Healthy Herd Kenya

Combating AMR by Improving Hygiene in Kenyan Farms

INVEST HERE

PROJECT DESCRIPTION

Specific:

Kisooa et al. (2023) found that the majority of farmers in Kenya use antibiotics for prophylactic reasons rather than solely for therapeutic treatments. This report therefore, proposes the implementation of an appropriate teat disinfection technique to prevent the spread of disease within the herd, thereby reducing or hopefully replacing the need for prophylactic use of antibiotics. Proper teat hygiene that minimises milk contamination and disease spread involves scrubbing the teat end with alcohol after pre-milking disinfection with an iodine-based teat disinfectant and drying with a single-use towel (Wattenburger, et al.,2020). The intervention will first be implemented in Central Kenya, focusing on small-holder farms that contribute 80% of the country’s agricultural output (Njoroge, 2022). Our team will initially provide farmers with iodine-based teat disinfectant, scrubbing alcohol, and single-use towels, with supplies restocked after each periodic follow-up. After the study concludes, participating farmers can order supplies through community-based travelling agents.

Measurable:

Since our intervention aims to combat the growing challenge of AMR by decreasing the spread of infectious diseases among farm animals and thereby minimizing the need for antibiotics, the primary measurement of the success or failure of our intervention will be the prevalence of infectious diseases in the farms using the appropriate hygiene techniques compared to those that do not. To evaluate this, we will perform a cohort study where 100 small-holder farms will be selected and randomly assigned to either the intervention or control group. The intervention group will be provided with iodine-based teat disinfectant, scrubbing alcohol, and single-use towels and will have an introductory session on how to properly use them, while the control group will be ordered to continue with their usual milking practices without additional hygiene measures. Disease prevalence will be monitored and recorded regularly over a six-month period, focusing on incidences of mastitis and other common infections within the herd based on the real-time PCR diagnosis (Wattenburger, et al.,2020). Additionally, potential antibiotic usage for therapeutic purposes will be tracked to assess any changes in dependency. Data will be analyzed to determine the effectiveness of the hygiene intervention in reducing disease prevalence and antibiotic use compared to the control group.

Attainable:

The main resources required for our intervention include personnel for consistent implementation and monitoring, and funding for hygiene products. The on-ground academic team comprised of different health professionals will conduct regular follow-ups and data collection and will be paid based on the funding for the project covered by the Bill and Melinda Gates Foundation. They will also collaborate with community members to set up shops and form travel agent teams. These teams will sell iodine-based teat disinfectants, scrubbing alcohol, and single-use towels to farmers. Engaging the community will enhance interest in the intervention and reduce reliance on external help. If successful, the intervention will be integrated and funded as part of the third focus point in the renewed National Action Plan on Prevention and Containment of Antimicrobial Resistance presented earlier (Government of Kenya, 2017). The Ministry of Agriculture and Livestock Development will then manage the shipment and distribution of hygiene products to the travel agent teams. This collaborative approach ensures the sustainability and effectiveness of the intervention.

Relevant:

Milk production is a vital livelihood source for smallholder dairy farmers in Kenya (Nyokabi, et al., 2021). Nevertheless, infectious diseases like ruminant mastitis continue to cause significant economic losses in the dairy industry and pose a major public health hazard globally by increasing dependence on antibiotics, which in turn drives AMR (Kabui, et al., 2024). Various studies have identified numerous bacteria from the milk of dairy cattle with clinical and sub-clinical mastitis (Kabui, et al., 2024; Ngotho, et al., 2022; Michira, et al., 2023). The main bacteria include Staphylococcus aureus, Streptococcus agalactiae, Corynebacterium bovis, Mycoplasma species, Streptococcus uberis, coliforms (Escherichia coli, Klebsiella spp., and Enterobacter aerogenes), Serratia spp., Pseudomonas spp., Proteus spp., and other Streptococcus and Enterobacter species, which can spread diseases among the herd and pose potential hazards to human health (Kabui, et al., 2024). Furthermore, studies have shown that most Staphylococcus spp. and E. coli isolates exhibit resistance to oxytetracycline, indicating the urgent need for intervention strategies addressing infectious diseases in farm animals and their role as drivers of AMR (Michira, et al., 2023; Kabui, et al., 2024).

Time-bound:

The intervention will be rolled out over a six-month period, starting from June 2024. Baseline data collection will occur in the first month, followed by the implementation of hygiene practices and periodic follow-ups. Midpoint evaluations will be conducted at the three-month mark, and final data collection and analysis will occur in November 2024. The results and recommendations will be compiled and reported by January 2025. If the intervention proves to be successful, conversations about scaling up as part of the National Action Plan on Prevention and Containment of Antimicrobial Resistance are planned. Additionally, focus groups with the farmers included in the intervention will be held after the end of the preliminary intervention, to gather feedback, discuss challenges and successes, and refine the approach for broader application.

Limitation and Challenges

We foresee three major challenges in our intervention: farmer compliance, cultural resistance, and economic constraints. To address these challenges effectively, we have developed a comprehensive approach to ensure the success of our intervention.

First, optimizing farmer compliance is crucial. To achieve this, we will select 100 small-holder farms on a voluntary basis, ensuring that participants are already internally motivated to take part in the study. This voluntary selection provides us with a sample that is more likely to be engaged and cooperative. Additionally, we will conduct extensive training sessions prior to the start of the intervention to educate farmers on the importance of teat disinfection and proper techniques. These training sessions will include demonstrations and hands-on experiences to ensure that farmers fully understand the procedures. To further encourage compliance, we will offer incentives, such as discounts on future hygiene products, to farmers who demonstrate consistent adherence to hygiene practices during follow-up inspections (self-monitoring and correct technique).

Second, to counteract cultural resistance, we will organise bi-monthly meetings that will provide a platform for farmers to share their experiences, challenges, and successes with the intervention. This peer support mechanism is designed to reduce resistance and foster a sense of community involvement, bringing the project culturally closer to the participants and creating a supportive environment. Finally, economic constraints pose a significant challenge for many farmers.

Lastly, to mitigate economic constraints, we will educate farmers on the long-term cost benefits of investing in preventative measures. By presenting a clear cost-benefit analysis, we aim to help farmers understand the financial advantages of improved hygiene practices. Additionally, we will seek additional funding from government programs and non- governmental organizations (NGOs) focused on agricultural development and public health. These funds will support ongoing subsidies, reducing the financial burden on farmers and making the intervention more economically feasible.