title: Participatory appraisal of the impact of epizootic lymphangitis in Ethiopia.
abstract: Epizootic lymphangitis (EZL) is reported to have a significant impact upon livelihoods within resource-poor settings. This study used a participatory approach to explore peoples' experiences of EZL and examine the perceived impact of disease, owner knowledge and understanding of EZL, lay management of disease and, attitudes and strategies towards disease prevention. Focus-group discussions were held with 358 cart-horse owners and drivers recruited from 7 towns attended by SPANA (Society for the protection of animals abroad) mobile veterinary clinics and 2 unexposed towns where no SPANA clinics were available. Focus group discussions explored four main research questions: (1) Is EZL recognised by animal owners, and is this considered an important disease in equids? (2) What factors do animal owners associate with the development of disease? (3) What happens to an animal with clinical disease and how does this impact upon the owner/community? (4) Are measures taken to reduce disease occurrence? These key areas were explored using photographs, disease ranking, matrices and open discussion. Data were analysed using descriptive statistics and thematic analysis. The results are presented thematically and include: recognition and descriptions of EZL, treatment strategies used, disease priorities and ranking, impact of disease, disease transmission and attitudes and approaches to disease prevention. EZL was widely recognised and ranked highly as an important disease of equids. However, there was uncertainty around identifying early cases of EZL, and this could impact upon the timing of initiating treatment and separating potentially infectious animals. People had varying knowledge of effective methods for disease prevention and reported particular difficulties with isolating infected animals. The impact of EZL was multi-dimensional and encompassed effects upon the horse, the individual owner and the wider society. Working equids provide a vital utility and source of income to many people in resource-poor settings. Often, infection with EZL resulted in a reduction in working ability which had a direct impact upon the livelihoods of owners and their dependent family members. EZL also impacted upon the welfare of the horse as sick animals continued to be worked and, in advanced cases, horses were abandoned due to ineffective or unavailable treatment. This study conceptualises the importance of EZL due to the effects of the disease on the horse and its impact upon human livelihoods. Epizootic lymphangitis is a neglected disease that requires further investigation in order to develop practical and sustainable disease control strategies within endemic regions.
authors.affiliation: Department of Epidemiology and Population Health, Institute of Infection and Global Health, School of Veterinary Science, Leahurst Campus, University of Liverpool, Neston, Wirral CH64 7TE, UK. Electronic address: claire.scantlebury@liverpool.ac.uk.
authors.forename: C E
authors.initials: CE
authors.lastname: Scantlebury
authors.affiliation: SPANA Ethiopia, College of Veterinary Medicine and Agriculture, University of Addis Ababa, Debre Zeit Campus, Ethiopia. Electronic address: abebaw_zerfu@yahoo.com.
authors.forename: A
authors.initials: A
authors.lastname: Zerfu
authors.affiliation: Department of Epidemiology and Population Health, Institute of Infection and Global Health, School of Veterinary Science, Leahurst Campus, University of Liverpool, Neston, Wirral CH64 7TE, UK. Electronic address: ginap@liv.ac.uk.
authors.forename: G P
authors.initials: GP
authors.lastname: Pinchbeck
authors.affiliation: SPANA UK, John Street, London, UK(3). Electronic address: Karen@thebrooke.org.
authors.forename: K
authors.initials: K
authors.lastname: Reed
authors.affiliation: SPANA UK, John Street, London, UK(3).
authors.forename: F
authors.initials: F
authors.lastname: Gebreab
authors.affiliation: SPANA UK, John Street, London, UK(3). Electronic address: nigatakat@yahoo.com.
authors.forename: N
authors.initials: N
authors.lastname: Aklilu
authors.affiliation: SPANA UK, John Street, London, UK(3).
authors.forename: K
authors.initials: K
authors.lastname: Mideksa
authors.affiliation: Department of Epidemiology and Population Health, Institute of Infection and Global Health, School of Veterinary Science, Leahurst Campus, University of Liverpool, Neston, Wirral CH64 7TE, UK. Electronic address: robc@liv.ac.uk.
authors.forename: R
authors.initials: R
authors.lastname: Christley
mesh_terms: D000822:Animal Husbandry; D000827:Animal Welfare; D000818:Animals; D055812:Community-Based Participatory Research; D005002:Ethiopia; D007722:Health Knowledge, Attitudes, Practice; D006734:Horse Diseases / Q000175:diagnosis / Q000517:prevention & control*; D006736:Horses; D006801:Humans; D008205:Lymphangitis / Q000175:diagnosis / Q000517:prevention & control / Q000662:veterinary*; D010067:Ownership; D012959:Socioeconomic Factors; D015047:Zoonoses / Q000175:diagnosis / Q000517:prevention & control*
keywords: Disease prevention; Epizootic lymphangitis; Participatory research; Qualitative analysis; Resource-poor settings; Working equids