or live cattle, suggesting an alternative cold chain that maintains these temperatures could be used to effectively manage ECF.

Cystic echinococcosis (CE) is a major zoonosis in Morocco. Despite a national hydatidosis control programme (NHCP) established in 2005, CE burden is still high nationwide. The aim of this study was to carry out an NHCP stakeholders' analysis to identify weak points and propose improvement strategies. In total, 164 semi-structured interviews were carried out with national and local stakeholder representatives, and one stakeholders' workshop was organized. Classical categories of stakeholder analysis (i.e. involvement, interest, importance, influence, priority, and power) were semi-quantified. Based on these categories, an analytical framework was proposed, by selecting elements from the stakeholder analysis, to structure the assessment around three criteria: measure appropriation, political agency, and socio-technical agency. Besides specific weak points of the NHCP, the analysis highlighted the complexity of implementing a zoonotic disease control programme due to the involvement of many different stakeholders. Finally, this study provides a simplified stakeholder analysis method that could be used to assess other health programmes targeting zoonotic diseases, in Morocco and in similar countries.

Cystic echinococcosis (CE) is a major zoonosis in Morocco despite the launch of a national control programme in 2005. As its economic consequences have not been studied yet in Morocco, this study estimated CE impact in terms of monetary losses, disability-adjusted life years (DALY), and DALY for zoonotic diseases (zDALY) in the entire country and in specific regions for the 2011 to 2014 period. The direct monetary losses were related to organ seizure from infected animal in slaughterhouses, and to healthcare expenses as well as lost wages for infected humans. Animal production losses concerned milk yield, fertility, carcass weight, and wool production. Losses due to human infection were also composed of disability and productivity losses at work. Monte Carlo simulations were used to estimate monetary losses and zDALY values. Nationwide, the estimated DALY was 0.5 years per 100,000 persons per year, and the zDALY was 55 years per 100,000 persons per year. Total yearly losses were estimated at 73 million USD (54-92 million USD). However, losses differed significantly among regions. Most of the economic losses consisted of unperceived consequences, i.e. decreased animal production and reduced productivity of asymptomatic individuals. Future studies should determine the socioeconomic and epidemiological factors underlying the differences in economic losses among regions to develop better adapted control programmes.

A longitudinal study was carried out in Middle atlas, Morocco (locality of Had Oued Ifrane) in a population of 255 dogs from three localities, including two categories of dogs (owned and stray dogs). The dogs were investigated three times over a period ranging from 4 to 8 months between December and August. At each investigation, dogs were treated with arecoline, inducing defecation and allowing feces collection. Dogs were further treated with praziquantel to clear them from Echinococcus granulosus. Microscopic examination of feces was performed to assess the infection status of dogs at each investigation, and positive samples underwent copro-PCR to determine the circulating strain of E. granulosus. A high prevalence of infestation ranging from 23.5% to 38.8% and from 51.3% to 68.5% was, respectively, found in owned and in stray dogs. The PCR results revealed the presence of G1 strain in all positive samples. A logistic regression model was used to determine the incidence of infestation and showed that stray dogs underwent a significantly higher risk of infection (odds ratio = 14; 95% confidence interval: 6-30; p < 0.001) compared with owned dogs. Only anthelmintic treatment intervals of 2 months efficiently prevented egg shedding in owned and stray dogs. The seasonal effect was also significant, with the highest risk of reinfestation in winter and the lowest risk in summer. This study confirms that stray dogs undergo an increased risk of infestation by E. granulosus and indicate that infective pressure is influenced by season.

Background Theileria parva causes East Coast fever (ECF), one of the most economically important tick-borne diseases of cattle in sub-Saharan Africa. A live immunisation approach using the infection and treatment method (ITM) provides a strong long-term strain-restricted immunity. However, it typically induces a tick-transmissible carrier state in cattle and may lead to spread of antigenically distinct parasites. Thus, understanding the genetic composition of T. parva is needed prior to the use of the ITM vaccine in new areas. This study examined the sequence diversity and the evolutionary and biogeographical dynamics of T. parva within the African Great Lakes region to better understand the epidemiology of ECF and to assure vaccine safety. Genetic analyses were performed using sequences of two antigen-coding genes, Tp1 and Tp2 , generated among 119 T. parva samples collected from cattle in four agro-ecological zones of DRC and Burundi. Results The results provided evidence of nucleotide and amino acid polymorphisms in both antigens, resulting in 11 and 10 distinct nucleotide alleles, that predicted 6 and 9 protein variants in Tp1 and Tp2 , respectively. Theileria parva samples showed high variation within populations and a moderate biogeographical sub-structuring due to the widespread major genotypes. The diversity was greater in samples from lowlands and midlands areas compared to those from highlands and other African countries. The evolutionary dynamics modelling revealed a signal of selective evolution which was not preferentially detected within the epitope-coding regions, suggesting that the observed polymorphism could be more related to gene flow rather than recent host immune-based selection. Most alleles isolated in the Great Lakes region were closely related to the components of the trivalent Muguga vaccine. Conclusions Our findings suggest that the extensive sequence diversity of T. parva and its biogeographical distribution mainly depend on host migration and agro-ecological conditions driving tick population dynamics. Such patterns are likely to contribute to the epidemic and unstable endemic situations of ECF in the region. However, the fact that ubiquitous alleles are genetically similar to the components of the Muguga vaccine together with the limited geographical clustering may justify testing the existing trivalent vaccine for cross-immunity in the region.

Cystic echinococcosis (CE), a neglected zoonosis caused by the larval stage of the tapeworm Echinococcus granulosus, remains a public health issue in many developing countries that practice extensive sheep breeding. Control of CE is difficult and requires a community-based integrated approach. We assessed the communities' knowledge and perception of CE, its animal hosts, and its control in a CE endemic area of the High Atlas Mountains, Morocco. We conducted twenty focus group discussions (FGDs) stratified by gender with villagers, butchers and students in ten Berber villages that were purposefully selected for their CE prevalence. This community considers CE to be a severe and relatively common disease in humans and animals but has a poor understanding of the parasite's life cycle. Risk behaviour and disabling factors for disease control are mainly related to cultural practices in sheep breeding and home slaughtering, dog keeping, and offal disposal at home, as well as in slaughterhouses. Participants in our focus group discussions were supportive of control measures as management of canine populations, waste disposal, and monitoring of slaughterhouses. The uncontrolled stray dog population and dogs having access to offal (both at village dumps and slaughterhouses) suggest that authorities should be more closely involved in CE control. This study also highlights the need for improved knowledge about the transmission cycle of the parasite among communities and health professionals. Inter-sectoral collaboration between health staff, veterinarians, and social scientists appears to be crucial for sustainable control of this parasitic zoonosis.

Purpose: Rabies kills every year 61000 humans in the world, mainly in Asia and Africa. In the Democratic Republic of Congo (DRC), rabies is endemic and the dog is the main vector of human rabies. From 1937 to 2017, around 1400 positive dog rabies cases were recorded across the country. The study aims to better understand the epidemiological factors of rabies maintenance in dogs in Kinshasa.

Illustrative quotes from the Focus Groups Discussions (a to n). Quotes (a to n) selected from the Focus Group Discussions conducted in the Hight Atlas in Morocco (October - November 2009) to illustrate the results. (DOCX 18 kb)