Implementation of the One Health approach to fight arbovirus infections in the Mediterranean and Black Sea Region: Assessing integrated surveillance in Serbia, Tunisia and Georgia

Background In the Mediterranean and Black Sea Region, arbovirus infections are emerging infectious diseases. Their surveillance can benefit from one health inter‐sectoral collaboration; however, no standardized methodology exists to study One Health surveillance. Methods We designed a situation anal...

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Published in:	Zoonoses and public health Vol. 66; no. 3; pp. 276 - 287
Main Authors:	Dente, Maria Grazia, Riccardo, Flavia, Bolici, Francesco, Colella, Nello Augusto, Jovanovic, Verica, Drakulovic, Mitra, Vasic, Milena, Mamlouk, Habiba, Maazaoui, Latifa, Bejaoui, Mondher, Zakhashvili, Khatuna, Kalandadze, Irine, Imnadze, Paata, Declich, Silvia, Knjeginic, Vesna, Stojkovic, Borka, Labus, Tatjana, Milicevic, Vesna, Veljovic, Ljubisa, Maksimovic‐Zoric, Jelena, Stoiljkovic, Vera, Svetlana Filipovic Vignjevic, Protic, Jelena, Zgomba, Marija, Petric, Dusan, Despot, Dragana, Pesic, Branislav, Serovic, Katarina, Aleksic, Ivan, Djuric, Ivana, Ilic, Dragan, Vrga, Svetlana, Pavlovic, Ljiljana, Plavsa, Dragana, Grego, Edita, Dr Milan Jovanović Batut, Harabech, Kaouther, Ministère de la Santé Publique, Nissaf Ben Alaya, Bougatef, Souha, Triki, Henda, Bouattour, Ali, Rebhi, Mohamed, Daaboub, Jabeur, Somai, Lamia, Zerlli, Malek, Oukaili, Kaouther, Heni Haj Ammar, Sghaier, Chedia, Fatnassi, Naouel, Kalthoum, Sana, Dhaouadi, Anissa, Abdelhak Ben Youness, Mahale, Issam, Marzouk, Mongi, Sassi Ben Bdira, Grira, Samia, Ayadi, Sonia, Mastouri, Faten, Allad, Abdelkader, Ben, Chakhunashvili, Giorgi, Babuadze, Giorgi, Mamuchishvili, Nana, Chanturia, Gvantsa, Adeishvili, Ekaterine, Avaliani, Lasha, Ninidze, Lena, Kartskhia, Natia, Gulbani, Ana, Kokhreidze, Maka, Donduashvili, Marina, Kekelidze, Anna
Format:	Journal Article
Language:	English
Published:	Germany Blackwell Publishing Ltd 01-05-2019 John Wiley and Sons Inc
Subjects:	Analysis Animals Arbovirus Infections - epidemiology Arbovirus Infections - veterinary Arbovirus Infections - virology arboviruses Black Sea Business process engineering Communicable Diseases, Emerging Crimean Congo Haemorrhagic Fever Data Data analysis Data collection Data processing Fever Frameworks Georgia (Republic) - epidemiology Health Health surveillance Humans Infections Infectious diseases Integration Mediterranean Region Modelling One Health Original Outbreaks Pest outbreaks Policies Population Surveillance Serbia - epidemiology surveillance Surveillance systems Tunisia - epidemiology vector‐borne infections Viruses West Nile virus Mediterranean Region Georgia (Republic) Serbia Black Sea Tunisia Georgia United States > US vector-borne infections surveillance Crimean Congo Haemorrhagic Fever West Nile virus arboviruses One Health
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Summary:	Background In the Mediterranean and Black Sea Region, arbovirus infections are emerging infectious diseases. Their surveillance can benefit from one health inter‐sectoral collaboration; however, no standardized methodology exists to study One Health surveillance. Methods We designed a situation analysis study to document how integration of laboratory/clinical human, animal and entomological surveillance of arboviruses was being implemented in the Region. We applied a framework designed to assess three levels of integration: policy/institutional, data collection/data analysis and dissemination. We tested the use of Business Process Modelling Notation (BPMN) to graphically present evidence of inter‐sectoral integration. Results Serbia, Tunisia and Georgia participated in the study. West Nile Virus surveillance was analysed in Serbia and Tunisia, Crimea‐Congo Haemorrhagic Fever surveillance in Georgia. Our framework enabled a standardized analysis of One Health surveillance integration, and BPMN was easily understandable and conducive to detailed discussions among different actors/institutions. In all countries, we observed integration across sectors and levels except in data collection and data analysis. Data collection was interoperable only in Georgia without integrated analysis. In all countries, surveillance was mainly oriented towards outbreak response, triggered by an index human case. Discussion The three surveillance systems we observed prove that integrated surveillance can be operationalized with a diverse spectrum of options. However, in all countries, the integrated use of data for early warning and inter‐sectoral priority setting is pioneeristic. We also noted that early warning before human case occurrence is recurrently not operationally prioritized.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 MeSA Working Group members are in Appendix 1. These authors contributed equally to the work.
ISSN:	1863-1959 1863-2378
DOI:	10.1111/zph.12562