The Need for Portable Field Kits in Improved Veterinary Diagnosis in the Tropics
Professor John E Cooper DTVM FRCPath FI Biol FRCVS
School of Veterinary Medicine, The University of the West Indies, Trinidad and Tobago
INTRODUCTION
The need to feed the world's population and to alleviate poverty, especially in the tropics, requires an inter-disciplinary approach (Cooper 1). Veterinarians and others concerned with animal health are an important part of the team. However, an ever-present constraint on veterinary diagnosis and disease control in developing countries is finance, often further exacerbated by difficult terrain and by deterioration of infrastructure, such as roads and communications. Decline in the efficiency and the funding of Government Veterinary Services has added to the difficulties. Some of this is a result of the prevailing economic situation but further erosion has occurred on account of external ("international") pressure for countries to reduce centralisation and to put more work and responsibility into the hands of private veterinary practitioners. The outcome of this has been a marked reduction in availability of veterinary services in rural areas, inadequate surveillance of disease and a clear deterioration in the quality and reliability of diagnostic and investigative techniques.
Work with animals in much of the Neotropics (Caribbean/Latin American Region) is subject to the pressures above. Although some countries in the Region are relatively wealthy, others face the problems of developing nations elsewhere in the world. Recent data show that almost 64% of the Caribbean's/Latin America's rural population live below the poverty line and that agriculture remains a major source of employment. The precarious existence of many people is accentuated by natural disasters such as hurricanes and the global economic decline in the wake of 11th September 2001 has affected the Region more than any other in the world. There is a clear requirement to improve the health and productivity of livestock – and thus the well-being of those who depend upon them.
In this paper a proposal by the University of the West Indies (UWI) to deliver better veterinary services to rural areas of the Neotropical (Caribbean/Latin American) Region by using a combination of computerised communications and molecular diagnostic tests is outlined and discussed. It is suggested that for such a programme to be effective there is a need to develop and use relatively inexpensive but reliable portable equipment for use in the field.
The proposal, part of an extension of UWI's growing involvement in tropical medicine and global health, is that the University, with its network of contacts on Caribbean islands and in some parts of South and Central America (the CARICOM countries), should serve as a centre for the collation and distribution of data relating to livestock health. Relevant information and advice could then be made available electronically to assist those in greatest need, especially in poorer areas where animals are such an integral part of subsistence living. It is further proposed that the development and use of modern molecular (nucleic-acid-based) techniques would greatly facilitate diagnosis of infectious disease in such rural environments and largely obviate the need for cumbersome laboratory equipment and reagents.
DISCUSSION
The use of an electronic database and networks to disseminate information about animal diseases has already been shown to be of great value to those working in scattered, sometimes isolated, areas (Anon 2). Similar systems have also been used in human medicine, to deliver healthcare to rural communities (Anon 3). Such a network also makes it is possible to employ "telemedicine" in order to receive images of pathological lesions, or parasites, or blood smears, and then transmit them to specialists in other parts of the world. However, these innovative techniques depend upon reliable access to computers and the internet; the actual transfer of the science to and from rural environments, where communications and infrastructure are so often basic, can present many practical problems.
Modern nucleic-acid-based techniques have found much favour human and veterinary medicine in recent years and mean that the diagnosis of an increasing number of diseases can be based on analysis of a tiny tissue sample. However, the test kit and reagents has to reach those working in the field and may then need to be transported back to a laboratory elsewhere for processing or interpretation.
Portable field kits, that can be readily transported by hand, on a bicycle or on a motorcycle, provide the means to span the gap between electronic and molecular technology and the rural communities where such state-of-the-art science is most needed. The situation can be likened to a neuromuscular junction, where acetylcholine is the essential "messenger", transmitting specific impulses to myofibres. The muscle will not contract if the acetylcholine is not present or is ineffectual. Without a reliable method of delivering information, equipment and reagents to those in the field, modern electronic and molecular technology is wasted and there is usually a corresponding failure to obtain vital feedback, including much-needed surveillance data.
A key feature of the proposal must, therefore, be the production and use of equipment that is readily portable and that does not depend upon running water, mains electricity or other infrastructure (Cooper and Samour 4). This may involve the recycling of cheap items that can play a role in fieldwork – for example, plastic film pots as specimen containers, wooden or plastic coffee stirrers as spatulae. To these basic items can be added equipment that has been specifically designed for field work – for example, the battery-operated endoscope and other instruments that are manufactured by MDS (Medical Diagnostics), Florida, USA and the range of portable equipment produced by Primary Diagnostics, Devon, UK. The rational and successful use of such technology in veterinary fieldwork has been described elsewhere (Frye et al 5, Hart et al 6 and Samour et al 7). There remains, however an urgent need to develop a more comprehensive range of instruments suitable for the diverse types of veterinary work that need to be performed in rural areas – clinical examination of sick animals, post-mortem investigation of dead animals, in situ laboratory analysis – and to incorporate these items into purpose-made kits that can readily be transported and used under adverse conditions.
It is clear that there is much merit in looking at what is already available in human medicine to see if some of this might be adapted to work with animals. It is for this reason that a veterinary input into the Third Seminar on Appropriate Medical Technology for Developing Countries is apt and welcomed.
The need for collaboration in this important area has never been greater and the current development at the University of the West Indies of a programme specifically concerned with tropical veterinary medicine would appear to offer exciting new opportunities for combining a whole range of different technologies for use in the Caribbean/Latin American Region.
ACKNOWLEDGEMENTS
This paper is presented on behalf of colleagues at the University of the West Indies, with the approval of the Acting Director of the School of Veterinary Medicine and the Campus Principal. I am grateful to Dr. Roy Rickman for his continued advice and encouragement, to my wife and myself and also to colleagues and students both here in the West Indies and in East and Central Africa. Many people have supported me in my endeavours to encourage the greater and better use of field equipment in veterinary projects, including the late Dr John McArthur, Mr Paul Butler, Dr Frederic Frye, Dr Ian Keymer, Dr Jaime Samour, Mr Mike Hart and staff from Jersey Zoo (Durrell Wildlife Conservation Trust). Thanks are extended to them all.
References
1.Cooper JE, 1998. Proc XXI Biennial Congress Caribbean Vet Med Ass, Georgetown, Guyana Nov 1-5, 1998.
2.Anon 2003. CSIRO Animal Health News October, 10.
3.Anon 2002. TDR News 69, 11.
4.Cooper JE and Samour JH, 1997. Proc of Euro Comm of Ass Avian Veterinarians, London, England May 19-24, 1997.
5.Frye FL, Cooper JE and Keymer IF, 2001. ZooMed, Bull BVZS 1, 28-36.
6.Hart MG, Samour HJ, Spratt DMJ and Hawkey CM, 1991. Comp Haematol Int 1, 145-149.
7. Samour HJ, Spratt DMJ, Hart MG, Savage B and Hawkey CM, 1987. Biological Conservation, 41. 147-158.
