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Skills in Epidemiology Lacking in the Caribbean

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Building capacities in Caribbean animal health in the : The VEP (Veterinary

Epidemiologist / Para-Epidemiologist) Project

A. Delgado 1 , C. Faverjon 2 , T. Lefrancois 2 , J. Shaw 3 , V. Gongora 4, , K. Hackshaw 5 , J. Pradel 2

1. IICA, San Jose, Costa Rica: 2. CIRAD UMR CMAEE, Petit Bourg, Guadeloupe: 3. USDA-APHIS-IS, Santo Domingo, Dominican Republic: 4. Belize Poultry Association, Cayo District, Belize 5.Vet Services, St Vincent and the Grenadines, Chair of CaribVET

Skills in Epidemiology Lacking in the Caribbean

• 4-year, 2 million USD, funded by USDA-APHIS-IS and implemented by IICA

Technical coordination: USDA, IICA, CIRAD

General coordination: The Caribbean Animal Health Network (CaribVET)

Steering Committee & Epidemiology WG: ensure that VEP project meet the needs of the participating countries, as well as the region overall

Joint activities: participation in CaribVET meetings and trainings, sharing internal and external communication means (fora, Website, Information Bulletin, etc.)

External Evaluation

VEPs

Strengthen the CaribVET Network & collaboration

between countries &

organizations

Encourage partnerships private/public &

animal/public health

Human capacity building & enhanced

infrastructure

Support a rapid national & regional emergency response

framework Develop & initiate

harmonized disease surveillance protocols Develop & reinforce national surveillance

systems

Create, strengthen, &

maintain coordinated &

harmonized databases

• Region made up of over 31 countries, territories, and

protectorates, with concomitant differences in language, culture, and historical experiences.

Disease surveillance and control has historically

been difficult with frequent introductions of exotic diseases and pests.

• Discontinuation of previous disease control programs left a need for personnel trained in epidemiology and

emergency response.

 Need for longer-term, tailored training in epidemiology, surveillance, and emergency response.

Countries, Participants, and VEP Responsibilities VEP Project Design, Coordination and Evaluation

Project Objectives

To strengthen the animal health surveillance and rapid response systems of

National Veterinary

Services in the Caribbean Region through the formation of a group of veterinary epidemiologists

or para-epidemiologists:

the “VEPs”

Specific

Training program focused on 5 key areas Impacts and Conclusions

Results of the project:

Strengthened collaboration between

countries/territories through the VEPs activities

• Very positive feedback from the participants after self-evaluation of improvements in capacities

• Individual-level results based on indicators built upon action reports, show variation among the VEPs.

Conclusions:

Project design allowed for continuation of action by CaribVET, even after project funding ends e.g. regional emergency preparedness & capacity building – Recommendations of the VEP project integrated in the Work Plan of the Epigroup of CaribVET

For future capacity building projects, recommend:

Improved participant oversight and development of concise indicators for monitoring training and activities

Planning for formal recognition of the training program to motivate participants to complete all training

Jean Rodney Jacques Simon

Wendy Gonzalez

Patricia Bartlette

Malaika Glasgow

Dennis Derek Thomas Vicki Aimey

Auria King-Cenac Lennox St Aimee Zakia Goodwin-Diaz

Tracey Challenger

Acknowledgements

VEPs with Coordination Team & Mentors

Basic Epidemiology

Epidemiology short courses (CSU), online RANEMA

program, mentored epidemiologic projects

Disease Knowledge

Endemic and exotic diseases

Emergency Response

Table-top and field simulations, use of the Incident Command System

Sample Handling &

Shipment

IATA certification, sample shipment simulation exercise

Data Collection and Management & GIS

Analysis

Non VEP countries ANTIGUA & BARBUDA BARBADOS

DOMINICA

DOMINICAN REPUBLIC GRENADA

HAITI NEVIS

ST. VINCENT ST. KITTS ST. LUCIA

• 7 Workshops, online and short course trainings

• 10 in-country epidemiologic

projects completed in collaboration

with a mentor

• 2 outbreak simulation exercises

• 1 final regional Simulation

exercise involving all VEP countries

Steering Committee

Epidemiology Working Group

Other Working Groups

Coordination Unit

VEPs

Technical & Administrative Coordination

Regional strategy, Recommendations & Technical Support

Technical Coordination

& Support

Information

National level Implementation

CVOs

Funding &Technical Support/Expertise

Program and practical implementation in the countries

Capacity Building Program: developed by epidemiologists from IICA, USDA, Colorado State, Univ. of Florida, & CIRAD  Theory, practice, & hands-on experience

• One participant (a “VEP”) nominated by the government in each participating country, formerly involved in CAP* program  VEP Working as full-time government employees throughout the project, allowing for immediate application of knowledge and skills

gained from training

• Funds provided to pay incentives (participation) & to purchase surveillance supplies

• Monthly Action Report used for follow-up of VEP activities

Responsibilities transferred to the VEPs to meet Project objectives

• Assist in the building /coordination of the epidemiological surveillance network

• Participation in external evaluation of their surveillance activities by SNAT*

• Coordinate sample collection, preparation, and submission

• Design & manage surveillance databases & GIS, farmer registries & livestock census info

Conduct disease prevalence surveys based on the country’s needs and priorities

Emergency situations: review of plans, participate in simulation exercises

• Establish and/or maintain communication with stakeholders

• Prepare and submit regular activity reports to the CVO* and to VEP coordinators

Abbreviations used:

CAP: Caribbean Amblyomma Programm; SNAT: Surveillance Network Assessment Tool (tool from the Epidemiology Working Group of CaribVET); CVO: Chief Veterinary Officer, CSU: Colorado State University

General

Period from June 2010 to April 2012

Average per VEP

Group level (Min-Max )

No. databases developed 2 0-4

No. questionnaires developed 1.8 0-4

No. maps created 1.4 0-4

No. Surveillance plans

developed 0.3 0-6

No. Emergency preparedness

activities 3 1-7

Sample Indicators Based on Monthly Action Reports From VEPs

% Improvement in Core Capacity Domains Measured by Self Assessment

Many thanks to the project participants in each country, their CVO’s, and animal health staff; epidemiologists and veterinarians from CIRAD, IICA, USDA, CaribVET,

CSU and University of Florida; and USDA-APHIS-IS for funding the VEP project.

Also, thanks to Linda Logan and Dave Hird for serving as external evaluators. For more information on the project, visit http://www.caribvet.net/en/vep-project

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