Interdecadal and interannual climate variability has led to emergence and reemergence of zoonoses in Kenya. We take cognizance of a community based approach in early and timely detection of RVF is vital to veterinary, health authorities and policy-makers in immediate decision making. It contributes to an integrated climate risk assessment of livestock vulnerability analysis using climate dependent RVF model to develop predictive risk maps that will be crucial in current and future control plans of other climate sensitive diseases and possibly provide Early Warning Systems (EWS). The output will contribute to institutional contingency frameworks dealing with concepts and indicators of warning systems which will facilitate the early identification of potential climate sensitive epidemics and decision support systems.

1. Climate Change Early Warning Systems for Rift Valley Fever
Pandemic Preparedness in Kenya
Nanyingi M O
Department of Public Health, Pharmacology and Toxicology
University of Nairobi
KENYA
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25,2012

2. Climate Change Impacts in Kenya
In 2006 and 2007, PH
Burden of RVF OB resulted
in 3.4 DALYs per 1000
people and household
costs of about Ksh 10,000
(USD120)
3%GDP loss
$500M/(2012)
$1-2 B(2030)
2
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25,2012

3. Disease Early Warning Systems (DE S)
W
MEWS (MODIS_NDVI)
HEALTH MAPPER
Are these tools available universally and utilized adequately?
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012

4. R Contingency plans for E S in K
VF W enya (ongoing)
 Linkage with communities to monitor climatic parameters.
 Precipitation ,flooding and mapping of “dambos”
 Remote sensing and GIS data(NDVI of 0.43-0.45/ SST by 0.5 degrees )
epidemic indicative
 Community-Based Early Warning System (CB-LEWS)
 DVS trains communities to capture data relevant for RVF-EW
 Monitoring of vector dynamics and virus activity in sentinel herds?
 Farmer/public awareness programmes by Veterinary
Communications and Extension Officer.
 Community radios ,flyers and mobile phones for preparedness.
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012

5. Kenya : Stakeholders in Climate Sensitive Diseases
Government
Veterinary ,Public Health, Agriculture,Met
Universities,Research Institutions ONE HEALTH
Vulnerable Communities COORDINATION
CAPACITY BUILDING
Risk Assessment
Lab Diagnosis
Information MS
Simulation DISEASE CONTROL
Exercise Community Sentinel Surveillance
 Vaccinations and Vector Control
COMMUNICATION
System Appraisal strategy
Participatory message devt (FGD)
Media Engagement(Radio, TV)
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012

6. Current Research: RVF Spatiotemporal Epidemiology
 Participatory Epidemiology: Rural
appraisal and Community EWS to RVF
investigated.
 Sero-monitoring of sentinel herds and
Geographical risk mapping of RVF hotspots?
 Trans-boundary Surveillance for
secondary foci(Neighboring country-
Uganda)
 Disease burden analysis and predictive
modeling
 Decision support tools for community
utilization(Risk maps, brochures, radio and
video clips)
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012

7. Participatory Community Sensitization
 Disease surveillance Committees (Animal
health workers ,Pastoralists , Veterinary and
Public health officers)
 Community mapping of watering
Points/Dams or “Dambos”
 Training of trainers(TOT) on EWS using flyers
 Information feedback mechanisms
( Schools, Churches, village meetings)
 Trans-boundary security committees
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012

8. R M
VF onitoring and Surveillance -Community Model
e-surveillance
Aanansen et al., 2009, Madder et al., 2012
 e-surveillance and data gathering by (Mobile phones, PDA)
 Community sensitization/awareness by Syndromic surveillance
 Dissemination of Information through community vernacular radio,SMS
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012

9. Communication tools : Risk Maps of R in K
VF enya
Bett et al.,2012
 Is there geographical restriction of the Diseases or Epidemiologic drifts?
What other factors (confounders) are involved in endemicity of RVF?
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012

10. Further secondary data analysis for R prediction
VF
 Precipitation and Temperature from the Kenya Meteorological
Department/ECMWF for time series analysis (2000-2011)
 Sero-prevalence and inter-epidemic estimates of RVF from the DVS
 Disease burden analysis using demographics from Human National
Census (Public Health)
 Vegetative Index (NDVI) and Soil type cover for suitability of vector
analysis.
 Process based geographical risk modeling and Linear regression
analysis for RVF distribution (ILRI,DVS)
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012

11. Outbreak Maps of R in K
VF enya –(1912-2010)
 Response can be geographically
targeted(Disease Information Systems).
 Vaccine allocation and distribution is
site specific(cost saving mechanism)
 Secondary foci of outbreaks in semi-
urban locations (Vectorial competence).
 Controlled Human and Animal migration
to curb the spread of climate sensitive
diseases
 Post Vaccination Sero-monitoring( AVID)
Bett et al.,2012
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012

12. Climate E S Caveats in K
W enya
 Lack of human capacity and expertise to contextualize climate
change sensitive disease predictions and scenarios.
 Dysfunctional or non existent communication channels
(technological inadequacies in rural communities)
 Trans-boundary armed conflicts (Pastoral cattle rustling)
 Financial Constraints in Climate Change Research(Parsimony??)
 Ethno-Religious Barriers and Insecurity(Al-Shabab)
 Ineffective government policies on climate sensitive Diseases
 Lack of efficient infrastructure(Roads, Electricity)
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012

13. Target beneficiaries of climate early risk assessment
 Sustainable planning and decision making tools to support the
development of appropriate climate change adaptation and mitigation
policies.
 Simulation exercises to test response to RVF epizootic and strengthen
working between veterinary, medical, and entomological sectors.
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012

14. Contributions to E S in K
W enya: Stakeholders Capacity and Networks
 Zoonoses Working Group has been established (One Health concept).-CDC
 Linking expert institutions through global networks within both the animal
and health sectors
 Improvements in governance, infrastructure and capacity building will also
prove valuable to secure the livelihoods of vulnerable populations.
 Participatory approaches : Farmer Field Schools and livestock owners’
training on climate change for zoonoses preparedness and prevention.
 Improved surveillance, early detection and timely diagnosis, transparency
of animal disease information
Rapid response to outbreaks as well as the potential use of the network
approach in providing data for studies related to climate sensitive diseases .
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012

15. Acknowledgements
Data and Financial Support
Contributing Authors
 Bett B, International Livestock
Research Institute, Kenya
 Thumbi SM, University of
Edinburgh, UK
Project Advisors
 Kiama SG, Wangari Maathai
Institute, University of Nairobi
 Muchemi GM, Department of
Public Health, Pharmacology and
Toxicology University of Nairobi
World Bank Expert Group_Early Actions of Reducing Climate Sensitive Diseases_Bellagio,Italy_August 21-25, 2012