Indigenous knowledge of Rift Valley Fever among Somali nomadic pastoralists and its implications on public health delivery approaches in Ijara sub-County, North Eastern Kenya.

Rift Valley Fever (RVF) is a zoonotic disease whose outbreak results in heavy economic and public health burdens. In East Africa, RVF is mainly experienced in arid and semi-arid areas predominantly inhabited by the pastoralists. These areas experience sudden, dramatic epidemics of the disease at intervals of approximately 10 years, associated with widespread flooding and the resultant swarms of mosquitoes. Pastoralists' indigenous knowledge and experience of RVF is critical for public health interventions targeting prevention and control of RVF. The study adopted a descriptive cross-sectional design combining both quantitative and qualitative methods of data collection. A total of 204 respondents participated in questionnaire survey and 15 key informants and 4 focus group discussions were interviewed and conducted respectively. In addition, secondary data mainly journal publications, books, policy documents and research reports from conferences and government departments were reviewed. Findings indicated that the Somali pastoralists possess immense knowledge of RVF including signs and symptoms, risk factors, and risk pathways associated with RVF. Ninety eight percent (98%) of respondents identified signs and symptoms such as bloody nose, diarrhea, foul smell and discharge of blood from the orifices which are consistent with RVF. Heavy rains and floods (85%) and sudden emergence of mosquito swarms (91%) were also cited as the major RVF risk factors while mosquito bites (85%), drinking raw milk and blood (78%) and contact with animal fluids during mobility, slaughter and obstetric procedures (77%) were mentioned as the RVF entry risk pathways. Despite this immense knowledge, the study found that the pastoralists did not translate the knowledge into safer health practices because of the deep-seated socio-cultural practices associated with pastoralist production system and religious beliefs. On top of these practices, food preparation and consumption practices such as drinking raw blood and milk and animal ritual sacrifices continue to account for most of the mortality and morbidity cases experienced in humans and animals during RVF outbreaks. This article concludes that pastoralists' indigenous knowledge on RVF has implications on public health delivery approaches. Since the pastoralists' knowledge on RVF was definitive, integrating the community into early warning systems through training on reporting mechanisms and empowering the nomads to use their mobile phone devices to report observable changes in their livestock and environment could prove very effective in providing information for timely mobilization of public health responses. Public health advocacy based on targeted and contextually appropriate health messaging and disseminated through popular communication channels in the community such as the religious leaders and local radio stations would also be needed to reverse the drivers of RVF occurrence in the study area. Author summary: Rift Valley Fever is a viral disease that affects both humans and animals. It is categorized as one of the re-emerging and neglected tropical diseases that mainly affects the poor and marginalized populations that lack access to health services and are readily ignored. Humans usually get RVF through bites from infected mosquitoes. Infections also occur when humans are exposed to the body fluids, or tissues of infected animals. Hence the risk of infection is greatest when slaughtering in the context of traditional sacrificial practices. This is the major reason outbreak of RVF is commonly associated with people whose livelihoods revolve around livestock rearing. In East Africa, RVF is mainly experienced in arid and semi-arid areas predominantly inhabited by the pastoralists. These areas experience epidemics of the disease at intervals of approximately 10 years associated with Elnino events. Understanding the knowledge base of the people in terms of RVF signs and symptoms and risk factors and pathways is important for the adoption of effective prevention and control measures. This study findings suggest that even though the Somali nomads are adept at recognizing RVF, this knowledge has not been translated into appropriate health practices due to the deep-seated socio-cultural practices. Hence, there is need for health authorities to mount locally appropriate public health advocacy campaigns, empower the livestock keepers to report observable changes in livestock and environment using their mobile phone devices and promote cross-disciplinary studies on RVF. [ABSTRACT FROM AUTHOR]