Bindu Raghavan

Variations in healthcare perceptions, knowledge and behaviors across different socioeconomic strata and regions underscore disparities in healthcare access and satisfaction levels. The Covid-19 pandemic exposed the vulnerability of forest-dependent communities to increased disease risks and the need to involve local communities in pandemic preparedness through education and awareness regarding disease and ill-health. This article synthesizes the challenges with respect to health and disease, healthcare services, and access to the same among forest-fringe communities. We undertook a Knowledge, Attitudes and Practices (KAP) survey of 35 villages in and around the Mudumalai Tiger Reserve in southern India. Semi-structured interviews using open-ended questions were used to collect information from households on these broad themes: self-reported health issues, healthcare-seeking behaviors, opinion on the healthcare options available to them, risky-behaviors related to disease and ill-health, and self-perceived risk factors for disease or ill-health. Data was also collected on socioeconomic status. Reponses were converted to nominal categories and analyzed using mixed methods. Our respondents self-reported a mix of acute (31%) and chronic (62%) health issues, with undiagnosed fever being the most reported acute ailment (57%). Access to healthcare services showed a preference for government facilities for primary care (63%) but private facilities for surgical procedures (30%, p < 0.05). A substantial portion (15%) reported paying more than a month’s income for healthcare services. Education levels seemed to influence perceptions, with higher education correlating to a broader understanding of disease causation (p < 0.05). Lack of basic amenities such as clean drinking water, proper methods of garbage and sewage disposal, and access to nutritious food seem to be important risk factors for disease and illness. Overall, majority of the respondents (76%) expressed satisfaction with government healthcare services, reporting dignified treatment (64%) and regular visits by healthcare workers (74%, p < 0.05). Our study highlights the need to incorporate socioeconomic inequities and barriers while devising healthcare outreach, awareness and service program. We suggest interventions aimed at enhancing healthcare access and promoting healthier practices that mirror the specific needs and socioeconomic dynamics of the local communities for improved community health and well-being.

Introduction. Silvopastoral systems (SSP) play a leading role in soil carbon sequestration and greenhouse gas mitigation. Objective. To quantify the ecosystem services provided by four SSPs in comparison with a grass pasture in the middle valley of the Sinú river in Colombia. Materials and methods. Methane and nitrous oxide fluxes were measured using closed chambers, during a period of eight consecutive weeks (September to November, 2013). Soil organic carbon was also measured at two depths (0-5 and 5–15 cm), by the combustion method, and soil physicochemical variables were determined. The design corresponded to randomized complete blocks with five treatments and three replications. The treatments corresponded to four silvopastoral systems made up of different tree components: Tectona grandis (SSP1), Tabebuia rosea (SSP2), Pachira quinata (SSP3) and Acacia mangium (SSP4), compared to a grass-only meadow (Megathyrsus maximus cv Mombasa). Results. The highest contents of organic matter, phosphorus, and calcium were registered within the SSP. Soil organic carbon (COS) was higher within the SSPs (39.43±15.34 t C ha-1), compared to the grassland (33.43±17.63 t C ha-1). The SSPs behaved most of the time as methane sinks, immobilizing on average -460±0.42 µg CH4 m-2 h-1. The lowest nitrous oxide emission rates were evident within SSP1 and SSP2 systems (460±0.60; 620±1.19 µg N2O m-2 h-1, respectively). Conclusion. The implementation of SSP contributes to the decrease of soil degradative processes (physical and chemical), to the increase of soil carbon stocks and, consequently, they are a greenhouse gas mitigation strategy in livestock systems.

In the absence of livestock contact, recurring lamb mortality in bighorn sheep (Ovis canadensis) populations previously exposed to pneumonia indicates the likely presence of carriers of pneumonia-causing pathogens, and possibly inadequate maternally derived immunity. To investigate this problem we commingled naïve, pregnant ewes (n=3) with previously exposed rams (n=2). Post-commingling, all ewes and lambs born to them acquired pneumonia-causing pathogens (leukotoxin-producing Pasteurellaceae and Mycoplasma ovipneumoniae), with subsequent lamb mortality between 4-9 weeks of age. Infected ewes became carriers for two subsequent years and lambs born to them succumbed to pneumonia. In another experiment, we attempted to suppress the carriage of leukotoxin-producing Pasteurellaceae by administering an antibiotic to carrier ewes, and evaluated lamb survival. Lambs born to both treatment and control ewes (n=4 each) acquired pneumonia and died. Antibody titers against leukotoxin-producing Pasteurellaceae in all eight ewes were ‘protective’ (>1:800 and no apparent respiratory disease); however their lambs were either born with comparatively low titers, or with high (but non-protective) titers that declined rapidly within 2-8 weeks of age, rendering them susceptible to fatal disease. Thus, exposure to pneumonia-causing pathogens from carrier ewes, and inadequate titers of maternally derived protective antibodies, are likely to render bighorn lambs susceptible to fatal pneumonia.

Mannheimia haemolytica causes pneumonia in domestic and wild ruminants. Leukotoxin (Lkt) is the most important virulence factor of the bacterium. It is encoded within the four-gene lktCABD operon: lkt A encodes the structural protoxin, and lktC encodes a trans -acylase that adds fatty acid chains to internal lysine residues in the protoxin, which is then secreted from the cell by a type 1 secretion system apparatus encoded by lktB and lktD . It has been reported that LktC-mediated acylation is necessary for the biological effects of the toxin. However, an LktC mutant that we developed previously was only partially attenuated in its virulence for cattle. The objective of this study was to elucidate the role of LktC-mediated acylation in Lkt-induced cytotoxicity. We performed this study in bighorn sheep ( Ovis canadensis ) (BHS), since they are highly susceptible to M. haemolytica infection. The LktC mutant caused fatal pneumonia in 40% of inoculated BHS. On necropsy, a large number of necrotic polymorphonuclear leukocytes (PMNs) were observed in the lungs. Lkt from the mutant was cytotoxic to BHS PMNs in an in vitro cytotoxicity assay. Flow cytometric analysis of mutant Lkt-treated PMNs revealed the induction of necrosis. Scanning electron microscopic analysis revealed the presence of pores and blebs on mutant-Lkt-treated PMNs. Mass spectrometric analysis confirmed that the mutant secreted an unacylated Lkt. Taken together, these results suggest that acylation is not necessary for the cytotoxic activity of M. haemolytica Lkt but that it enhances the potency of the toxin.

Mannheimia haemolytica consistently causes severe bronchopneumonia and rapid death of bighorn sheep (Ovis canadensis) under experimental conditions. However, Bibersteinia trehalosi and Pasteurella multocida have been isolated from pneumonic bighorn lung tissues more frequently than M. haemolytica by culture-based methods. We hypothesized that assays more sensitive than culture would detect M. haemolytica in pneumonic lung tissues more accurately. Therefore, our first objective was to develop a PCR assay specific for M. haemolytica and use it to determine if this organism was present in the pneumonic lungs of bighorns during the 2009-2010 outbreaks in Montana, Nevada, and Washington, USA. Mannheimia haemolytica was detected by the species-specific PCR assay in 77% of archived pneumonic lung tissues that were negative by culture. Leukotoxin-negative M. haemolytica does not cause fatal pneumonia in bighorns. Therefore, our second objective was to determine if the leukotoxin gene was also present in the lung tissues as a means of determining the leukotoxicity of M. haemolytica that were present in the lungs. The leukotoxin-specific PCR assay detected leukotoxin gene in 91% of lung tissues that were negative for M. haemolytica by culture. Mycoplasma ovipneumoniae, an organism associated with bighorn pneumonia, was detected in 65% of pneumonic bighorn lung tissues by PCR or culture. A PCR assessment of distribution of these pathogens in the nasopharynx of healthy bighorns from populations that did not experience an all-age die-off in the past 20 yr revealed that M. ovipneumoniae was present in 31% of the animals whereas leukotoxin-positive M. haemolytica was present in only 4%. Taken together, these results indicate that culture-based methods are not reliable for detection of M. haemolytica and that leukotoxin-positive M. haemolytica was a predominant etiologic agent of the pneumonia outbreaks of 2009-2010.

The non-steroidal anti-inflammatory drug diclofenac is a major cause of the rapid declines in the Indian subcontinent of three species of vultures endemic to South Asia. The drug causes kidney failure and death in vultures. Exposure probably arises through vultures feeding on carcasses of domesticated ungulates treated with the drug. However, before the study reported here, it had not been established from field surveys of ungulate carcasses that a sufficient proportion was contaminated to cause the observed declines. We surveyed diclofenac concentrations in samples of liver from carcasses of domesticated ungulates in India in 2004–2005. We estimated the concentration of diclofenac in tissues available to vultures, relative to that in liver, and the proportion of vultures killed after feeding on a carcass with a known level of contamination. We assessed the impact of this mortality on vulture population trend with a population model. We expected levels of diclofenac found in ungulate carcasses in 2004–2005 to cause oriental white-backed vulture population declines of 80–99% per year, depending upon the assumptions used in the model. This compares with an observed rate of decline, from road transect counts, of 48% per year in 2000–2003. The precision of the estimate based upon carcass surveys is low and the two types of estimate were not significantly different. Our analyses indicate that the level of diclofenac contamination found in carcasses of domesticated ungulates in 2004–2005 was sufficient to account for the observed rapid decline of the oriental white-backed vulture in India. The methods we describe could be used again to assess changes in the effect on vulture population trend of diclofenac and similar drugs. In this way, the effectiveness of the recent ban in India on the manufacture and importation of diclofenac for veterinary use could be monitored.