relation to zoonoses in northern

Background: Many diseases are known to be naturally transmissible between vertebrate animals, including cattle and humans. Currently, much effort is being made to promote dairy farming in Malawi but there is limited information about zoonotic diseases including public awareness and practices. This study was designed to determine factors associated with dairy producer's awareness and practices with regard to zoonoses in Northern Region of Malawi. Materials and Methods: A structured questionnaire was used to collect information from 140 randomly selected dairy producers between January and June 2011. Level of awareness and practices with respect to zoonotic infections was evaluated using a score ranging from 0 to 11. Chi-squared test followed by a multivariable logistic model were used to assess potential factors associated farmer's awareness and practices. 2 Results: Awareness and practice level was unsatisfactory. Significantly higher number of respondents (75.7 vs. 32.9%,˜ = 51.81, df =1, p< 0.001) had satisfactory level of awareness when compared to those who practiced preventive measures. Awareness of the existence of zoonotic infections and practices was higher in farmers who acquired animals through loan (p = 0.008), farmers with above primary education (p = 0.002) and farmers with more than six years of dairy farming experience (p = 0.010). Most farmers (59.3%) received information about zoonoses through Agricultural extension services. Conclusion: Awareness and practices with respect to zoonotic infections was dependent on farmer's formal educational level, dairy farming experience and means of acquiring parent stock. Regular disease surveillance and promotion of education on the risk associated with zoonotic infections through dairy extension and medical services should result in increased awareness and efficient control of zoonoses in Malawi.


Introduction
of animal, inadequate disease control programs and lack of information about disease burden have been Zoonoses are still a major challenge to human reported to be associated with the persistence of health worldwide.In Africa, it is estimated that zoonotic diseases [5,[8][9][10][11][12].infectious diseases account for up to 68% of all deaths Though information about zoonotic disease especially in vulnerable groups such as children and burden in animals and humans in most African people infected with HIV/AIDS [1].Sixty-one per cent countries including Malawi remains scarce [13], of the 1,415 species of infectious agents reported to reports have demonstrated their existence [4,6,[14][15][16][17].cause disease in humans are naturally transmissible In Malawi, reported cases of human infection with from vertebrate animals to humans and vice-versa [2].
animals [6,10,14,19,20].Amongst these, only rabies is While zoonotic infections remain age-long, many being given considerable attention though insufficient factors including increase contact between animals and funds, lack of information on the disease burden as well humans continue to play a key role in their emergence diagnostic facilities continue to be a major setback in and persistence.Environmental changes, customs and the management of the disease control programs [6,8].traditions, increase in human population, rural to urban Direct contact with infected tissues or animals and oral migration as well as increase movement of animals are transmission (mainly contaminated food from animal some of the reasons for increased contact between Man origin) have been earmarked are most important means and animals.As such, animals do not only serve as a of animal to human transmission zoonoses [7,8,12,15].reservoir for infectious agents but also a means of Considering that most disease control schemes introducing new infectious agents into the human including compensation paid to livestock producers for population.In sub-Saharan Africa, farming practices, infected animals that are culled is not very feasible in low educational level, culture and eating habit, most developing countries mainly because of limited presence of reservoir population, increase movement resources, improving animal owners' awareness and methodology was explained to the farmers and their disease identification skills could optimise their oral consent was obtained before enrolment in the prevention and control.Hence, an understanding of study.The first section of the questionnaire covered demographic information including respondents' farmers' awareness and practices which has received location, gender, age, experience in dairy farming, and much attention recently [5,11,[21][22][23][24]] could be a useful education level.The second section contained 8 core tool in developing and improving existing control questions: 3 for awareness of the existence of zoonoses measures.To the authors' knowledge, no reports into and 5 for practice associated with preventing zoonoses factors associated with livestock producers' awareness (Table-1).Most of the questions were closed-ended and practices associated with zoonotic diseases has questions and answers were assigned pre-existing set been documented in Malawi. of answers (Yes/Not sure/ No).A maximum of 2 points The objective of this study was to determine were assigned to question 1 if the answer was "yes"; 1 factors that could influence dairy producers' awareness point if answer was "not sure" and 0 points if answer and practices with regard to zoonoses in the Northern was "no".For questions 2 and 3, the response was Region of Malawi.assigned points ranging from 0 to 2 points as described

Methodology
in Table -2.Regarding the questions on practices Study area and population: This study was carried out associated with preventing zoonotic diseases, a score around Mzuzu, the capital city of the Northern Region of 1 point was assigned if the answer was "Yes" or 0 of Malawi between January and June 2011.This region point if the answer was "Not sure" or "No".In total, 6 has estimated at 1,067,084 inhabitants and experiences and 5 points were used to assess respondents' level of the highest annual population growth rate (3.3%) in the awareness and prevention practices related to zoonotic country [25].The region also has the highest number of disease, respectively.Respondents with at least 4 and 3 imported dairy cattle in the country.More than 90% of points were considered to have satisfactory awareness the dairy cattle population in this region are located level and practice a satisfactory level of zoonotic around Mzuzu [26][27][28].At the time the study was disease prevention, respectively.In order to be carried out, there were 684 registered farmers owning considered to have an overall satisfactory awareness as an average of two animals each in the study area.Dairy well as zoonotic disease prevention practices, a cattle breeds kept are predominantly Holsteinparticipant had to attain a score of at least 7 out of the Friesians, Jerseys and their crosses with the indigenous total of 11points.Malawi Zebu.These animals are mainly stall-fed or Statistical analysis: Data obtained was entered into grazed on communal pasture land near human Microsoft excel.They were analysed using SPSS dwellings [10,27,28].A total of 140 (20.5%)were (version 12.0; spss Inc., Chicago IL,USA).Uncondirandomly selected were included in the study.
tional association between potential farmers demographic Questionnaire survey: A structured questionnaire factors were assessed using the chi-square test.The which covered demographic characteristic, awareness response variable was "satisfactory" if the farmer has a and preventive measures against zoonotic diseases was score of at least 4, 3 and 7 for awareness, practices and used to collect data.The purpose of the study as well as overall assessment, respectively and "unsatisfactory"  if otherwise.Variables with a p-value of less than 0.25 their means of acquiring dairy animals, educational were included in multivariable logistic model with a level and duration in dairy farming in the final significance level of 10%.Variables with the highest p-multivariable analyses (Table -3).More than half of the values were removed beginning with the highest p-respondents received information about zoonotic value in each step and the regression was re-run.In the diseases from agricultural extension workers.Other final stage, the significance level was lowered to 5% important sources of information include medical and any factor with p value greater than or equal to 0.05 officers and throgh format education (Table -4).was removed.The goodness of fit of the final model Discussion was assessed using the Hosmer-Lomeshow statistic Results of this study show that smallholder dairy option.
farms ownership in the northern region of Malawi is

Results
dominated by women.This is contrary to reports from Characteristics of study population: Sixty per cent of other dairy farming communities such as the centre the farms included in the study were owned by women.region of Malawi and Zimbabwe [24,29] and reflects The mean age of participants was 47.5 ± 13.8 years and the presence of donor organisations in the study area.the dairy farming experience was 7.5 ± 5.8 years.A These organisations use dairy farming as means to majority of the respondents acquired parent stock ensure food security give priority to women as well as through donations (72.9%) and had below primary the under privileged in the communities [30].school education level (71.4%).
Many zoonotic infections can be eliminated or reduced using basic measure such as adequate hygiene Awareness, practices and source of information about and animal husbandry practices.In order for the zoonotic diseases: The overall awareness level of prevention of zoonotic infections to be effective, dairy farmers was unsatisfactory with the average animal owners and those who are in contact animal score for awareness, practices and overall score of 4.6 ± must be aware of these risks and their health behaviours 2.1, 2.0 ± 1.1 and 6.6±2.4 respectively.Significantly or practices should play a key role in reducing the risk more respondents (75.7 vs. 32.9%,51.81, df = 1, p< of transmission.However, recent studies have revealed 0.001) had satisfactory awareness level when compared poor knowledge of livestock owners, medical practitito those who implemented prevention measures.The oners as well as the existence of eating habits continue proportion of respondents with satisfactory awareness to predispose humans to zoonotic infections [5,9,12,17].level was higher (94.1 vs. 61.7%,18.68, df = 1, The risk of exposure to zoonotic diseases has been p<0.001) in respondents with above six years of dairy reported to be influenced by animal owners' farming experience.Similarly, more farmers (52.5 vs. knowledge, attitude, and practices [5,12,15,17].In this 25.0 %, 8.59, df = 1, p = 0.003) with above primary study, the awareness and prevention practices related to education level reported to practice measure that zoonotic diseases were comparable to that observed in prevent zoonotic disease transmission.
smallholder dairy farms in Egypt, Tanzania and On the overall, farmers' level of knowledge and Zimbabwe [11,22,24].However, more farmers had practices was significantly influenced (p<0.05) by  satisfactory awareness level but preventive practices developing countries, improving livestock producers' against zoonotic diseases were rarely reported.This awareness and disease identification skills could difference may be due to failure to perceive the risk or optimise disease control.The current study shows that to identify zoonotic diseases.Like in most African milk producers had satisfactory knowledge of zoonotic countries where more than 70% of total milk produced diseases but prevention measures were rarely is sold through informal markets or is consumed on the implemented.Regular testing of cattle for zoonotic farm without being pasteurised [31], most of the diseases as well continuous training as well as farmers in the study area processed milk into cultured improvement in dairy extension system would be milk "Chambiko".Given this, the risk of exposure to necessary for the control and prevention zoonotic milk borne zoonoses is apparent.diseases in Malawi.In addition, regular testing dairy animals for zoonotic diseases was not a common practice at the The author is grateful to Dr M.G.G.Chagunda time this study was carried out.More than 80% of the (Scotland's Rural College, UK) and Professor S. farms had not been checked previously for a zoonotic Wiedemann (University of Kiel, Germany) for their disease since they were established.Further, little assistance during data collection.The management of information on zoonotic disease burden in animal and World University Service of Canada (Malawi Office) is human population was available [8,10].This lack of thanked supporting and accepting this paper for information could have contributed to the low zoonotic publication.The assistance of the staff of Department disease prevention practices recorded in this study.
of Animal Health and Livestock Development, Mzuzu Similar observations were made in neighbouring Agriculture Development Division and participation Tanzania where low level of awareness of zoonoses in of dairy farmers around Mzuzu is highly appreciated.addition to food consumption habits is thought to increase the risk of exposure of livestock keepers to Competing interests zoonotic infections [11].
Author declare that he has no competing interest.Overall score for awareness and practices with respect to zoonotic diseases was not satisfactory but .5455/vetworld.2013.249-253

Table - 1
. Core questions on awareness and practices with regard to zoonoses Guidelines for scoring awareness and practices of respondents regarding zoonoses in Table-2 were used *

Table - 2
. Guidelines for scoring knowledge and practices of respondents regarding zoonoses* *Adapted from[23]

Table - 3
. Final multivariable logistic regression model for factors associated with respondent's awareness and practices zoonotic diseases