 Good afternoon, everyone. My name is Arastas Mollenge from Cambridge, and I'm going to present this study on behalf of Zipora Gitao and Christina, who is away in the US. Zipora is with us. And also on behalf of the other consortium members, Dr. Odomu is with us and Hebad. This study is on one health studies at human animal environment interface in the Olo Sokut Conservancy Narrow County. This conservancy provides a good platform to apply one health because the people and the animals live in the same environment and together with one life. So it is really a good environment for us to conduct one of the studies. According to the definition of one health, it is an integrative effort of multiple disciplines working locally, nationally, globally, to attain optimal health for people, animals and the environment. And in Kenya in the year 2012, the one health program was initiated and they are followed the creation of the Zoonotic Disease Unit under the Minister of Health. And this was done in collaboration with several ministries, Minister of Health, Livestock, Environment, where they came up with a five year plan on implementation of one health activities in the country. And this platform listed a number of diseases that were to be considered as priority for implementation of one health. So, back to the conservancy. This conservancy was initiated in the year 2006. It is located in Transmara West's Narrow County. And this is part of the Greater Mara Ceregete ecosystem. The conservancy, the conservancy has a membership of 109 households. And at the time of sampling, the population of Livestock was 21,200 cattle, 3,000, 35,850 sheep and goats, 881 dogs. And this is that we carried out in this conservancy, used this one, the other approach in that we did studies on people, animals and the environment. And the one approach is the one that considers funding, data correction, analysis implementation of control interventions, as opposed to separate budget and health professionals working in silos. In many of the projects, we started with some incentives given to the community there, or in the conservancy. All the dogs were vaccinated against Rebis and Kenan Bestempa, and they were also be warmed against industrial elements. Later, the community was also treated for soil transmitted elements. And therefore, some of us were collected from the people, from the dogs Livestock, and the wildlife that is currently being collected. And therefore, these studies I said in the beginning is composed of three abstracts, one on, on intestinal enemies in dogs, and another one on prevalence of intestinal parasitic infection in humans by Zipora Gitao and another one on the knowledge attitude and practices by Dr. So during the sampling process or during the sampling exercise, we collected samples from the community. And in this, during that time we did the CAHPS surveys, you could see in the picture, second picture up there, we were doing some of the interviews actually with the people. Later, we did the human study where we collected data from people. We collected FICO samples for analysis. We collected FICO samples from dogs and samples from blood samples and FICO samples from Livestock. The picture down here is, and this is this was an activity that we did in the conservancy because some of the analysis was done in the conservancy office. In the intestinal enemies in dogs, this study was carried out in partly in the field and part of it in Cambridge. And we published a paper entitled the survey of intestinal enemies in domestic dogs in a human animal environment or interface, the so good conservancy in our county. So there, we all know how dogs are in terms of the interaction with people. And this has shown that dogs play a very critical role in the social being of people. And besides that dogs also transmit very important diseases, particularly in this case, parasitic diseases. The first to us is cystic echinococcuses. The picture of the first picture demonstrates how severe cystic echinococcuses appears in humans, specifically in domestic in pastoralist communities. The second one is the same disease in Livestock. It infects mainly the liver and the legs but also other body organs, also other organs in the in the in the body. And the picture to the right presents what we call the cystic cystic echinococcuses, but mainly presentation of tinea and the tigena in Livestock. And this particular disease is actually of major economic importance, as well as tinea, tinea office which causes cystic echinococcuses in Livestock as well, particularly in ship, caused by tinea office. And the last picture is one of the most important actually neglected diseases in the region, called zinureosis, the information of our cysts in the brain of small livestock. And this is caused by dog transmitted the terpworm called tinea multiceps. So dogs also transmit further diseases of interest to the people, the first two pictures demonstrate what we call cutaneous level migrants. This is mainly when people are getting get infected by and salastomers species, particularly Brasiliases and caninam. They cause this cutaneous level migrants. So caracanis, so caracanis from dogs and cats respectively cause ocular level migrants the second picture, you can see a worm in the high of a patient. This is caused by dog parasites. And the figure below, the photograph below demonstrates the infection of terpworm called spirometra species, which is transmitted by dogs as well, and because of this we call sphagnosis. Creators poridium and geodiasis, protozoan infections that are very important in immunocompromised people, particularly creatures poridium and the dogs transmits these parasites to people and livestock as well. Now we did the study. We started with the vaccination of dogs against Rebis and Kenan distemper, and the dogs were dewarmed. We collected fecal samples from 100 dogs, and the samples were processed in Cambridge. The 100 fecal samples represented 76 out of the 109 households in the conservancy and the pictures they had demonstrated the group that did this work together with the vaccination. So from this study, we found out that of the 100 dogs that were examined, 65 of them had at least an infection with one helmet. And we also found out that uquam was the most common species followed by tinnia, followed by spirometra and tinnies, and the others in that hogar. We noticed that of the 76 households that we sampled, 54 households are dogs infected with at least one helmet. And of importance to note here is that the parasites that we detected in dogs are quite great significance in terms of public health. Toxocara species, toxocara catties and toxocara cannies. Particularly in this case, toxocara cannies cause diseases in humans, as well as the uquam species, tinnia species. All these are important parasites can cause zoonosis. The other parasites cause diseases in dogs, some of them cause very severe diseases, like for example, an astro-stomachaninam causes bleeding. All these diseases are of importance in terms of the health of the animals. And more importantly, also that the parasites we detected in these dogs, some of them are acquired from wildlife. For example, tinnia seriaris and tinnia modegi are tinnia species that are acquired from dogs interacting with wildlife. When dogs prey in the world, they come across underlops, the hair from the wildlife, and this is how the dogs get infected. From this study, we can conclude that nine genera of intestinal parasites were detected in dogs, and uquam species were the most common species in dogs. They said also report the detection of spirometra terraria as the most, as terraria, depletium caninam and mesostatis for the first time in the country. The zoonotic ailments found in dogs pose great risk to the people because they are infectious in people. And the helmets also reported in this study show a clear information that the dogs in that consequence interact with wildlife. And therefore we recommend the control of these helmets in dogs, humans and wildlife cause for corroborative effort from the human animal, environmental health professionals in the context of one health. So the next study is the one on prevalence of intestinal parasitic infection in humans by Zipora Gitao, who is an MSc student in Western Nairobi, serviced by Dr. O'Donwen myself. Parasitic infections are of great importance in terms of public health because they cause great burden of disease into people. And there are common in areas where sanitation is poor and hygiene practices. They are transmitted mainly through fecal root, through food or water, insects, and to some extent through bianimos, zoonosis. And the WHO uses the warming as a measure to stop these infections. So therefore in Kenya in the year 2012, the country started the national school based the warming program with aim to reduce infections in people and the associated mobility. But this program was started in areas with high infections. These are, these were actually the initial the provinces where the infection rates were more than 20%. This was Nyanza, Western coastal province and part of Rifte Valley. But despite all this, the program is faced by a number of challenges that even when people are dewarmed, they get frequently infected. The program is based on school programs, but it doesn't take care of the other people in the community. There's growing evidence showing the drug resistance to the drugs being used. Even after the warming, the environment in which these people live is not taken care of. So the people still get contaminated by the soil where they live, soil water and other parameters. And there is also that possibility of transmission through zoonosis. So this study, this study involved collection of recruitment of patients or participants, you can see the features there that my colleagues were recruiting patients or participants, they collected samples. And the samples were analyzed partly in the field. This is in the field and partly in Cambridge. The results from this study indicated that there was quite high prevalence of parasitic infection in the people. By the first method which was done in the lab in Cambridge, 57% of the people were infected with at least one parasitic infection. The second method which was done in the field is many done on elements. So it's not applied for protozoans and the prevalence was 32%. This range is actually in the range of that region because the earlier study that before the program started at a range of about 53% infections. So from this study, we observed that in Amoeba Estolitica, this power muscofisky complex was the most common infection with that 2%, that 3% followed by Trituris Trituria and by the both methods they agreed that Trituris Trituria was the most common infection. We also found Ascaris rubricoidis in terms of ailments by cataclysm and for mojita concentration, we found Ancelostoma species or Neckita americanas, the wukwams. And interestingly, we found a few cases of human infected with the tiniest species, which we think is most likely tiniest aginata, but we'll type that to be able to know the species. Additionally, we, we intend to type the Jadiarabia because we know some, some of the Jadiar assemblages are known to be zoonotic just to find out whether some of this could be infection from animals, as well as the wukwam species. They are wukwam species that are infectious in humans but originate from animals, particularly Ancelostoma selenica which comes from dogs. So from that study we, we found out that women were more infected than males, and the age bracket between 5 and 14 was the most commonly infected population, and the infection increased with age. And therefore, as our conclusion for this study, we found out that the infection of intestinal protozoan infections suggests that the conservancy of these people live in poor water and sanitation, poor water, sanitation and hygiene conditions. The high prevalence of Elm is in non targeted population requires attention. This, this is to mean that because the most of the programs are based on school go and children live out there, those who are, those that are not in school, or they are not population there is need to focus on those neglected or left out populations to have a whole impact. Then the presence of the senior species confirms the currents of zoonosis in the community and therefore we recommend that the entire community is included in a compressive health and protozoan control program, because as you have seen and from the, even from the ministry point of view that the control programs just does the women or inmates but does not consider the treatment of protozoans, and you could see the infections was very in the community. The last study is the one on one is the one on a knowledge attitude practices relating to risk factors for zoonotic diseases in the or support conservancy using a one other approach, and this was by Christina from the University of Western University of sciences California the US and the other partners. So this study involved 15 of the 15 households out of the one or nine households in the community, and the user one other approach and participatory epidemiology to collect data on people animals and their environment. And the goals for these was to highlight the major risk factors and their needs that perpetuate the transmission of neglected diseases prioritized by wto and the zoonotic disease unit. The study also sought to, to, to understand cultural norms specifically to the conservancy residents. And lastly Taylor culturally sensitive and sustainable control strategies that will be recommended for implementation at the local level. For the cup study, the survey, as says the degree of the knowledge of zoonotic diseases. Transmission treatment and prevention. The attitude towards the zoonotic diseases and practices and general behavior that impact on the risk of exposure. So the results. So the results show that out of the out of the questions that were being asked from the households that for example the first question do you know, do you know these diseases for example anthrax brucellosis cystic echinococosis the second question was asking whether they know whether it affects people or whether they know it affects animals. And they responded by showing that they knew most of these diseases, but a few people, a few of them didn't understand that diseases like cystic echinococosis, sorry, brucellosis brucellosis, brucellosis. No cystic echinococosis and trips somersis affected people. And they, they didn't know that brucellosis and tuberculosis are also infectious in animals. So for the second part of the question was whether they knew what causes the disease, how the diseases treated, and how to prevent it. So it's clear that some of the respondents did not know what causes the disease, particularly for anthrax and cystic echinococosis. Others did not know how to treat it, like trips somersis, and how to prevent it. So these are the responses that we got, the responses that we got from the, from the people interviewed. For this group discussion, we came across a goat that was infected with the sonora cerebraries, what I mentioned earlier, sonoresis. It's the level stage of tinnia multiseps. And the local community called the disease there. It's a very common disease in the area. People knew about it. And it causes some severe clinical symptoms in sheep and goats. And with the permission from the owner of the goats, we were able to slaughter the goat and remove the cysts. And use this as an example to train them on how the disease is transmitted and how it can be prevented. So this is a common disease according to the people in the area. And also our dog studies in the area show that this parasite exists in the dogs, meaning that it transmitted to the livestock. And one thing about this disease is that every infected animal, the end result is dead. So it's a disease that causes serious economic losses to the people. So from the respondents, they showed that they understood how some of the diseases were being transmitted and prevented, like for example, diseases such as rabies. This was through contact with dogs, sleeping sickness. This is through Cessar fly. And they thought that the Cessar fly in this case were being brought by elephants who which live in the in the conservancy. So the people are really clear understanding of the disease and the prevention. And this is a case of anthrax in the in the conservancy. So what we conclude from this we conclude that there was limited awareness of zoonotic diseases. So understanding of the transmission roots. The people were most aware with diseases of diseases of higher consequences such as rabies, because rabies causes death, or diseases that cause high livestock production losses such as TB and glossolosis. There was inadequate or improper water sanitation and hygiene in the in the conservancy, and that people also live with animals. The risk of wildlife increased the risk of transmission. We, we, from this study we were able to establish factors that contributed to the disease perpetuating the diseases, the zoonotic disease and this included lack of access to clean water, lack of health, health education, lack of access to health care, lack of access to veterinary health care, lack of access to education. And therefore this study, this pilot study provided baseline data and identified adaptable adapted control measures for the implementation of sustainable interventions. The proposed combination of one health and the participatory epidemiology could be used in other pastoral communities for disease control and prevention. Towards the end, some community projects were initiated and study with collecting of rainwater. The Minister of Health pledged to construct additional dams for the people and their livestock. The Minister of Health, through the current director of health deployed a clinical officer and lab technician to the health center and also provided more equipment and supplies. The county veterinary services implemented the control vector programs. And this is to control vectors that such as SESA and others, SESA fly and others, and also started the livestock selective livestock breeding programs to increase meat and milk yield. A veterinary officer was also deployed in the conservancy to implement the vaccination programs and disease control programs. And a local aggravates is planning to start veterinary depot in the conservancy. The community recommended implementation of preventing measures against predators. This is by use of fencing and use of lion lights. And therefore the intersectoral intersectoral intersectoral collaboration and community participation were critical to the implementation of these interventions. So I acknowledge the following the director of the conservancy, the count officials from the Minister of Health veterinary services and water and all the other groups that contributed to this work and the people represented by these institutions. Thank you very much for inviting me to come and present this and for listening. Thank you. Thanks for a nice presentation. I think it's very holistic. What you are doing within within the conservancy. I have a question and I'm sure there will be questions from the audience as well. First on I see your final slide on the recommendations, almost like a little bit disconnected from what you're doing, which sort of speaks to how we approach health. So it seems like from the farmers or the people in the conservancy, they worry about predators. Yes, they do. The livestock sector went for breeding programs. And they are clear, you know, disease issues as well. So what would be a comment on that and the second question related to that is, you have done I think what we don't often do with one hell we look for one disease like rabies. I've looked at multiple infections and the NTD programs that are looking to leave one behind and the limit of these NTDs are advocating for integrated programs. What would be a thought around integrating control programs for not just rabies but also the hell means that you are talking about in this presentation. Okay. Maybe I can answer this. The first question maybe everybody will be opening the second question. The first one. The approach that we used or the approach that you are saying is quite important because even from the first slide. I mean it's, many people are doing research on their own. For example, I come from Cambridge. Dr. David O'Donogh is from the University of Nairobi, maybe they have a project there or others that we work with. They do it on their own, but from our own approach point of view, we decided to look at the quite large profile of diseases at a go. And this from the economic sense of view, it also saves money. And it's able to, when we combine the data together, we're able to give quite well informed findings from this particular area. So I think the aspect of integrating many sectors working together gives out a good, a better outcome rather than opposed to people going on their own. Maybe Abad could answer the answer on the first one. So the initial idea to create such a program was everybody talks about one health, but it is more or less a theoretical approach and we wanted a practical approach to see what is possible in a community. And what factors can be brought together to do something in one health. So the first start, we started with do a disease profile. We went in the community and asked them what is your problem. What are the diseases? What do you know about the diseases? Do you know the transmission? And this is then part and parcel of the, of the outcome what was just reported. The problem we have only is that we had very little funding, so we had to do PIP and that's why we wanted to do it all comprehensive and that we have the data together and then go one step forward. Additionally, we approached and the authorities in Iraq and the veterinary services and the medical services and asked them now where do you come in. And they said, well, the one health project, so you must come in. So they pledged what he has reported. They, they said, well, the dispensary was underfunded by, had not enough personnel, and the dispensary was not equipped very well so they stepped in. The dispensary people came in with providing as well personnel for the veterinary services. And our idea was to use them community based that they live with the community and go around from time to time to have in to do a kind of survey and what's going on is an up and down the diseases, periodical and whatsoever. And this is the background of the whole thing and we are still in midst of the whole thing it's not finalized and we want to see and then do it on a yearly basis to see what can be done in so disease surveillance. And thanks for that. Any questions online. There is one, one question online that is asking if you were able to comment on the extent of implementation of one health at the county level. So how well one health has been institutionalized within our county. I will address this to you but I was in the room so maybe this could be a jointly answer question. Thank you. Yes, this is quite difficult for me to to come to comment because this is actually the whole county, but particularly the area we are working on we, the county officials, both in the Minister of Health and the veterinary services are really supported as implementing our project, but from the current perspective will be, it is very difficult for me to comment. Thank you. The question is about the implementation of the one health approach at the county level. I would say that is not optimum yet, but at narrow County, we have quite a variety of activities that are going on under the one health approach, and we are escalating that. And we have some partners, being one of them, and the various activities they are doing. And also some other partners like the Red Cross CP three project. So they're quite a number of activities that we are performing with a one health approach. We, we, we have had quite some collaboration with the health component, including a consultative meeting to make reports last week. And we would probably soon have a consultative forum to even escalate that further with Ilri as a host. So there's something going on with the one health approach. Okay, any other question. Comment. Yes. Thank you very much, Dr. Mollinger and your team. My comment is that you have looked at all the issues which touch on the one health and you have brought them to the fall, because I see in your presentation the findings and the combinations you look at water. And more health. Look at people. And it means you are brought the three pillars of the one health together. And I think your findings, though it may not look very scientific. It may not look like conclusive, but it provides a very good baseline of what somebody can pick to address a one health issue in that particular area. And I think, as you mentioned, it is still work in progress, but I think we can learn from it that if I want to study helmetosis in a, in a rock and find the best way to control it, you are brought all the factors contributing to it. That is a very important aspect. Thank you.