CONNECTING ECO-HEALTH COMMUNITY TO WILDLIFE ZOONESES
Shukor Md Nor (DVM, PHD) School of Environment and Natural Resources Faculty of Science and Technology University Kebangsaan Malaysia
ECOHEALTH VS ONE HEALTH
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ONE HEALTH “One World One Health” was first launched at The IUCN World Conservation
Congress in Bangkok on 11-25 November 2004
One Health concept Strategy for expanding interdisciplinary collaborations and communications in all aspects of health care for humans, animals and the environment.
One Health Definitions
One Health is the collaborative effort of multiple disciplines working locally, nationally, and globally, to address critical challenges and attain optimal health for people, domestic animals, wildlife, and our environment.
One Health Commission (http://www.onehealthcommission.org/)
The One Health concept is a worldwide strategy for expanding interdisciplinary collaborations and communications in all aspects of health care for humans and animals.
One Health Initiative (http://onehealthinitiative.com/)
The One Health concept is the realization that human, animal, and environmental health are interrelated.
Powdrill TF, Nipp TL, Rinderknecht JL. 2010
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Ecohealth Definitions
Ecosystem approaches to public health issues acknowledge the complex, systemic nature of public health and environmental issues, and the inadequacy of conventional methodologies for dealing with them.
Dr. David Walter-Toews, University of Guelph
The Ecohealth approach focuses above all on the place of human beings within their environment. It recognizes that there are inextricable links between humans and their biophysical, social, and economic environments, and that these links are reflected in a population's state of health.
International Development Research Centre (IDRC)
Its approach is inherently transdisciplinary and recognizes complex biophysical, social, cultural, political and economic relationships between the ecosystem and human health.
-National Council for Science and the Environment
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Ecohealth is a ‘new’ field that has encouraged innovative, cross-disciplinary work both locally and internationally
6 Ecohealth principles
Systems thinking
Transdisciplinarity
Participation
Sustainability
Gender and Social Equity
Knowledge-to-Action
Encourages dialogue and partnerships between different groups and recognizes the relationships between human and ecological health
Ecohealth Principles
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One Health VS Ecohealth
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????
One Health VS Ecohealth
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Ecohealth Vs Ecosystem Health
One Health VS Ecohealth
Many similarities
Different traditions/backgrounds
Tentative steps toward integration
In this talk I considered both created for the same puproses.
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KEY FACTORS Human
Animal
Environment
Their interactions
Understanding based on transdisciplinary approach
Human
Animal Environment
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WILDLIFE ZOONOSES
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BACKGROUND
Wildlife serves as a reservoir for many diseases common to domestic animals and humans. Generally, wildlife zoonotic disease is more easily prevented than treated. Many wildlife zoonotic diseases are so common in nature, so rare in humans, or so mild in their symptoms, that wild animals pose a minimal health risk to people. However there are important and need to understand and study due to possible emergence – Emergence need to be controlled via surveillance.
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BACTERIAL DISEASES Leptospirosis Brucellosis Bubonic Plague Psittacosis Salmonellosis Tetanus Tularemia MYCOTIC DISEASES Aspergillosis Histoplasmosis VIRAL DISEASES Rabies
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HELMINTH PARASITIC DISEASES Baylisascaris procyonis PROTOZOAL DISEASES Giardiasis Toxoplasmosis TICK-BORNE DISEASES Lyme disease Rocky Mountain Spotted Fever PHYSICAL TRAUMA
LIST OF DISEASES GROUPED ACCORDING TO THEIR CAUSATIVE AGENT OR MODE OF TRANSMISSION
HOWEVER NOTE THAT THERE ARE SEVERAL ZOONOTIC DISEASES THAT NEED ATTENTION ALTHOUGH MIGHT NOT CONSIDERED ENDEMIC/ PENDEMIC. THERE ARE ALSO POTENTIAL EMERGENCE AND REMERGENCE HAS DIRECTLY AND INDIRECTLY MAY HAS IMPACT ON WILDLIFE AND HUMAN
ONE HEALTH PROGRAM FOR MALAYSIA
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UNDERSTANDING LINKAGE OF PATHOGEN, WIDLLIFE
HOST AND DISEASES EMERGENCE
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Connecting the Health of Wildlife, People and their Animals
One Health triad that encompasses humans, domestic animals, wildlife and the changing ecosystems in which they live.
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PATOGEN
WILDLIFE
HUMAN
(INFECTED)
DOMESTIC
LINKAGE AMONG WILDLIFE, DOSMESTIC ANIMAL
AND HUMAN
spilled back
spilled over
ANIMAL (host)
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PATOGEN
HOST/
RESERVOIR
(RESISTANT
– DEAD END
HUMAN
(INFECTED)
HOST/
RESERVOIR –
SPILL OVER
HOST/
RESERVOIR
(MAINTANANCE)
exposure
surveillance
emergence
reemergence
Question – What would trigger pathogens / infection agents? Random, host,
environment, all combination?
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Wildlife
Urbanization
Agricultural, land use
and animal husbandry
changes/practices
Habitat
alteration
Species’ Ecological-evolutionary Dynamics
Opportunistic habitat expansion/ecological release
Vector (domestication) Vector/reservoir species
Wildlife/reservoir transport/encroachment Human encroachment
Host-Pathogen Dynamics
Emergence Processes of ‘Host-Parasite Biology’ Host switching (host novelty) • Breaching of pathogen persistence thresholds
Transmission amplification and genetic change (pathogen novelty)
Disease Emergence ecosystem continuum
H
U
M
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C
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S
Y
S
T
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M
N
A
T
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R
A
L
E
C
O
S
Y
S
T
E
M
Global
climate
change
Demographic Changes
Technology/Globalization
Socio-cultural organization
REGIONAL ENVIRONMENTAL CHANGE
Wilcox, B. A., & Colwell, R. R. (2005). Emerging and Reemerging Infectious
Diseases: Biocomplexity as an Interdisciplinary Paradigm. EcoHealth, 2(4), 244-
257.
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PATOGEN
HOST/
RESERVOIR
(RESISTANT
– DEAD END
HUMAN
(INFECTED)
HOST/
RESERVOIR –
SPILL OVER
HOST/
RESERVOIR
(MAINTANANCE)
exposure
surveillance
emergence
reemergence
Not all exposure will be transmitted to human ?
FACTS ABOUT WILDLIFE AND ZOONOSES
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Example 1 – Demographic Change: Increase Population to Increase Outbreak
Outbreaks were positively correlated with growing population densities where 60.3% were zoonoses and 71.8% of these originated in wildlife. Jones, Patel, Levy, et. al. Nature, 2008 Feb. 21; 451 (7181):990-3
Example 2 – Change Agriculture Pratices to Increase Emergence
Changing agricultural practices produced another outbreak of zoonotic disease, Nipah virus infection, in Malaysia in 1998–1999.8 Deforestation and intensive fruit tree cultivation combined with increased pig farming to elevate the exposure of pigs to fruit bats subclinically infected with and shedding Nipah virus. The virus rapidly spread through the country’s pig population, certainly through trade and possibly also between farms by dogs and cats. Humans in direct contact with pigs then acquired the infection and its often-fatal encephalitis.
Emergence of Diseases From Wildlife Reservoirs, J. C. Rhyan, and T. R. Spraker. 2010
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Example 3 – Decrease Host Species Diversity and Increase Prevalence
Explanation 1
Dilution effect, whereby increasing species diversity decreases disease prevalence by diluting the availability of competent hosts with increased numbers of non competent hosts.
a dilution effect could occur if 1) individuals of the host species remain as species diversity decreases, 2)the disease is spread within the host species through direct encounters (such as biting), and 3) presence of other species causes encounters among the host species to decrease.
- Implication for conservation
Increased Host Species Diversity and Decreased Prevalence of Sin Nombre Virus Laurie J. Dizney and Luis A. Ruedas (2009)
Explanation 2
Encounter reduction - as more species, and more individuals within those species, are added to the community, the number of potential disease-transmitting encounters decreases because other species are non-host (not competent, or non-amplifying) species.
Explanation 3
Competition - if increasing species diversity increases the number of competitors in an ecosystem, thereby increasing the amount of time a host species has to spend securing limited resources (food, nest sites), in turn decreasing the time spent on intraspecies encounters.
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Explanation 4
Predation – if predation and competition are decreased or absent in a community, a zoonotic release of predatory and competitive controls appears to have occurred, infection prevalence will increase drastically.
The implications of wildlife EIDs are twofold: i) emerging wildlife diseases cause direct and indirect loss of biodiversity and ii) add to the threat of zoonotic disease emergence.
35 Anthropogenic environmental change and the emergence of infectiousdiseases in wildlife. Daszak P, Cunningham AA, Hyatt AD. Acta Trop. 2001 Feb 23;78(2):10316.
Example 4 – Decrease Habitat size (fragment) Increase Prevalence
Landuse change for development reduced habitat size. Resources availability are reduced and increased stress on wildlife. High stress allow to increase prevalence.
WILDLIFE ZOONOSES – RODENT HOST OR RESERVOIR
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Rodents have proven to be of increasing importance in transmitting diseases to humans in recent decades, through the emergence of worldwide epidemics trough the emergence of diseases (e.g. leptospirosis and scrub typhus).
From wild to anthropized habitats, rodents can be reservoirs, hosts or vectors of infectious organisms.
Occupying almost all biotopes and by rapidly adapting to environmental changes, rodents are fundamental in the maintenance and transmission of an impressive number of infectious organisms to humans.
Investigations of parasites and pathogens in murine rodents have helped to describe the implication of the main species and understand the different ways of transmission.
Sathaporn Jittapalapong1*, Vincent Herbreteau2, Jean-Pierre Hugot, Peera Arreesrisom, Anamika
Karnchanabanthoeng, Worawut Rerkamnuaychoke and Serge Morand, 2013
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Why Rodents ?
They are known to transmit diseases and act as reservoir host for many zoonotic pathogens including parasites that pose a health risk to humans (Walsh et al., 1993; Mayer et al., 1995; Singleton et al., 2003).
Endo-parasites of rodents play an important role in the zoonotic cycles of many diseases, e.g. schistosomiasis and angiostrongyliosis. Several studies on endoparasites of commensal and forest rodents have been carried out in Malaysia
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Why Rodents ?
Why Rodents?
Some rodent-reservoir zoonoses are ‘sleeping giants’ that may awake at any time.
A crucial point here is that zoonotic pathogens that are virulent in humans are typically avirulent in their natural reservoirs: the same pathogens are therefore often medically important but archetypically ‘endemic’ in a rodent population.
Disease: health effects on humans, population effects on rodents Michael Begon
Rodents are a key mammalian group and are highly successful in adapting to many environments throughout the world.
There are more than 1700 species of rodents identified in the world (RatZooMan, 2006).
How about Bats?
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EXAMPLE WILDLIFE ZOONOSES STUDY 1:
Leptospira
Prevalence and serovars
distribution
Molecular detection
Molecular epidemiology
Virulent gene
identification
Target gene identification
Clinical parameters & predictors
Production and clinical course
of biomarkers
Host immune response
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GROUP 1
Diagnostic and Prognostic Biomarker
GROUP 2
Determination of
Epidemiology & Molecular
characteristics of Leptospira
GROUP 3
Socio behavioural & Risk Perception
GROUP 4
Identification and control of
Leptospira hosts
Sociobehavioural risk factors
Risk perception
Interactive health education
Host biology
Host diversity
Methods of
population control
LINKS AMONG PROJECT GROUPS
Project 4 – Prevention and
control
Source: Nature Reviews Microbiology 7, 736-747 (October 2009)
MODE OF TRANSMISSION (MOT)
Reservoir
MOT
Mus msuculus, Asian House Mouse (house and buildings)
Rattus rattus, House Rat (house, garden)
Rattus tiomanicus, Malayan Field Rat (Plantation, garden)
Rattus norvegicus, Norway Rat
(Town and port)
Rattus exulans, Pacific Rat
(Paddy, garden, house)
POTENTIAL SPECIES
UNANSWERED QUESTIONS
1. Is there any specific host species for leptospira,
2. How do the hosts become the major carrier of transmitting leptospira to the human within a specific habitat,
3. What is the pattern of leptospirosis occurrence (prevalence) at specific habitat and time?,
4. What are the important environmental factors contributing to the occurrence of the leptospirosis cases?
5. Is the prevalence of the leptospirosis cases associated with the host population, or human negligence?,
6. What are the best options in reducing the occurrence of the leptospirosis cases in this country?
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HYPOTHESES AND ASSUMPTIONS
1. Rodent (rats) is an important wildlife reservoir for leptospira compare to other wildlife (WHY)
2. Rapid population growth of this group contribute to the rapid transmission of the leptospira (HOW)
3. Rodent species closely associated with human (habitat) potentially is the main carrier and reservoir for the transmission (WHY and HOW)
4. Water (not direct contact) an important mode of transmission from the reservoir to the human (HOW)
5. There are many compounding factors determining the transmission of leptospira (HOW)
STUDY SITES AND DESIGN
• High prevalence areas in Perak, Selangor, and Kelantan.
• Two habitats – Recreational areas and urban and semi-urban areas
• Two study plots for each habitat.
• Live trapping with 100 traps each
• Intervals of 10m apart
• Trapping intervals with 3-5 days per month
• Examination and identification (weighing and external measurement)
• Ear tagging and radio collar (if selected),
• Urine sample
• Release and monitoring
METHODOLOGY 1
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METHODOLOGY 1 – WHAT CAN BE ACHIEVED
Understanding home range, habitat preference, activity and movement patterns of potential leptospira hosts.
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METHODOLOGY 2
50 RELEASE MONTHLY MONITORING
METHODOLOGY 2 – WHAT CAN BE ACHIEVED
Determination the small mammal diversity and species composition
Population structure of small mammals
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METHODOLOGY 3
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Education
environmental control
• Choice depend on the test either one or combination of many control methods
• Educating communities also required ?
METHODOLOGY 4
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Collection of urine for leptospira screening Drink and fasting overnight
LAB RELEASE
CONCLUSION
It is uncertain if the leptospiras are transmitted from specific animal species or all the animals are the potential reservoir for the leptospiras.
It is still uncertain if the outbreak of leptospiras are initiated from the host/ reservoir or environment or combination of all factors.
This study will uncover the general pattern of how the leptospiras are transmitted to human.
The population and ecological data will be used to generate a suitable (and practical) control method of the hosts/ reservoirs, thus the leptospirosis cases can be controlled.
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EXAMPLE WILDLIFE ZOONOSES STUDY 2:
Ticks and Mites
Movements and home range of a common species
of tree-shrew, Tupaia glis surrounding houses of
otoacariasis cases in Kuantan, Pahang
Dr Mariana Hj Ahamad
Acarology Unit, IMR
Ticks inside human ear canal
Literatures
Cases of ticks entering ear canal of human
(Indudharan et al., 1986; 1995; 1999; Srinovianti & Raja Ahmad, 2003,
Mariana et al., 2008)
Biological dynamics of ticks involved (Mariana et al., 2008)
Common small animals caught inside houses & compounds of affected human (Mariana et al., 1996; Mariana et al., 2010)
Research Questions: Source of tick infestation
Human otoacariasis is not a natural occurrence but rather accidental
Human may be infested when living, working or conducting activities in close contact with tick-infested animals or close to the environment where ticks naturally occur
There are also possibilities for animals (shrews & rodents)
to introduce the ticks into houses and compounds (Mariana, pers. comm)
Objectives
To obtain information on activity and movement patterns,
home range, nesting behaviour and social organization of 5
individuals of a common tree-shrews, T. glis caught
surrounding houses of otoacariasis cases in Felda Bukit
Goh, Kuantan.
To document these information for spatial distribution of
tree-shrews with ticks for public health research.
Study Area
The study was conducted in
Lorong Bukit Goh 3/1, Felda
Bukit Goh, Kuantan, Pahang
(N03º54’ E103º15’), an area
with high number of new
and repeat otoacariasis
cases (adult & children)
Bukit Goh
Tick species
distribution
GIS
Identification & body
engorgement index
Cases related to
Meteorological Factors
Survey of ticks
surrounding
house of cases
Study on movements of animals with ticks
Catch, mark &
release
Movements & Home range of shrews with ticks
using Mark-Recapture Techniques
Toe nail-clipping method to mark shrews (Yasuma & Andau, 1999)
3 times in a period of 3 months
(Apr – Jun 2008)
5 – 7 consecutive nights
130 wire-traps, laid 10m apart
5 shrews (3 , 2) were monitored
Chip track with portable telemetry receiver fitted with a 3-element Yagi antenna
Observation period: time exit from nest till enter nest
Fixes plotted on graph paper for coordinates
Analyse coordinates using Ecological Software Solutions (Biotas Version 1.03)
Population Study Telematry study
Epidemiological studies
Tick species
distribution
Epidemiological studies
GIS
Clinical study Identification & body
engorgement index
Cases related to
Meteorological Factors
Survey of ticks
surrounding
house of cases
Study on movements of animals with ticks
Transmitter chip radio-collar
Ticks Battery
(operates between frequencies of 154.13 -154.21 MHz)
Modal (mode) time of exit and entry into nest for T. glis in Bukit Goh.
ID Sex
Nest
Modal time of
exit from nest
(hour system)
Modal time of
entry into nest
(hour system)
13 Male House No. 197 (kitchen) 0601-0700 1901-2000
15 Male Jack fruit tree with bushes around 0601-0700 1901-2000
17 Female House No. 197 0601-0700 1901-2000
19 Female House No. 211 0601-0700 1901-2000
21 Male Long Bushes and scrubs behind
House No 211
0601-0700 1901-2000
2 houses were identified as nests
2 shrews of different sex shared the same house as their nest.
Beginning of activity between 6.01 -7.00 am. By 8.00 pm, shrews were already in their nest
Layout of houses (numbered 196 to 213; house # 207 was no longer
exist during study) and designated points (T1 to T7) for taking
compass bearing for telemetry.
Fruit orchard
Land for
rearing
cows &
chicken
Long bushes
at the back
Coconut
trees
Secondary
forest
Small village road
T1 T2 T3 T4
T5
T6 T7
209 210 211
212
213
196
197
198 199 200 201
202 203
204 205 206
208
Table 4. Total length of active period, mean and range of total daily
distances moved by every individual of T. glis.
ID Sex Number of
days
Mean total
active period
(hour)
Mean total
daily
distances
moved (m)
Range of
total daily
distance (m)
13 Male 74 5.75 372.01 2976.08
15 Male 116 6.30 273.78 3285.36
17 Female 54 5.00 349.99 2449.93
19 Female 141 7.00 382.59 4591.08
21 Male 93 4.90 270.11 2971.21
Mean active period = 4.9 – 7.0 hrs / day
Mean total daily distances moved = 270 – 383 m
Range of total daily distance = 2445 – 4591 m
Table 5. Mean daily rate of movement and maximum observed rate of movement
by each individual of T. glis.
ID Sex Number of
days
Mean daily
rate of
movements
(m/hour)
Maximum
observed rate
of movement
(m/hour)
13 Male 74 64.69 113.11
15 Male 116 43.46 136.12
17 Female 54 69.99 174.09
19 Female 141 54.66 201.31
21 Male 93 55.12 197.73
Mean daily rate of movement = 44 – 70 m / hr
Maximum observed rate of movement = 113 – 201 m / hr
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Conclusion
1. Their total active periods spent moving around from vegetations / trees in fruit orchards or from a nearby secondary forest to trees in compound of 4 – 7 houses and vice versa
2. Evidences of shrews having close contact with human in this area:
Nest for 3 shrews were found in 2 houses
Presence of a shrew in kitchen of a house
A dead drowned shrew in water pool of a house
Shrews are potential carriers of tick from the wild into
houses and their compounds based on ….
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EXAMPLE WILDLIFE ZOONOSES STUDY 3:
Blood Meals
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EXAMPLE WILDLIFE ZOONOSES STUDY :
Effect of fragmentation on Blood parasite prevalence
Effects of forest fragmentation on
parasite prevalence in avian blood
Farah Shafawati Binti Mohd Taib
Fakuti Sains & Teknologi,
Universiti Kebangsaan Malaysia
Bangi, Selangor MALAYSIA
INTRODUCTION
Recently, number of Emerging infectious disease-EIDs
especially from wildlife have risen in the last few
decades.
The main factor that brought in EIDs include
urbanization, rising human population, agricultural
activities, wildlife trade, loss of biodiversity, pathogen
from invasive species and global warming.
Blood parasites play a fundamental role in the ecology
and evolution of birds as they are able to affect the
fitness and survival of their hosts.
Forest fragmentation
Forest fragmentation??
Forest fragmentation occurs when a large
continuous forest reduced to smaller fragments
that are isolated by surrounding due to
anthropogenic activities.
It also includes a subdivision of forest patches
into more isolated fragments by expanding urban
areas, agriculture and other types of land uses
(Navjot et al., 2011).
Parasite prevalence vs Forest
fragmentation
Fragmentation process which increase edge effect may alter host-parasite relationship through:
1) Enhancing the ability of parasite which easily infected edge areas to infect the interior community.
2) Increasing edge effect allows contact between bird species that nesting in nearby habitat which resulting to exposure of fragment inhabitants towards new species or vector.
3) Loss of habitat for nesting forcing nest re-use.
4) Social and physiological preassure which related to reduction in habitat quality resulted in pathogenesis which consequently affecting fitness.
Kota
Damansara
(KD)
Ayer Hitam
(AH)
Bangi
(Bangi)
Bukit
Nanas
(BN)
Bkt. Sungei
Puteh (SP)
& Sg. Besi
(SB)
Pangsun
Sg. Tua (ST)
Materials & Method
In the field
In the lab: Staining blood smears (Giemsa Stainning)
Parasite prevalence among sites
Plasmodium
Trypanosoma
Haemoproteus
Leucocytozoo
n
Babesia Aegyptianella
Erlichia Microfillarea
0
10
20
30
40
50
60
70
AH Bangi BN KD SB SP Pgsn ST
Fragmented Continuous
Para
site
pre
vale
nce (
%)
Forest type
Infection (%) Multiple infection (%)
Parasite prevalence among sites
Site
Num. of
captured
birds
Num. of
Infected
birds Infection
(%)
Multiple
infection
(%) Pla
smodiu
m
Haem
opro
teus
Leukocyto
zoon
Try
panoso
ma
Babesi
a
Aegypti
anella
Erl
ichia
Mic
rofi
llare
a
AH 31 20 64.5 37.5 9 8 10 0 9 9 1 1
Bangi 7 4 57.1 42.9 2 3 1 0 1 2 0 0
BN 10 4 40 20 0 0 2 1 1 0 2 1
KD 45 14 31.1 15.6 4 4 4 0 5 9 2 0
SB 26 11 42.3 15.4 1 1 5 1 5 5 0 0
SP 26 13 50 18.5 4 2 2 3 7 0 0 0
Pgsn 98 19 19.4 6.25 7 5 6 0 0 5 0 4
ST 71 20 28.2 14.1 6 2 2 0 0 13 0 8
Plasmodium
16%
Haemoproteus 14%
Leucocytozoon 19%
Trypanosoma 4%
Babesia 22%
Aegyptianella
20%
Erlichia 4%
Microfillarea 1%
Forest fragment Continuous forest
Plasmodium 22%
Haemoproteus 12%
Leucocytozoon
14%
Trypanosoma 0%
Babesia 0%
Aegyptianella 31%
Erlichia 0%
Microfillarea 21%
Parasite prevalence vs Diet type
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9
1 1 2
4 3
42
10
3
1 2
14
10
0
5
10
15
20
25
30
35
40
45
Num
ber
of
indiv
idual
Number of species infected total
52%
90%
33.3%
100%
100%
29%
30%
0 20 40 60 80 100 120
Insectivores
Carnivores
Picivores
Generalist
Granivores
Frugivores
Nectarivores
Percentage (%)
% infected
Parasite prevalence vs Forest-
dependency
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13
4
52
22
6
0
10
20
30
40
50
60
High Medium Low
Num
ber
of
indiv
idual
Number of species infected Total
46%
59%
67%
0 20 40 60 80 100
High
Medium
Low
Percentage (%)
% infected
Conclussion Parasite prevalence is higher in fragmented forest compared to continuous
forest.
In general, parasite prevalence is higher in small patches compared to
larger patches. But, there were exception in Ayer Hitam forest (largest
fragment with highest parasite prevalence).
Aegyptianella showed the highest prevalence with 41%, followed by
Plasmodium (31.4%) and Leucocytozoon (30.5%), whereby Trypanosoma
and Ehrlichia have the lowest prevalence of 4.8% respectively.
Oriental scops-owl (Otus Sunia) was found to be the highest infected
species where 7 from 8 individuals sampled were infected primarily with
Plasmodium and Leucocytozoon. This was followed by olive-winged bulbul
(Pyncnonotus plumosus) and White-rumped shama (Copsychus
malabaricus) with 57.1% and 53% respectively.
HAS SENT FOR PUBLICATION
HOW TO CONNECT ECO-HEALTH COMMUNITY TO WILDLIFE
ZOONOSES
1. Continue with OneHealth Program – at Country level
2. Establish Research Sub-group at Department level
3. Research Sub-group need to communicate at national
level
4. Enhance the existing research (wildlife zoonoses)
e.g. MyOHUN
5. Organise meeting, seminar and training.
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CHALLENGES
Research funding
Lack of cooperation
Lack of expert
Lack of leading expert
Lack of awareness
Lack of focus
But ALL problem can be solved ??
SEKIAN TERIMA KASIH