Strengthening global health security by improving disease surveillance in remote rural areas of low-income and middle-income countries

Katherine E.L. Worsley-Tonks, Jeff B Bender, Sharon L. Deem, Adam W. Ferguson, Eric M. Fèvre, Dino J. Martins, Dishon M. Muloi, Suzan Murray, Mathew Mutinda, Darcy Ogada, George P. Omondi, Shailendra Prasad, Hannah Wild, Dawn M. Zimmerman, James M. Hassell

Research output: Contribution to journalReview articlepeer-review

26 Scopus citations

Abstract

The COVID-19 pandemic has underscored the need to strengthen national surveillance systems to protect a globally connected world. In low-income and middle-income countries, zoonotic disease surveillance has advanced considerably in the past two decades. However, surveillance efforts often prioritise urban and adjacent rural communities. Communities in remote rural areas have had far less support despite having routine exposure to zoonotic diseases due to frequent contact with domestic and wild animals, and restricted access to health care. Limited disease surveillance in remote rural areas is a crucial gap in global health security. Although this point has been made in the past, practical solutions on how to implement surveillance efficiently in these resource-limited and logistically challenging settings have yet to be discussed. We highlight why investing in disease surveillance in remote rural areas of low-income and middle-income countries will benefit the global community and review current approaches. Using semi-arid regions in Kenya as a case study, we provide a practical approach by which surveillance in remote rural areas can be strengthened and integrated into existing systems. This Viewpoint represents a transition from simply highlighting the need for a more holistic approach to disease surveillance to a solid plan for how this outcome might be achieved.

Original languageEnglish (US)
Pages (from-to)e579-e584
JournalThe Lancet Global Health
Volume10
Issue number4
DOIs
StatePublished - Apr 2022

Bibliographical note

Funding Information:
EMF was supported by the One Health Network for the Horn of Africa (HORN) project, which receives funding from UK Research and Innovation and the Biotechnology and Biological Sciences Research Council (project number BB/P027954/1), the CGIAR Research Program on Agriculture for Nutrition and Health, led by the International Food Policy Research Institute, and the CGIAR Fund Donors. DJM was supported by the Mpala Research Centre and Princeton University. DMM was supported by the CGIAR Research Program on Agriculture for Nutrition and Health, led by the International Food Policy Research Institute and the CGIAR Fund Donors. HW was funded by a Bill & Melinda Gates Foundation Grand Challenges Exploration award (grant number INV-015886). DMZ and JMH were supported by the US Army Medical Research and Development Command (contract number W81XWH-21-C-0001) and the Armed Forces Health Surveillance Division, Global Emerging Infections Surveillance branch award P0031_21_WR. We thank the Smithsonian Conservation Biology Institute and Field Museum for covering publication charges. We also thank staff and teams at the Mpala Research Centre for their support towards our research.

Publisher Copyright:
© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license

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