Territorialized integrated management of health risk in Côte d’Ivoire: case of the 2021 highly pathogenic avian influenza outbreak

Abstract

Background: Grand-Bassam plays a key economic role in Côte d’Ivoire, thanks to poultry farming and tourism. It also hosts rest areas for migratory birds, potential reservoirs of highly pathogenic avian influenza. Its poultry market, however, suffers from biosafety shortcomings. Aim: The aim of the study was to determine whether the way the 2021 epizootic was managed favored or limited the spread of the virus. Methods: A territorialized analysis of the risk of dissemination of the 2021 epizootic outbreak in Grand-Bassam, based on the “One Health” approach, was carried out in May 2023. A retrospective survey identified the central actors and their social network via a questionnaire on their interactions. In parallel, logistic regression on epidemiological surveillance data was used to identify risk factors and map territories at risk of secondary notification of avian mortality. Results: The main stakeholders involved in the response network were the Departemental Directorate of Animal Health and the National Directorate of Vetenarian Services. In addition, 60% of those involved had neither a scientific profile nor technical expertise. Territorial and integrated risk analysis highlighted key factors contributing to the worsening of the HPAI outbreak. More specifically, statistically significant links were identified between the reporting of HPAI-related secondary mortalities and certain factors: (i) environmental factors, such as the presence of a resting area 10 km or more away, and distance of at least 15 km from a poultry market; (ii) farming-related factors, notably traditional farming methods and the presence of a guinea fowl flock of at least 85 individuals. On the other hand, no significant association was observed for anseriforms (ducks and geese). Conclusions: The study highlights the increased spread of HPAI on the periphery of the response zoning, underlining the importance of strengthening the response network. It recommends a territorial and transdisciplinary approach to improve resilience, and proposes synchronous monitoring combining early detection in avifauna and screening of at-risk populations.