L’antibiorésistance est une préoccupation majeure et globale de santé publique. La problématique de recherche de cette thèse visait à fournir au gestionnaire une aide à la décision pour la mise en œuvre et l’évaluation des mesures de lutte contre l’antibiorésistance en santé animale. Pour espérer limiter le phénomène et le gérer, il faut en connaître la dynamique d’évolution : la surveillance des résistances se positionne donc comme un enjeu clé de la lutte. En premier lieu, ces travaux ont déterminé, au travers d’une enquête populationnelle et d’une approche sociologique, dans quelles mesures les données collectées par le réseau d’épidémiosurveillance de l’antibiorésistance des bactéries pathogènes animales (Résapath) pouvaient être utilisées pour répondre à la problématique. La représentativité et la couverture du Résapath estimées satisfaisantes, l’évolution des résistances a été investiguée avec des modèles additifs généralisés à partir des données de surveillance. La mise en parallèle des tendances des résistances avec les mesures de maîtrise a illustré l’impact positif des changements de pratique sur l’évolution des résistances. Enfin, dans la perspective du concept One Health, qui prône une approche intégrée et collaborative de la santé, le rapprochement entre les dynamiques des résistances chez les animaux et chez l’Homme a été exploré, en se basant sur les données du réseau MedQual en médecine de ville. Les tendances des résistances ont évolué de manière spécifique à chaque espèce, sans dynamique commune entre l’Homme et les animaux. Les efforts pour lutter contre l’antibiorésistance doivent donc être menés de concert, tant en médecine humaine que vétérinaire / Antimicrobial resistance is a major and global public health concern. In this context, the research problem was to provide decision support to the risk manager for the implementation and assessment of control measures in animal health. To limit and manage the phenomenon, we must know the dynamic of its evolution: the surveillance is therefore a key element in the fight against antimicrobial resistance. At first, using a population survey and a sociological approach, this research determined to what extent the data collected by the French surveillance network of antimicrobial resistance in diseased animals (RESAPATH) could be used to answer the research problem. Since the representativeness and the coverage of the RESAPATH were considered satisfactory, surveillance data were used to characterize the dynamics of the resistances and generalized additive models were developed. The comparison of resistance trends and control measures underscored the positive impact of changes in practices on the evolution of resistances. Finally, in the context of the ‘One Health’ concept that advocates an integrated and collaborative approach to health, the parallel was drawn between resistances in isolates from animals and humans. Data from the French surveillance network of antimicrobial resistance of bacteria isolated in community (MedQual) were analysed. Resistance dynamics were specific to each species. These results advocate that the efforts to fight antimicrobial resistance must be carried in all sectors and for all species, both in human and veterinary medicine

Introduktion: Antimikrobiell resistens är en av de stora utmaningarna för folkhälsan i världen. Enligt synsättet One Health är kunskap viktig för att antibiotikaresistens ska kunna bromsas. I Sverige finns en låg men dock tilltagande förekomst av multiresistenta bakterier. Tidigare studier visa att personer som är bärare av multiresistenta bakterier upplever okunskap och otillräckligt och inadekvat bemötande, främst bland hälso- och sjukvårdspersonal. Sår är en riskfaktor för Meticillinresistenta Staphylococcus aureus MRSA, Extended spectrum betalactamase ESBL, Extended spectrum beta-lactamase ESBL-CARBA och Vancomycinresistenta enterokocker VRE. Syfte: Att beskriva hur personer som har sår och som har smittats av någon typ av multiresistent bakterie upplever bemötandet från sin omgivning på grund av smitta. Metod: En kvalitativ intervjustudie med induktiv ansats. Åtta semistrukturerade intervjuer genomfördes med studiedeltagare som hade svårläkta sår och som var bärare av en eller flera multiresistenta bakterier. Resultat: Den kvalitativa innehållsanalysen visade två övergripande teman: Bemötande från omgivningen och Bärarskap av multiresistenta bakterier påverkar omgivningen. Kategorierna för temat Bemötande från omgivningen var: Bemötande av hälso- och sjukvård; Bemötande från familj och vänner och Bemötande från övriga i samhället. Kategorierna till Bärarskap av multiresistenta bakterier påverkar omgivningen var: Överkonsumtion av skyddsutrustning; Personer som är bärare av multiresistenta bakterier har ett eget ansvar mot sin omgivningoch Samhällets ansvar för information om multiresistenta bakterier.  Slutsats: De flesta av studiedeltagarna upplever att de blev bra bemötta eller att reaktion saknades från omgivningen, dock förekom det enstaka situationer där multiresistensen påverkade bemötandet. Det fanns en kunskapsbrist, både hos de personer som är bärare av multiresistenta bakterier och från omgivningen. / Introduction: Antimicrobial resistance is a major challenge for public health globally. Out of a One Health approach, knowledge is important for slowing down spread of antibiotic resistance. In Sweden, the prevalence of multi-resistant bacteria is low but, however, is increasing. Previous studies show that people who are carrier of multi-resistant bacteria perceive lack of knowledge and incompetent and inadequate encountering mainly with health care professionals. Ulcer is risk factor for Methicillin-resistant Staphylococcus aureus, Extended-Spectrum-Beta-Lactamase, Extended-Spectrum-Beta-Lactamase- Carba and Vancomycin-resistant Enterococcus. Aim: To describe how people who have been infected by some type of multi-resistant bacteria experience the treatment from their surroundings due to infection. Method: A qualitative content analysis with inductive approach. Eight semistructured interviews were conducted with patients who had ulcer and were carriers of one och more multi-resistant bacteria. Results: The qualitative content analysis showed two overarching themes: Treatment from the enviroment and Carrier of multi-resistant bacteriaaffect the enviroment. The categories for the theme Treatment from the enviroment were: Treatment from health care; Treatment from family and friends and Treatment from others in the community. The categories for Carrier of multi-resistant bacteria affect the enviroment were Overconsumption of protective equipment; People who are carrier of multi-resistant bacteria have a responsibility for the environment and Society’s responsibility for information on multi-resistant bacteria. Conclusion: Most of the study participants felt that they were treated well or that there was no reaction from the environment, however, there were occasional situations when the multi-resistance affected the treatment. There was at lack of knowledge, both among the people who are carriers of multi-resistant bacteria and from the enviroment.

<p>Anthropogenic effects on ecosystems have expanded in their scope and intensity, with significant consequences for global environmental, wildlife and human health. As human encroachment into wildlife habitat grows, habitat degradation and fragmentation intensify, leading to increased contact among wildlife, humans and domestic animals. Due to this increasing frequency of interaction, and the emergence of several high-profile diseases, global concern has grown over the risk of emerging infectious disease from zoonotic origins. </p><p>Due to Madagascar's rampant rate of human population growth and deforestation, its incredible species diversity, the widespread presence of domestic and invasive species, and its evolutionary isolation, it can be viewed as a high risk region for potential disease emergence. There is a need for assessment of the zoonotic and reverse zoonotic disease potential within this country. </p><p>To contribute to this assessment, consistent baseline health monitoring provides an effective tool for evaluating wildlife health and preparing for future disease occurrences. Limited, disconnected surveys of lemur health have occurred, yet there remained a need for more extensive, country-wide evaluations that also addresses invasive species, domestic animal and human health, as well shifting patterns of environmental and climatic change. </p><p>This research has investigated the connections among human, animal (both domestic and wildlife) and ecosystem health in Madagascar. I have examined current trends in anthropogenically-driven environmental change in Madagascar--including deforestation, illegal logging of precious hardwoods, mining, hunting, and agriculture--and evaluated how this change affects patterns of lemur, domestic animal and human health by evaluating a suite of health measures and parasite prevalence and richness. I have also examined how predicted global climate changes may influence the spatial patterns of lemur parasites and human infectious disease by assessing their shifts in distributions and geographic extent. </p><p>To assess the risk of disease transmission among lemur, domestic animal and human hosts, I have modeled the areas of geographic overlap among these parasites and their hosts and identified high-risk areas for disease emergence using geospatial analysis. This information can help to develop predictive statistical and spatial tools, which can inform both environmental management and public health planning. </p><p>Through this work, I have evaluated the severe loss of distribution that rosewood species have undergone, which highly qualifies them for international trade protection. We predicted areas of high risk for future logging, many of which occurred within protected areas in the biodiverse northeast. </p><p>Secondly, I have compiled the most comprehensive record of parasites of lemurs to date. Building upon the Prosimian Biomedical Survey Project data and the published literature, we have recorded 88 parasites that have been documented in lemurs. These are composed of helminths, bacteria, ectoparasites and protozoa. Of the 23 focal parasite species studied more in depth in this study, we noted high variability in prevalence measures for unique parasites at different sites. Parasite coinfection occurred quite commonly, with up to as many as 7 parasites concurrently. On average, lemur parasites tend to be less species-, genus-, or family-specific than other parasites across all primates. </p><p>Thirdly, I documented highly significant differences in health measures from two populations of Indri that exist under differing levels of anthropogenic pressure. Of note, the parasite richness, leukocyte count and differential, and nickel and cobalt levels were significantly higher in the more exposed population, while the total protein measures were significantly lower. These data suggest that the exposed population experiencing more anthropogenic pressure suffered from elevated health and nutritional stress. </p><p>Fourthly, I have documented strong correlations among environmental drivers (temperature, precipitation and landscape-scale features) and lemur parasite distributions. Striking shifts in their distributions are predicted to occur with projected climate change in Madagascar, including an expansion of helminth, virus and ectoparasite distributions, but a contraction of bacteria distributions due to warming and drying in the south. </p><p>Fifthly, I have examined 10 human and domestic animal parasites that hold great consequence for lemur, human and domestic animal health in Madagascar. I have similarly demonstrated strong correlations among environmental drivers (temperature, precipitation and landscape-scale features) and the distributions of these human parasites. Shifts in the distributions are also predicted to occur with projected climate change, including an expansion of helminth parasites, and a contraction of viruses and bacteria due to warming and drying in the south. I have identified areas of high risk for the transmission of parasites from human hosts to lemurs, as well as conversely from lemur hosts to humans. These risk indices will serve to highlight geographic areas at particular risk, and will also help to direct limited funds and staff to those areas most in need of attention. </p><p>Sixthly, I have demonstrated a need to train a growing cadre of One Health professionals from many different disciplines. I have offered several suggestions to integrate One Health training into graduate education, and have identified several geographic regions of potential to be a Center of One Health Excellence, of which the North Carolina Triangle area is one of great promise.</p> / Dissertation

Fernando de Noronha é um arquipélago oceânico localizado a 345 km da costa brasileira, habitado desde o século XVII. Sua economia é baseada no turismo, que tem apresentado rápido crescimento nas últimas décadas. Este ecossistema único é reconhecido como Patrimônio Mundial pela Unesco e é um sítio Ramsar. Toda sua extensão terrestre e grande parte da área marinha ao seu redor é protegida por duas unidades de conservação federais, sob tutela do Instituto Chico Mendes de Conservação da Biodiversidade. Existem pelo menos 15 espécies de plantas e animais nativos oficialmente ameaçadas de extinção, algumas destas endêmicas do arquipélago. Dentre as 22 espécies de animais e plantas invasoras conhecidas em Fernando de Noronha, o teiú (Salvator merianae) constitui um grande risco à fauna nativa por ser um predador oportunista de grande porte. O potencial impacto do teiú é reconhecido e seu manejo é previsto pelas unidades de conservação do arquipélago. O teiú se encontra presente em altas densidades na ilha principal tendo sido também registrados indícios de sua presença ao menos na Ilha Rata. A densidade de teiús encontrada em Fernando de Noronha foi de 13,8&#177;3,9 animais por hectare em uma área não habitada e com vegetação relativamente preservada e de 4,0&#177;1,1 animais por hectare numa área pouco habitada. O número estimado de indivíduos atualmente vivendo na ilha principal variou entre 6.906 a 12.270 indivíduos adultos. A área de vida estimada foi de 10,5 (7,3- 15,3) ha para ambos os sexos. A probabilidade de captura foi de 0,24&#177;0,06 animais/armadilha/dia na área, com 4 animais/ha, sendo influenciada pelo tamanho dos indivíduos. O teiú também constitui um potencial risco à saúde pública do arquipélago, por serem portadores da bactéria Salmonella entérica, isoladas em 56,9% dos animais capturados e em 70,5% dos pontos amostrados. Ao menos 15 sorotipos foram determinados por métodos moleculares para esta população. Para propor formas de manejar esta espécie em Fernando de Noronha, foram criados modelos de viabilidade populacional com diferentes cenários de manejo por 10 anos. Nos cenários sem manejo, a população de teiús não se extingue ao longo de 30 anos. O aumento das probabilidades de extinção é proporcional ao aumento da intensidade de manejo, tanto nos cenários que consideram a população de toda a ilha principal (A) quanto nos cenários que consideram parte desta população numa área de 214 ha (B). A remoção anual de 20% dos indivíduos adultos seria suficiente para gerar cenários de extinção da população. Com a remoção anual de 50% dos indivíduos adultos, a probabilidade de extinção seria de 54% e a média do tempo para a extinção estaria entre 5,2 e 5,4 anos de manejo, demonstrando que o controle desta espécie é possível em Fernando de Noronha, se os métodos de captura e esforço forem 16 adequados. O manejo em uma pequena área (C) de 2,14 ha poderia ser feito em apenas 13 dias utilizando-se 10 armadilhas. Na área B (que inclui a área C), o manejo de maior intensidade poderia ser realizado em 44 dias por ano, durante quatro anos, utilizando 258 armadilhas. As recomendações incluem o aumento gradativo da área manejada, o uso de manejo adaptativo, o envolvimento da sociedade e o sinergismo com outros esforços de manejo de espécies invasoras na área ambiental e de saúde pública. Este estudo fornece a base científica para um programa de manejo com objetivo de conservar a biodiversidade e de melhorar a saúde pública em Fernando de Noronha. / Fernando de Noronha is an oceanic archipelago placed 345 km off the Brazilian coast and inhabited since the 17th century. Its tourism-based economy is increasingly growing in the last decades. This unique ecosystem is recognized by Unesco as a World Heritage site and is also a Ramsar site. The whole terrestrial extension and a large marine area around the archipelago are protected by two federal protected areas, supervised by the Instituto Chico Mendes para Conservação da Biodiversidade. There are at least 15 species of native plants and animals officially endangered, some of them endemic to the archipelago. Among the 22 invasive species of plants and animals known to Fernando de Noronha, the tegu lizard (Salvator merianae) constitutes a great risk to native fauna as a large opportunistic predator. The potential impact of the tegu is recognized, and its management is predicted to the protected areas of the archipelago. This species achieves high densities on the main island and there is evidence of its presence at least on Rata Island. Densities found for FN were 13.8 &#177; 3.9 animals per hectare in an uninhabited area of preserved vegetation and 4.0 &#177; 1.1 animals per hectare in a sparsely populated area. Total numbers of animals for the main island ranges from 6,906 to 12,270 adults. The home range is 10.54 (7.3-15.3) hectares for both sexes. Capture probability is 0.24 &#177; 0.06 animals/trap/day in the area with 4.0 animals/ha, being influenced by the size of the individuals. The tegu also represents a potential public health risk for the archipelago, as carriers of the bacteria Salmonella enterica, isolated from 56.9% of the captured animals and found in 70.5% of the sampled spots. At least 15 serotypes were determined by molecular methods for this population. In order to propose management options for this species in FN, models of population viability were created with different scenarios of management over 10 years. In control scenarios, populations persist for over 30 years. Extinction probabilities increases with management intensity either in the scenarios considering the entire main island population (A) or part of the population from an area of 214 ha (B). Removal of 20% of adults yearly should be enough to generate extinction scenarios. The yearly removal of 50% of adults leads to a probability of extinction should be of 54% in an extinction mean time of 5.2 to 5.4 years of management. This demonstrates the possibility of control of the species in Fernando de Noronha if effort and methods are appropriate. Management in a smaller area (C) of 2.14 ha could be done in only 13 days using 10 traps. The highest intensity management to the area B (including area C), could be done in 44 days per year, for 4 years, using 258 traps. The recommendations include gradual increment of the managed area, the use of adaptive 18 management strategies, community involvement and synergism with other environmental and public health efforts on invasive species. This work provides scientific basis for a management program to conserve biodiversity and improve public health in Fernando de Noronha.

Objetivos: Identificar e comparar grupos de pacientes potencialmente de risco para tuberculose zoonótica (TBz), investigando a existência de fatores associados. Apresentar a distribuição espacial dos casos de tuberculose (TB) em bovinos e dos casos humanos. Método: Trata-se de estudo descritivo de casos confirmados de TB por todas as formas clínicas, residentes no estado de São Paulo, do período de 2006 a 2015. Definiram-se seis grupos potenciais de risco para TBz conforme critérios estabelecidos pela literatura. A análise descritiva foi realizada separadamente para pacientes menores de 15 anos e pacientes com 15 anos ou mais de idade, comparando os grupos identificados com a população de estudo por meio do teste do Qui-quadrado/Exato de Fisher. A existência de associação entre TB intestinal e/ou ganglionar (aceita como proxy de caso suspeito de TBz) e as exposições de interesse foi investigada pelas estimativas da odds ratio bruta e ajustada, com os respectivos intervalos de 95% de confiança, usando regressão logística. . A distribuição dos casos suspeitos foram apresentados em mapas temáticos. Resultados: Aplicados os critérios estabelecidos para o estudo, foram incluídos 190.368 casos de TB por todas as formas clínicas. Dentre estes: 134 tinham menos de 15 anos e residiam em municípios com até 20.000 habitantes (grupo A); os demais tinham 15 anos ou mais, sendo 1.238 trabalhadores rurais (grupo B); 201 magarefes (grupo C); 1.012 residiam em municípios com até 20.000 habitantes e com rebanhos infectados pela TB (grupo D); 2.776 imigrantes sul americanos (grupo E); e 160 imigrantes africanos (grupo F). Os grupos B e F foram os que mais apresentaram características semelhantes à TBz descrita na literatura, destacando-se no grupo B as maiores proporções de casos de residentes em municípios com caso de TB em bovinos e das formas intestinal e ganglionar periférica. Enquanto que no grupo F verificou-se maior proporção de casos com a forma clínica ganglionar periférica e de coinfecção HIV/TB. Os grupos A, C e D também apresentaram características distintas em relação ao total de casos de TB e associadas à TBz segundo a literatura, porém de maneira menos nítida. O grupo E não apresentou características relacionadas aos casos típicos da TBz. Dentre os pacientes menores de 15 anos de idade, após ajustes, destacaram-se como fatores associados à TB ganglionar e/ou intestinal, residir em município com menores índices de urbanização e com casos de TB em bovino conforme registro oficial. Entte os pacientes com 15 anos ou mais de idade, destacaram-se as associações com a ocupação de trabalhador rural e com a de magarefe. A distribuição dos tipos de rebanhos bovinos foi ampla sendo registrados casos da doença em animais em praticamente todas as regiões do estado. Conclusões: Os dados de vigilância da TB humana e animal, permitiram identificar grupos de pacientes com características associadas à TBz, salietando a importância da aplicação da proposta de Saúde Única, além de oferecerem subsídios para o desenvolvimento de um componente para TBz na vigilância da TB no estado de São Paulo, assim como, para pesquisas sobre o tema. / Objectives: To identify and compare groups of patients potentially at risk for zoonotic tuberculosis (zTB), investigating the existence of associated factors. To present the spatial distribution of cases of tuberculosis (TB) in cattle and human cases. Method: This is a descriptive study of confirmed cases of TB by all clinical forms, residents in the state of São Paulo, from 2006 to 2015. Six potential risk groups for zTB were defined according to literature. The descriptive analysis was performed separately for patients younger than 15 years and patients 15 years of age or older, comparing the groups identified with the study population using the Chi-square / Fisher\'s Exact test. The existence of an association between intestinal and/or ganglion TB (accepted as a proxy for a suspected zTB case) and the exposures of interest was investigated by the estimates of the crude and adjusted odds ratio, with the respective 95% confidence intervals, using logistic regression. The distribution of suspected cases was presented in thematic maps. Results: After applying the criteria established for the study, 190,368 TB cases were included in all clinical forms. Among them: 134 were less than 15 years old and lived in municipalities with up to 20,000 inhabitants (group A); the others were 15 years old or over, with 1,238 rural workers (group B); 201 magarefes (group C); 1,012 resided in municipalities with up to 20,000 inhabitants and with herds infected by TB (group D); 2,776 South American immigrants (group E); and 160 African immigrants (group F). Groups B and F were the ones that presented the most similar characteristics to the zTB described in the literature. In group B, the highest proportions of cases of residents in municipalities with cases of TB in cattle and of the intestinal and peripheral ganglion forms were highlighted. While in the F group there was a higher proportion of cases with peripheral ganglionic form and HIV / TB co-infection. Groups A, C and D also presented distinct characteristics in relation to total TB cases and associated with TB, according to the literature, but less clearly. Group E did not present characteristics related to typical zTB cases. Among patients younger than 15 years of age, after adjustments, they were identified as factors associated with lymph node and/or intestinal TB, living in a municipality with lower rates of urbanization and with cases of TB in cattle according to official records. Among the patients aged 15 years and over, the associations with the occupation of rural workers and magarefe stood out. The distribution of bovine herd types was extensive and cases of the disease were recorded in animals in practically all regions of the state. Conclusions: Human and animal TB surveillance data allowed the identification of groups of patients with characteristics associated with zTB, stressing the importance of applying the One Health proposal, as well as providing subsidies for the development of a component for zTB in TB surveillance in the state of São Paulo, as well as for research on the subject.

Submitted by Marcos Anselmo (marcos.anselmo@unipampa.edu.br) on 2018-09-28T15:48:23Z No. of bitstreams: 1 Laura Ilarraz Massia 06072017.pdf: 1328355 bytes, checksum: 8a7632d06256c43e7c8999831a3405b3 (MD5) / Approved for entry into archive by Marcos Anselmo (marcos.anselmo@unipampa.edu.br) on 2018-09-28T15:48:38Z (GMT) No. of bitstreams: 1 Laura Ilarraz Massia 06072017.pdf: 1328355 bytes, checksum: 8a7632d06256c43e7c8999831a3405b3 (MD5) / Made available in DSpace on 2018-09-28T15:48:38Z (GMT). No. of bitstreams: 1 Laura Ilarraz Massia 06072017.pdf: 1328355 bytes, checksum: 8a7632d06256c43e7c8999831a3405b3 (MD5) Previous issue date: 2017-05-29 / A leishmaniose é uma das doenças mais negligenciadas no mundo e ocorre, principalmente, nos países em desenvolvimento. O Brasil concentra 96% dos casos de leishmaniose visceral (LV) das Américas, com uma incidência de 4,35 casos por 100.000 habitantes. Os métodos usuais de controle dessa enfermidade falharam na prevenção de novas epidemias. A LV deve ser compreendida sob a abordagem Saúde Única, que prevê a unificação das ciências médica e veterinária através da colaboração mútua para o controle de enfermidades entre espécies. O objetivo desse projeto foi avaliar a percepção dos profissionais de saúde quanto à ocorrência da LV, em Uruguaiana (RS). Um estudo observacional transversal foi realizado através de um questionário autoaplicado em dezembro de 2016 e janeiro de 2017. Participaram 187 profissionais de saúde, sendo 138 integrantes da Estratégia da Saúde da Família, 22 agentes de endemias e 27 veterinários. Identificaram-se deficiências de conhecimento dos profissionais de saúde a respeito da epidemiologia e da sintomatologia da doença. É necessário investir em estratégias de capacitação sobre a leishmaniose visceral, visando corrigir deficiências de conhecimento e implementar a discussão sobre o tema. / Leishmaniasis is one of the most neglected diseases in the world and occurs mainly in developing countries. Brazil concentrates 96% of the cases of visceral leishmaniasis (VL) in the Americas, with an incidence of 4.35 cases per 100,000 inhabitants. The usual methods of controlling this disease have failed to prevent new epidemics. LV should be handled with the One Health approach, which provides the unification of the medical and veterinary sciences through mutual collaboration for the control of diseases among species. The objective of this project was to evaluate the perception of health professionals regarding the occurrence of VL in Uruguaiana (RS). A cross-sectional observational study was carried out through a self-administered questionnaire, in December 2016 and January 2017. 187 health professionals participated, of which 138 were members of the Family Health Strategy, 22 agents of endemics and 27 veterinarians. Health professionals' knowledge deficiencies regarding the epidemiology and symptomatology of the disease were identified. It is necessary to invest in training strategies on visceral leishmaniasis, in order to correct deficiencies of knowledge and to implement the discussion on the subject.

Orientador: Julio López-Abán / Resumo: O tráfico, contrabando e comércio ilegal de animais é a quarta atividade ilícita mais comum no mundo, colocando em risco a extinção de diversas espécies. Além disso, o comércio ilegal de animais silvestres pode ser meio de veiculação de enfermidades, principalmente de caráter zoonótico, ao serem transportadas por animais. O trabalho tem por objetivo identificar espécies de animais da fauna silvestre através do DNA mitocondrial (mtDNA), tricologia e determinar a prevalência de Trypanosoma cruzi agente etiológico da enfermidade de Chagas, uma Enfermidade Tropical Negligenciada (NTD), segundo a Organização Mundial da Saúde (OMS). Foram coletadas amostras de tecido muscular, pele, sangue e pelos em animais oriundos de apreensões no território brasileiro. Para a identificação genética, foi sequenciada uma região conservada do mtDNA de aproximadamente 600 pares de bases e comparados com o banco de dados genético Barcode of Life Database (BOLD). A identificação por pelos foi realizada através de análise comparada e o diagnóstico T. cruzi através da técnica Loop-mediated Isothermal Amplification (LAMP), uma técnica rápida, barata e sensível. Foram identificados animais das espécies Dasypus sp., Mazama gouazoubira, Pantera onca, Cerdocyon thous, Tamandua tetradactyla, Didelphis aurita, Puma concolor, Myoprocta sp., Cavia sp., Galictis cuja; através do sequenciamento genético do mtDNA e as espécies Alouatta sp., Ozotoceros bezoarticus, Sylvilagus brasiliensis, Didelphis albiventris, Pa... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Animal trafficking, smuggling and illegal trade is the fourth most common illegal activity in the world, increases the risk of extinction of several endangered species. An important point concerning illegal animal trade and the increasing globalization is that represents a possible vehicle for illness spreading, including zoonosis, creating a health public issue. The aim of this research is to identify species from the wildlife by mitochondrial DNA (mtDNA), hair and determines the prevalence of the zoonotic agent Trypanosoma cruzi, etiological agent of Chagas’ disease, a Neglected Tropical Disease (NTD) according to World Health Organization (WHO). Samples were collected from blood, muscle and skin from trafficking animals in Brazilian territory. A preserved region from mtDNA (600 base pair) was sequenced and compared to the Barcode of Life Database (BOLD) in order to do the genetic identification. Hair identification was complete by compared analysis. The diagnosis of T. cruzi ware made using the Loop-mediated Isotehrmal Amplification (LAMP) assay, a rapid, cheap and sensible technique. Have been identified the following species: Dasypus sp., Mazama gouazoubira, Pantera onca, Cerdocyon thous, Tamandua tetradactyla, Didelphis aurita, Puma concolor, Myoprocta sp., Cavia sp., Galictis cuja; using mtDNA sequencing and these species: Alouatta sp., Ozotoceros bezoarticus, Sylvilagus brasiliensis, Didelphis albiventris, Panthera onca, Puma concolor, Myrmecophaga tridactyla, Leopard... (Complete abstract click electronic access below) / Resumen: El tráfico, contrabando y comercialización ilegal de animales es la tercera actividad ilícita que más ocurre en el mundo, poniendo en riesgo la extinción de muchas especies. Además el comercio ilegal puede ser un vehículo de transmisión de enfermedades, principalmente las zoonosis, que pueden ser llevadas por los animales. La investigación tiene por objetivo identificar especies de animales de la fauna silvestre a través de ADN mitocondrial (mtDNA), tricología y la determinación de prevalencia del parásito Trypanosoma cruzi, causante de la enfermedad de Chagas, una Enfermedad Tropical Desatendidas (NTD) de acuerdo con la Organización Mundial de la Salud (OMS). Se recogieron muestras de tejido muscular, piel, sangre y pelos de animales procedentes de aprensión en el territorio nacional de Brasil. Para la identificación genética, fue realizado secuenciación de una región conservada del mtDNA con aproxidamente 600 pares de bases y luego fueron comparados con el banco de datos genético Barcode of Life Database (BOLD). La identificación por pelos ha sido llevada a cabo por análisis comparado y el diagnostico de los agentes infecciosos con carácter zoonosis fue determinado con la técnica Loop-mediated Isotehrmal Amplification (LAMP), que es sensible, barata y rápida. Los animales identificados fueron Dasypus sp., Mazama gouazoubira, Pantera onca, Cerdocyon thous, Tamandua tetradactyla, Didelphis aurita, Puma concolor, Myoprocta sp., Cavia sp., Galictis cuja; por medio de secuenciac... (Resumen completo clicar acceso eletrônico abajo) / Doutor

This study describes the results of a cross-sectional survey conducted in Mambwe district in the Eastern Province in Zambia. It uses a One Health approach to assess the impact of veterinary, medical, environmental and social determinants on animal and human health and wellbeing. One Health is defined as a holistic and interdisciplinary approach that describes the complexities between people, animals, the environment and their health. Human wellbeing is defined in this thesis as 'a condition in which all members of society are able to determine and meet their needs and have a large range of choices to meet their potential' (Prescott-Allen, 2001). As a first step, eight focus group discussions with the inhabitants followed by key informant interviews with stakeholders in the area were conducted to give a primary impression and narrow down the problems in relation to animal and human health of the area in general. Following this, a randomized selection of 210 households was visited and in each household blood samples were taken from all humans and all animals belonging to five animal species, namely cattle, goats, sheep, pigs and dogs. A third of the households did not keep any of the animal species chosen for sampling, but their inclusion was important for the social analysis. In all of these 210 households a wellbeing questionnaire was administered and, for every human and animal sampled, a health questionnaire. The study area falls within the tsetse-infested region of Zambia. It has a high wildlife density reflecting the proximity of several national parks and is historically endemic for both human and animal African trypanosomiasis (HAT&AAT). Therefore humans and animals were tested for trypanosomiasis using internal transcribed spacer (ITS) polymerase chain reaction (PCR). Since it is important as a differential diagnosis, malaria was tested for by a rapid diagnostic test in the field from human blood. Sera from mature individuals from all animal species except pigs were tested in a field laboratory for brucellosis using the Rose Bengal test. Additionally, cattle and dogs were tested for five genera of tick-borne infections (TBI) including Anaplasma, Ehrlichia, Theileria, Babesia and Rickettsia using reverse line blot (RLB) in the laboratory at the University of Edinburgh (UoE). The blood samples for PCR and RLB analysis at UoE were stored on WhatmanTM FTA cards. A total of 1012 human samples were tested for HAT and none found positive. 1005 (seven people had been tested positive or treated against malaria shortly before the sampling) people tested for malaria showed an overall prevalence of 15% (95% CI 13.2-17.7). None of the 734 Rose Bengal tests showed up positive for brucellosis. The prevalence of AAT in 1275 samples tested was much lower compared to former samplings; in cattle 22% (95% CI 18-27.2), in goats 7% (95% CI 4.5-9.2), in pigs 6% (95% CI 3.2-9.4), in dogs 9% (95% CI 5.2-13.6) and no samples were found positive in sheep. The prevalence of TBIs is much more complex with many multiple infections. A total of 340 cattle and 195 dogs were tested. In cattle the number of samples positive for any microorganism was as follows; 92% (95% CI 88- 94.2). Overall there were fewer positive samples from dogs with 25% of animals infected (95% CI 19.2-31.8). The wellbeing and health questionnaires were designed to help to identify possible risk factors for the above-mentioned diseases and signs, such as fever, diarrhoea and seizures, indicative for several other diseases. The results of these surveys might also help to identify potential reasons for a lower or higher prevalence of trypanosomiasis and malaria found than expected from previous studies. Additionally, information on personal happiness, attitudes towards veterinary and medical services, medical treatments received, education, women's reproductive history, drug abuse, people's perceptions of changes in environment and agriculture, demography, poverty and migration were collected via the questionnaires alongside information on livestock demographics and fertility. One of the main conclusions is that both medical and veterinary health care systems suffer from a number of shortcomings. The distance to appropriate treatment and care facilities is far and the necessary drugs are often unavailable. Also, both the knowledge and technology for diagnosing selected diseases is not in place. This study suggests that neurocysticercosis (NCC) plays an important role in this area due to the high number of seizures reported in people, in whom treatment for epilepsy was unsuccessful. Samples taken from a few pigs indicated the presence of Taenia solium, the causal agent of NCC. Furthermore, many of the TBIs are of zoonotic nature and further investigations must be made to begin to assess the burden of these diseases in humans and animals. Environmental changes such as degradation of the vegetation are likely to have an influence on the prevalence of studied diseases and this aspect is being investigated further in other studies. Due to the nature of a cross-sectional study, only limited conclusions can be drawn on the causal relationships of disease prevalence, but the social analysis conducted in this study confirmed the interactions of selected factors related to health and wealth unique for this study area.

Rabies management can be described as successful only if examined through a human health perspective. Negating companion animal health outcomes in rabies management creates systemic failures as cats and dogs are significant within our society and bridge humans and wildlife in rabies transmission. A shifting pet ownership culture has created opportunities for increased rabies risk. This thesis applied the One Health concept to the rabies management system in an Ontario municipality. The One Health concept considers that the health of humans is inherently connected to the health of companion animals and their shared environment. A mixed methods design informed a visual conceptualization of the rabies management system. Factors influencing human and companion animal health outcomes were identified through multivariable logistic regression models. The human outcome of interest was the recommendation of rabies post-exposure prophylaxis after a potential rabies exposure by a companion animal; the companion animal outcomes were receiving a post-incident rabies vaccine, being euthanized for rabies testing and being placed under observation. Semi-structured interviews were conducted with private veterinarians to understand their perceived role in rabies management. Rabies management is more complex than linear interactions and processes that occur to protect human health. An explicit link between the human and companion animal health outcomes was found. Companion animal species appeared as an influential factor and indicates that ownership practices differ between cats and dogs. This implies that veterinarians are not effectively leveraged as the link between public health and pet owners. Indeed, veterinarian’s approach their rabies management roles based on their prioritization of the seriousness of rabies compared to the risk. Through the application of One Health thinking to the municipal rabies management system, it is clear that there is a public-private divide where mitigating human rabies exposures conflicts with the prevention of rabies in companion animals.

Emerging infectious diseases continue to represent serious threats to global human health. Novel zoonotic pathogens are continually being recognised, and some ultimately cause significant disease burdens and extensive epidemics. Research and public health initiatives often face emerging pathogens with limited knowledge and resources. Inferences from empirical modelling have begun to uncover the factors determining cross-species transmission and emergence in humans, and subsequently guide risk assessments. However, the dynamics of virulence and transmissibility during the process of emergence are not well understood. Here, I focus on RNA viruses, a priority pathogen type because of their potential for rapid evolution. I use comparative trait-based analyses to investigate how aspects of both host and virus ecology contribute to the risk of virulence and transmissibility within human RNA viruses. To explore these questions, data were collected via systematic literature search protocols. In the first half of this thesis, I focus on viral determinants of virulence and transmissibility. I ask whether virulence can be predicted by viral traits of tissue tropism, transmission route, transmissibility and taxonomic classification. Using a machine learning approach, the most prominent predictors of severe virulence were breadth of tissue tropism, and nonvector-borne transmission routes. When applied to newly reported viruses as test set, the final model predicted disease severity with 87% accuracy. Next, I assess support for hypothesised routes of adaptation during emergence using phylogenetic state-switching models. Propensity for adaptation in small ‘stepwise’ movements versus large ‘off-the-shelf’ jumps differed between virus taxa, though no single route dominated, suggesting multiple independent trajectories of adaptation to human hosts. In addition, phylogenetic regressions showed vector and respiratory-transmitted viruses to be more likely to progress through early stages of emergence. In the second half of this thesis, I focus on how dynamics of virulence and transmissibility differ with respect to nonhuman host diversity, identity, and ecology. Using a regression framework, I observe that viruses with a broader mammalian host range exhibited higher risk of severe virulence, but lower risk of transmissibility, which may reflect potential trade-offs of host specificity. Furthermore, viruses with artiodactyl hosts exhibited lower risk of severe virulence and viruses with bat or nonhuman primate hosts exhibited higher risk of transmissibility. Next, I test hypotheses that mammal species with faster-paced life history may be predisposed to host viruses with greater virulence and transmissibility. Mammal body mass was used as an established proxy for pace of life history. In regression analyses, mammals with faster-paced life history hosted more viruses with severe virulence, though evidence for a relationship with transmissibility was limited. The broad-scale associations presented in this thesis suggest the evolution of virulence and human-to-human transmissibility during zoonotic emergence is a multifactorial, highly dynamic process influenced by both virus and host ecology. Despite this, general characteristics of high-risk emerging viruses are evident. For example, severe virulence was associated with broad niche diversity of both tissue tropisms at the within-host scale, and host species at the macroecological scale. However, risk factors for virulence and human-to-human transmissibility often did not coincide, which may imply an overarching trade-off between these traits. These analyses can contribute to preparedness and direction within public health strategies by identifying likely candidates for high-impact emergence events among previously known and newly discovered human viruses. The inherent connectivity between RNA viruses, their nonhuman hosts and the resulting implications for human health emphasise the holistic nature of emerging diseases and supports the One Health perspective for infectious disease research.