Mathilde S. Merridale-Punter

Background: Working horses, donkeys and mules are used to support the livelihood of millions of households in low- and middle-income countries through their work in agriculture, transport and assistance with domestic duties among others. In doing so, these working equids often relieve their users from demanding physical tasks and contribute to their wellbeing. For many households, this support is provided primarily to women. This study aimed to explore working equid contributions to the health and wellbeing of those they support under a One Health perspective. Methods: This qualitative study consisted of a series of semi-structured in-depth interviews with ten female working equid users in two Ethiopian communities in the Oromia and Amhara national regional states during 2023. Interviews were conducted with simultaneous translation into the local language and verbatim transcripts were analysed thematically. A systems map was generated illustrating identified One Health links. Results: Five main themes were identified concerning the contributions of working equids to One Health: direct health benefits and hazards, nutrition and food and water security, access to health services and commodities, support services and systems, and wellbeing and lifestyle. Examples of human health impacts included direct physical and mental health benefits, facilitating access to healthcare or medicine and support for the sick. Animal health gains included improved nutrition and provision of veterinary care, and environmental benefits included the production of biofertiliser and contributions to waste management. Health hazards such as work-related animal welfare compromise and unhygienic shared environments were also identified. Conclusions: The relationship between working equids and their female users is multifactorial and deeply intertwined, with profound connections at social, economic and health levels. Evidencing this relationship through identified One Health links facilitates advocacy efforts and informs the establishment of appropriate support systems. Addressing working equid communities under a One Health and One Welfare framework is essential to ensure their wellbeing and promote their sustainable development. One Health impact statement: This research places the use of working equids in low-income Ethiopian communities within a One Health context. These animals provide essential support to livelihoods, food and water security as well as socio-economic resilience. Additionally, we explore how they influence human, animal and environmental health both directly and indirectly using a female and participatory perspective, foundational principles of inclusion, and engagement of communities and marginalised voices. This work was performed collaboratively with local partners, including authors with scientific and social backgrounds, promoting a transdisciplinary approach as well as social and multicultural parity. This work may inform and facilitate the implementation of holistic systems that address the use and ownership of working equids and ensure the adequacy of their supporting systems and structures, ultimately with the aim of improving community wellbeing sustainably.

Working equids support the livelihoods of millions of low-income households worldwide and face several welfare challenges. Although equipment-related wounds are common, little is known about specific risk factors. This cross-sectional study surveyed equids used for cart-work in three Ethiopian towns. Number, size, severity and location of wounds were recorded for each animal, as well as work equipment characteristics and indicators of equipment fit and assembly. Questionnaires were conducted with each cart-driver focusing on equipment practices and attitudes. Logistic regression models were generated to investigate associations between equipment-related wounds (outcome) and equipment, work, driver and animal-related factors (predictors). In total, 369 equids and cart-drivers were surveyed. The prevalence of equipment-related wounds was 72.6% (268/369) with girth wounds being the predominant wound type in horses (50%; 122/244) while donkeys had predominantly shaft-related wounds (59%; 72/122). Donkeys were two times more likely to have equipment-related wounds than horses. The presence of equipment-related wounds was associated with factors such as previously having wounds, inadequate collar positioning and using purchased equipment compared to partly home-made equipment. Characteristics of specific equipment components were also associated with certain wound types, such as narrow saddle pressure points and saddle wounds. Equipment-related wounds are highly prevalent in working equids, representing a serious welfare concern. Factors relating to equipment design, fit and assembly were associated with the presence of wounds. Importantly, species differences require tailoring of preventive approaches amongst working equids. A better understanding of work equipment should therefore be promoted as part of wound prevention and animal welfare strategies.

Despite several millions of working equids worldwide, there are few published studies regarding the epidemiology of their health and welfare. Data collected by non-governmental organisations (NGOs) operating in the working equid sphere therefore have important epidemiological value and could be used towards animal health surveillance. The aim of this study was to identify common clinical findings and mortality patterns of working equids in low- and middle-income countries and investigate their epidemiology using data collected from an international NGO. A retrospective analysis was conducted to determine the proportion of clinical findings and mortality risk by equid species, year and region. Negative binomial regression models were generated to investigate differences in mortality risk and proportion of key clinical findings between equid species, hemispheres and calendar month. A total of 4,313,606 presentations were reported from 14 countries between January 2005 and March 2021 (mean 22,121; SD ± 7,858 per month). Wounds and abscesses were the most reported clinical finding for all equid species (mean proportion 35%; SD ±0.19 of all findings). A higher proportion of wounds (mean proportion 41.7%; SD±0.2) was recorded in donkeys than mules or horses (P<0.001). Mules had higher reported mortality risk (1.2%; 95% CI 0.94–1.46%) than horses (0.4%; 95% CI 0.36–0.55%; p<0.001) or donkeys (0.2%; 95% CI 0.14–0.22%). Work-related wounds were the predominant finding in working equids, particularly so in donkeys. Prevention strategies should focus on improvements to work equipment and practices for all equids. Future investigations required include refinement of diagnostic approaches for donkeys and investigation of risk factors to understand the higher mortality in mules. Routine monitoring of clinical findings reported by national or international NGOs could be included in animal health surveillance strategies, although standardisation of data for this purpose is needed so that changes in prevalence following implementation of prevention strategies can be monitored.

Background: Millions of working equids provide socio-economic support for many low-income communities worldwide. With the prevalence of harness-related wounds reported as higher than 60%, this study aims to describe the equipment used by working equids in three locations of the Ethiopian national regional state of Oromia (Fiche, Bishoftu and Shashamene), and the attitudes and practices of equid owners, users and harness makers regarding work equipment. This mixed-methods study consists of cross-sectional surveying of working equids used for taxi or transport of goods or water, as well as cart-driver questionnaires and focus groups (FG) with working equid stakeholders. Activities conducted with FG included participatory ranking of equipment attributes and equipment drawing exercises. Indicators of equipment design and assembly, as well as cart-driver attitudes and practices were described quantitatively. Associations between equipment characteristics and species, work-type and cart-driver indicators were investigated through univariable logistic regression models, whereas focus group discussions were transcribed and analysed thematically.Results: In total, 368 working equid surveys and cart-driver questionnaires were completed and 87 participants took part in nine FG. Equipment composition and characteristics differed considerably from ideal animal draught and harnessing principles described in the literature, with none of the observed harnesses adhering to all principles and thus not considered fully adequate. Various harness compositions were used, with only saddles and breast collars present in all. Donkey equipment had fewer components than that of horses, such as swingle trees (OR 0.02; 95% CI 0.01–0.06;p < 0.001) or girths (OR 0.09; 95%CI 0.02–0.4;p = 0.002). Horse equipment was more likely to have functional elements such as breeching (OR 7.8; 95% CI 2.9–20.9;p < 0.001). Of all equipment attributes, FG participants ranked cost, design and impact on animal wellbeing as having the highest importance. Thematic analysis identified motivations and priorities regarding equipment; awareness and knowledge of design and function; barriers to using ideal equipment; and consequences of equipment design and practices as key themes.Conclusions: Various weaknesses of design, assembly and use of equid work equipment were identified. Promoting behavioural change through awareness and training could lead to a sustainable improvement of work equipment quality, access, and prevention of equipment-related problems.

Lameness is an important concern in working equids of low- and middle-income communities (LMICs) with significant One Welfare implications. This study aims to determine the prevalence and influencing factors of lameness in working equids of LMICs. A systematic review and meta-analysis were performed to investigate pooled outcome prevalence using a random intercept regression model. Subgroup and sensitivity analysis were performed through meta-regression. A meta-analysis of study factors for lameness prevalence was performed. Sixty-four studies were included in the review. The pooled prevalence of lameness was 29.9% (n = 42, 95% CI 17–47%), while the pooled prevalence of gait abnormality was 62.9% (n = 12; 95% CI 31–87%). When considering both outcomes together, the pooled prevalence was 38.4% (n = 46; 95% CI 23–57%) with a significant (p = 0.02) difference between lameness (29.5%; 95% CI 16–48%) and gait abnormality (78.8%; 95% CI 40–95%). Species, country income level, gait assessed, and risk of bias did not significantly affect the pooled prevalence. Lower body condition scores, unresponsive attitudes, and old age were the most frequently reported factors positively associated with lameness-related outcomes. Working 7 days per week was positively associated with lameness. The standardization of outcome terminology, grading systems, and study factor categorization is recommended to enable more accurate interpretation and comparison between studies.

Background: Emergency laparotomies in donkeys are infrequently performed and there is limited literature on the subject.Objectives: To determine findings and associated outcomes of exploratory laparotomies in donkeys.Study design: Descriptive retrospective study.Methods: Donkeys undergoing emergency exploratory laparotomy for investigation and treatment of colic at seven UK referral hospitals between 2005–2017 were included. Data were retrieved from available hospital records. Descriptive statistics and inferential statistical analysis of outcomes of interest was performed in three steps.Results: Thirty‐three cases fulfilled the inclusion criteria. Clinical signs on presentation were available for 32 donkeys, of which 53.1% (17/32) presented for investigation of colic while in 46.9% (15/32) the presenting complaint was non‐specific. Primary lesion location included small intestine (42.4%, 14/33), large colon (39.3%, 13/33), caecum (6.1%, 2/33), stomach (6.1%, 2/33) and 6.1% (2/33) had multiple abnormal findings without a clear primary lesion. Overall survival to discharge was 54.5% (18/33). Five donkeys (15.2%, 5/33) were euthanased at surgery and of those recovering from general anaesthesia a further 35.7% (10/28) were euthanased or died prior to discharge. Six donkeys (21.4%, 6/28) required a second laparotomy of which 4 (66.7%, 4/6) survived. Post‐operative complications occurred in 82.1% (23/28) of cases and included hyperlipaemia (42.9%, 12/28), incisional complications (21.4%, 6/28), ileus (21.4%, 6/28) and persistent colic (17.9%, 5/28). When adjusted for other complications, donkeys with primary gastric lesions were less likely to have presented with severe colic compared with those with primary small intestinal lesions (OR: 0.07, 95% CI 0.01–0.95, p = 0.05). Only age was positively associated with death prior to discharge (OR: 1.18, 95% CI 1.03–1.36, p = 0.02).Main limitations: Small sample size and retrospective design.Conclusion: Donkeys with abdominal lesions may present with a range of signs often not including colic. Surgical findings were diverse and survival to discharge appears to be lower than in horses.