An exploratory study of the conditions for local actor engagement in tick and tick-borne disease risk management
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| Anzahl der Teile | 45 | |
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| Identifikatoren | 10.5446/66806 (DOI) | |
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Transkript: Englisch(automatisch erzeugt)
00:00
Thank you. My name is Iona Zortman. I'm finishing my PhD research at the CIRAD in Montpellier, France. And today I prepared a presentation that will hopefully fairly successfully summarize what I've been working on for the past three years,
00:29
which is focused on exploring how transdisciplinary and social ecological systems approaches could improve local actor engagement in infectious disease surveillance.
00:43
And I use tick-borne disease risk within the Occitani region of southern France as my case study. So my presentation will follow a fairly classic structure. So I'll start with what I hope will be a fairly brief introduction to the context of my research, followed by the general purpose and the questions that guided my work.
01:06
I'll then explain a bit of the methods that I use to collect my data. And then I'll move into the results of my research. And finally, I will conclude with some ideas for the potential doors that this type of research can open for future surveillance programs.
01:28
So to begin, my research constitutes a sub task within moods first work package. This work package uses participatory approaches to create an interface with stakeholders with the aim to increase the likelihood that the stakeholders will adopt the different mood innovations.
01:51
So while these activities of this work package are based on a bottom-up approach that integrates stakeholders into not only the conceptualization of these tools and services, but also in their adaptation and validation.
02:07
However, a lot of the work predominantly targets public health and animal health stakeholders that intervene at more national and international levels.
02:21
However, as I think was quite clear with Julia's presentation and something that I will briefly describe next, tick-borne disease risk has very local implications that go beyond strictly public and or I guess I should say traditionally public and animal health institutions, which
02:46
makes risk detection and prevention dependent on a wider set of diverse actors that intervene at a local level. However, these local actors, well who these local actors are, as well as how they engage in tick
03:01
-borne disease surveillance, how they engage with tick-borne disease surveillance agencies has yet to be extensively explored. So I won't go into the details of the ecology of ticks, because I think Julia did a very great job of describing that. But as we know, ticks are obligate hematophages ectoparasites.
03:26
So they rely on blood meals from various vertebrate hosts that include humans and domestic animals to complete their life cycle. And it's through these blood meals that they can acquire and subsequently transmit what is
03:42
now considered the most diverse group of pathogenic agents affecting simultaneously human and domestic animal health. And the complexity of the tick life cycles, as well as the pathogen transmission chains is largely what complicates tick-borne disease surveillance and control strategies because ticks are highly dependent on seasonal and micro climatic conditions.
04:12
Additionally, humans and domestic animals are only considered accidental hosts, which means that we
04:20
only come in contact with ticks by entering into tick-infested habitats or moving tick-infested animals into previously non-infested areas. So this combination of environmental, ecological, and also social behavior factors make tick risk spatio-temporally heterogeneous and highly localized to specific social ecological contexts.
04:51
So ticks are historically considered a major economic and health burden within the agriculture sector in various parts of the world. However, it's only since the late 1990s that their importance as pathogen vectors for public health has
05:06
grown tremendously, to the point that they are now considered the primary pathogen vector of public health concern in Europe. The two species of particular concern when it comes to public health importance are Ixodes ricinus,
05:22
which we hear talked about often because it's a species that is capable of transmitting the pathogenic agent of Lyme disease and also tick-borne encephalitis, along with a multitude of other pathogenic agents. And also, Iloma marginatum, which is the most competent species vector of Crimean-Congo hemorrhagic fever
05:45
virus, which is, well, in both cases, both species are expanding in their geographic distribution and that of the pathogens that they transmit, both in new areas and also within endemic regions.
06:01
And this is due to, this is largely due to a combination of ecological climactic and anthropogenic drivers. However, in Europe, the true burden of tick-borne diseases at the European level is difficult to estimate because each country conducts
06:22
surveillance differently. And there's, there's sort of a lack of standardization amongst, amongst countries as well as within countries. So in the, in the figure that you see on the screen, the different colors correspond to different
06:40
surveillance strategies or different surveillance definitions for Lyme disease, according to the country. So if we do a focus on France, there are actually five species of ticks that are considered important for both public and animal health, including, of course, Ixodes ricinus and Iloma marginatum, which is considered established in the Mediterranean region
07:08
of southern France since 2015. Sorry, where am I?
07:20
Tick-borne disease surveillance in France predominantly concerns Lyme disease, for which surveillance data relies on voluntary notifications from general health practitioners, as well as tick-borne encephalitis, which has only recently become, has only recently been added to the list of obligatory notifiable diseases in 2021. So for these reasons, surveillance data
07:47
can be considered incomplete at the national level, at the national and sub-national level, and also insufficient for orienting effective control policy.
08:01
However, the continual increase of tick-borne diseases over the last two to three decades has caused sufficient concern amongst the population and public health practitioners in France, leading to the country's first national plan to combat tick-borne diseases, which
08:21
was proposed in 2016 by the Public Health Ministry, as well as the introduction of a citizen science initiative which is aimed at encouraging citizens to report tick bites, and this data is used to create risk maps in different parts of the, throughout the country.
08:45
So while these two initiatives have been largely successful, it is still presumed that avoiding tick bites is, remains the best way to prevent tick-borne diseases, which makes risk detection and risk prevention the responsibility of individuals at local scales.
09:09
So because tick-borne disease risk is dependent on local scale social, interlinked social ecological factors, and the most successful detection and prevention strategies exist at the local individual level,
09:23
my research proposes a transdisciplinary social ecological systems approach to tick-borne disease surveillance, which active, which aims to actively bring together a diversity of societal non-academic actors who are confronted with the tick-borne disease risk problem,
09:45
and put them in collaboration with researchers so that they can, so these actors can collectively identify relevant and context dependent social ecological drivers of disease, as well as co-produce locally relevant solutions.
10:01
So the purpose of my research was to place the actor at the center of the problem in order to understand how they understand tick risk within its social ecological dimensions, and in the context of my research, we defined, well we used the word tick risk instead of
10:22
tick-borne disease risk or tick-borne diseases or tick and tick-borne disease risk, and we define tick risk generically as any negative effect, whether it be direct or indirect of ticks on public or animal health, as well as the environmental impact of tick population control strategies.
10:42
So in order to respond to, in order to explore how actors, how local actors understand tick risk within its social ecological dimensions, we first asked the questions, who are the actors that are implicated? So it's important to identify who these actors are. To what extent do they find tick risk to be an issue for them? And also, how do they collectively envision managing tick risk?
11:10
And all of these questions led to the ultimate question that I attempted to respond to, which is overall, what are the benefits of a transdisciplinary social ecological systems framework to improve tick-borne disease risk management?
11:28
So due to the exploratory nature of my research, I relied predominantly on qualitative social science and participatory methods, which consisted of semi-structured interviews, some participant observations with local actors,
11:44
and finally organizing multi-actor participatory workshops. So my research can be divided into three major phases, beginning at a more macro level, at the more national level, before scaling down to the local level with local actors. So
12:05
in the absence of time, I won't go into detail of how each phase was conducted. If anyone's interested in this, we did publish an article late last year, which gives essentially a step-by -step guide on how to operationalize this type of methodological approach that was published in the One Health Journal.
12:29
So to discuss a bit of my results, in phase one, I attempted to map the social network of tick-borne disease surveillance of the tick-borne disease surveillance landscape in France.
12:43
So to do so, I interviewed 13 stakeholders that are involved in surveillance activities, and I inventoried the different activities, interactions, barriers, and levers of the current system. Based on their interviews, we determined
13:06
that there is currently no formalized surveillance system, but instead what I determined to be four interdependent yet distinct surveillance processes that each rely on, or sorry, that together rely on local surveillance-oriented research
13:27
to produce national level risk evaluation and policy creation. And this policy is then applied at the regional level to orient
13:41
more surveillance-oriented research. Each process is composed of informal multi-actor networks that are largely based on professional connections. However, stakeholders did express a desire and a need to formalize these networks, especially when it comes to improving
14:02
intersectoral collaborations. Here are two quotes from the actors that I interviewed that express the necessity to connect field veterinarians with general practitioners to detect disease, and also stating that tick management must be integrated
14:22
into a larger question regarding environment management, which shows that actors are reflecting on not only the need to integrate animal health and public health sectors, but also integrate environmental management sectors. In addition, stakeholders also express the need to connect national policies and national decision-making to local
14:49
realities, where some actors stated that they don't feel like they have any form of institutional recognition, that scientists and researchers give recommendations that are only partially applied by the state,
15:05
and that regional public health agencies are mandated to orchestrate putting in place policy at a local level. However, they're not given any sort of guidance in how to implement.
15:26
So the results of Phase 1 sort of gave us the green light to test our framework through a case study to explore different avenues with local actors on how to formalize these multi-actor networks that were previously discussed and improve tick-borne disease surveillance
15:46
through transdisciplinary research approaches and using a social-ecological systems perspective. So we identified the Occitania region in the south of France as an interesting case study, which we call the social-ecological system,
16:01
due to the already existing and potentially emerging health, economic, and environmental stakes that tick risks represent, which I, for the sake of time, I won't go into detail, but if anyone has any questions about this slide, we can always go back to it.
16:20
So within this region, I interviewed 23 local actors who were willing to discuss their perspectives of tick risk and current tick risk management approaches within their territory. These actors were predominantly actors within the agriculture and environmental sectors. However, we were able to discuss with some public and veterinary health practitioners and only one public health administrative agent.
16:48
Most of the people that I interviewed were women and the large majority of the participants were between 30 and 60 years old. So based on the discussions with these local actors, I was able to extract social,
17:05
environmental, and ecological indicators of tick risk that were mentioned by the actors during the interviews. And I use this information to create tables, which you see an example of the social indicators that either increase or decrease tick risk as perceived by the local actors.
17:27
And I was also able to use this information to construct a social-ecological systems model of tick risk as the local actors perceive it, which represents the nested social and ecological properties, as well as
17:40
the interactions between these social-ecological properties that determine tick risk. So while actors easily recognized environmental and ecological determinants of tick risk, they predominantly constructed risk and represented risk in relation to the social system. So in relation to public health and in relation to domestic animal health.
18:06
So after identifying how local actors individually represent tick risk within the social ecological dimensions, we then invited the actors to participate in a transdisciplinary workshop with research representatives to
18:21
co-create what we call a shared vision of the future of tick risk management. So we organized two participatory workshops. However, I will just focus on the first one. So by the end of the workshop, the participants had co-defined what we call an organizational tool,
18:47
which is in the form of a transdisciplinary tick and tick-borne disease risk steering committee, which would operationalize. New interactions between various actors are implicated in tick risk surveillance, prevention and management
19:05
to better apprehend the tick risk problem within their territory and at larger scales. The steering committee would have specific responsibilities deemed priorities by the participants that would include inventory,
19:29
inventorying, consolidating, co-creating and circulating information that is correct, simple, practical and verified to not only the larger public, but also amongst the actors within the network.
19:42
So in summary and in conclusion, France's current tick-borne disease surveillance system is characterized predominantly by informal multi-actor networks that currently lack sufficient intersectoral and multi -level collaborations, as well as bottom-up recognition of both academic and non-academic actors.
20:04
The actors interviewed acknowledged that these are barriers to improving surveillance for accurate risk evaluation at both the national and subnational levels, and they desire more effective communication tools to improve these interactions.
20:22
When it comes to non-academic local actors, each type of actor is confronted differently by tick risk, which means that each actor has different motivations and different priorities when it comes to tick risk. However, they all consider risk within both its social and ecological dimensions.
20:41
However, they do require more consistent interactions with researchers, public health experts and decision makers to accurately prevent tick risk individually and collectively. So my research was able to not only make a diversity of local actors collectively aware of the social ecological state of tick risk within their shared territory, but also motivate them to participate in transdisciplinary co-research activities.
21:09
And we're hoping that the future of this research will actually allow for living labs to be put in place to test the effectiveness of this transdisciplinary tick and tick-borne disease risk steering committee,
21:22
as well as utilize the social ecological indicators that the local actors identified and to formalize these indicators into tools that can eventually be used by decision makers in order to orient surveillance activities and also improve risk information. So thank you. I totally lost track of time, so I
21:45
don't know how long that took, but thank you for your attention, and I look forward to your questions.