| Source of technology and funding | IFAD-supported research carried out by the International Livestock Research Institute (ILRI) |
| Expected Benefit: | Higher adoption of technology, greater sustainability, improved productivity of livestock, enhanced impact of the technology |
| Crops and enterprise: | Livestock-keeping |
| Agro-ecological zones: | All |
| Target region and countries: | East, Central and Southern Africa |
| Keywords: | Impact assessment, East Coast fever, Infection and treatment, rapid appraisal, Kenya |
A method to immunize cattle against East Coast fever (ECF), one of the major diseases of livestock in Kenya, has been available for several decades. The method, known as the infection and treatment method (ITM), has not been widely adopted by livestock keepers. A study was carried out to assess the ex-post impact of the ITM technology and identify the factors that might have limited its adoption among livestock keepers in Kenya. Results confirm that ITM is effective in the control of ECF and that demand for the technology exists among farmers. A number of policy, technical and institutional issues were identified that need to be addressed to improve the delivery and adoption of ITM technology.
The study used two methods. First, a review of the available literature was carried out. The areas targeted for review included the concept of ITM, the impact of ITM on livestock productivity and reproduction, the impact of ITM on acaricide use, and financial and economic analysis.
Second, a rapid appraisal was carried out to evaluate progress in the delivery and impact of ITM in Coast Province, where ITM has been provided on a commercial basis since 1998. Semi-structured interviews were held with key informants, farmers and other stakeholders in Coast Province and in Nairobi. A checklist of questions on issues of importance were determined and posed open-ended fashion to permit flexibility. Key informants were selected to represent a wide range of stakeholders in both government and the private sector (Table 1).
A list frame of farmers on whose farms ITM had been carried out between 1992 and 1997 was assembled, and a random sample of 20 farmers were selected for interview. Each farmer was visited separately to assess the impact of ITM at the individual farm level and provide a double check through observation.
Table 1. Type and number of stakeholders interviewed and their roles
| Type | No | Role |
| Government Veterinary Officers | 5 | - extension service to farmers on use of ITM - transfer of ITM from pharmaceutical company to farmers |
| Non-Governmental Organizations | 1 | - promotion and transfer of ITM technology |
| Private Veterinary Officers | 4 | - transfer of ITM from pharmaceutical company to farmers |
| Pharmaceutical Companies | 1 | - marketing and promotion of the technology - support research on ITM for use in other areas |
| Paraveterinarians | 2 | - transfer of ITM from pharmaceutical company to farmers - monitoring after immunization and extension advice |
| Large-scale Farmers | 5 | - users of the technology |
| Officers, Department of Veterinary Services |
2 | - formulation of policy regarding use of ITM by stakeholders |
| KARI Staff | 4 | - manufacture of ITM - further research on ITM |
| Smallholder-Farmers | 20 | - users of technology |
*KARI = Kenya Agricultural Research Institute.
Literature Review
The following is a summary of key features of ITM as reported in recent literature.
The ITM concept
ITM involves two simultaneous processes. The first is the active infection of cattle with a known strain of T. parva, and the second comprises treatment of the recipient cattle with a chemotherapeutic agent. The chemotherapeutic agent acts to neutralize the early stages of the disease and generally results in mild reactions and a solid immune response. The live T. parva parasite is stored in liquid nitrogen in the form of a tick stabilate, while the chemotherapeutic agent is normally a long-acting tetracycline.
The impact of ITM on cattle productivity and reproduction
Although economic losses caused by ECF have not been systematically quantified among cattle producers, the disease is known to lead to high mortality in cattle, especially in exotic (Bos taurus) breeds and their crosses, among which mortality rates can approach 100%. In indigenous animals, mortality rates can be as high as 30%. Although ITM trials have been carried out in several areas in Kenya, only limited data are available for analysis of the impact of ITM on livestock productivity.
Studies have been carried out to investigate the impact of ITM on cattle fertility, the oestrus behaviour, serum progesterone concentrations and pituitary response to gonadotrophin releasing hormone.
Conclusion: ITM has a net positive impact in productivity as a result of the reduced effects of ECF morbidity and mortality and does not have any adverse effect on reproduction in immunized animals.
The impact of ITM on acaricide use
The advantages of the reduced use of acaricides against cattle ticks are numerous, including reduced labour requirements and lower costs at the farm level, as well as reduced acaricide accumulation in the environment (Fivaz and De Waal, 1993). It is also believed that the reduced use of acaricides would delay the onset of resistance to acaricides by ticks.
An added benefit of ITM to the farmer would therefore be the possibility of reducing the frequency of tick control following immunization. However, due to the existence of other tick-borne diseases, like babesiosis, anaplasmosis and heartwater, that do not have readily available vaccines, researchers have been reluctant to advise farmers to reduce tick control following ITM before these issues are well understood (Norval and Young, 1990).
Many studies have therefore been carried out to assess the impact of ITM immunization on the frequency of tick control.
Conclusion: ITM has the potential of substantially reducing the costs borne by farmers through tick control. The level of the reduction in costs would depend on the management system practiced by the livestock keepers in the different production systems. Researchers and farmers have reported reductions of acaricide application of between 30-80% among immunized cattle.
Financial and economic analysis of ITM
Several studies in and outside Kenya have attempted to estimate the cost of ITM using a variety of methodologies. The benefit-cost ratio of immunization against ECF has also been calculated to be in the range of 9-17, indicating a high level of economic return.
Conclusion: Estimates of the cost of ITM range from USD 2-20 depending on the production system in which ITM was carried out and the components included in the costing. Most estimates have included the costs of stabilate, antibiotics and transport, but not the professional charges by veterinarians and other associated costs. ITM shows a high benefit-cost ratio.
Farmer perceptions of ITM
Studies were carried out in Kilifi District, Coast Province (Research International, 1997), and in Kiambu, Central Province (Ndua et al., 1999), to assess farmer perceptions of ITM. The majority of the farmers in Kilifi had no experience with ITM, while most of those interviewed in Kiambu had had their animals immunized the previous four years. Results from these studies are summarized below.
a) Farmer interest in ITM
Among farmers, 96% in Kilifi District and 84.3% in Kiambu District were interested in using ITM. This high level of interest in the technology is related to the fact that farmers recognize ECF as a major constraint to cattle production. Farmers in Kilifi District identified ECF as the most important disease, with at least 26% of the 220 respondents claiming they had lost at least one animal during the preceding year.
b) Farmer perceptions on the efficacy of ITM
Among farmers, 90% in Kiambu and 94% in Kilifi believed that ITM protected their cattle against ECF, while 6% of the farmers in both districts reported that the vaccine failed to protect their cattle against ECF.
c) Farmer perceptions on the benefits of ITM
The major benefits of ITM were perceived to be the reduction of ECF cases and reduced costs for tick control.
d) Farmer concerns about ITM technology
A few farmers expressed concern about milk loss following vaccination, the high cost of the vaccine and the danger of cattle contracting ECF because of the vaccination.
e) Farmer awareness of ITM
In both Kilifi and Kiambu, the main source of information about the ECF vaccine was the veterinary officers/government workers, followed by friends, neighbours, or relatives.
Veterinarian perceptions of ITM
By means of a rapid appraisal, a different study evaluated the interest by veterinarians in delivering ITM in Coast Province (Peeler and Muraguri, 1996). The main finding of the study was that the veterinarians were concerned that vaccination with ITM could cause death (from reactors) and result in loss of their reputation.
Rapid Appraisal
In addition to reviewing the literature to synthesize the lessons learned to date about the slow adoption of ITM, a rapid appraisal of the current status of ITM delivery in Kenya was also conducted.
An appraisal was particularly necessary in light of the recent policy changes that have occurred in ITM delivery. In 1998, the Kenya Agricultural Research Institute (KARI) sought a partner that would undertake the marketing of the vaccine. Cooper (K) Ltd. won the bid for exclusive distribution of ITM, but this was limited to only Coast Province. The company was also to support further research to confirm the efficacy of ITM in other areas, as well as research into tick control. Cooper (K) Ltd signed a memorandum of understanding in the same year to formalize the arrangement.
Impact of ITM on-farm
Of the farmers interviewed who had experience with ITM, 16 in 20 felt that there was less ECF on the farm. They also said that there was almost no disease among the immunized animals since the vaccination of the animals. They cited the potential to reduce ECF as a benefit of immunization since ECF was viewed as a major constraint to livestock production in the region. Most of the respondents felt that the control of ECF would increase milk production, because improved cattle could be kept as farmers became aware that ECF would no longer be a threat.
Price of ITM
Farmers in Kaloleni and Bahari Divisions of Kilifi District who participated in the immunization in 1996 and 1997 had paid KES 800 and KES 1 000 per immunization for a calf and adult, respectively. With a commercial company, the new prices for a dose of ITM vaccine would be KES 1 200 and 1 600-1 800 for a calf and adult, respectively.
Impact of ITM on acaricide use
It was found that there was little change in acaricide application following immunization in most of the smallholder farms surveyed. Of the 20 smallholder farmers interviewed, 14 continued to dip or hand spray their cattle once per week (which was the recommended rate before immunization), three once every two weeks, two once every month and one once every two months. Farmers attributed the continued high use of acaricide after immunization to lack of information from research and extension staff on what to do.
Another reason mentioned by farmers for not reducing acaricide use was that farmers (and veterinarians) were not sure whether a relaxation of tick control would cause animals to get ECF and other tick-borne diseases. Farmers were in fact advised by veterinarians to continue tick control as before.
Six of the 20 farmers interviewed had relaxed tick control after immunization gradually by trial and error. These included veterinary officers and others in the profession who had immunized their cattle and a few farmers who did so on the advice of this group.
The experts interviewed (mainly researchers in tick-borne diseases) agreed that it was not possible to give a blanket recommendation on tick control for all regions because tick populations vary greatly in different production systems.
Demand for ITM
Demand was taken to mean willingness to vaccinate and pay for the vaccination. Most of the farmers interviewed (17 of 20) expressed their willingness to vaccinate their animals and pay for the vaccination, two of 20 were unsure, and one was unwilling to vaccinate. It was therefore felt that demand for the ITM technology exists, but might depend on the price.
Farmers who had vaccinated animals had requested that the vaccination be continued.
Demand for ITM
Veterinarians were of the opinion that it was up to the farmers to come to them to request the ITM. Up to then, however, very few farmers or none had done so.
They felt that it is unethical for the veterinarian to go to farmers and promote the technology, recruit them and immunize. Their view was that it was the responsibility of the company to create awareness about the existence of the technology, benefits and risks associated with the technology to increase demand for it.
The farmers, on the other hand, were waiting for the vaccine to be brought to them by veterinarians because this is how they first received ITM and other vaccines. Most of the veterinarians interviewed said that, since the moment when a commercial company had taken responsibility for marketing the vaccine, nothing had been done to create awareness, and not a single dose of the vaccine had been sold. However, since the rapid appraisal study, nearly 1 000 animals have been immunized (Kiara, personal communication).
Delivery pathway for ITM
Most of the veterinarians thought the delivery pathway was an obstacle. Currently, the delivery pathway is:
KARI —›Cooper (K) Ltd —› Local Depot —› Veterinarian —› Farm
KARI is responsible for making the stabilate and supplying it to Cooper (K) Ltd. Cooper (K) Ltd markets it to the veterinarians, who then deliver it to the farmers. Cooper has a depot at Mombasa where field veterinarians purchase the vaccine.
Ownership of ITM technology
Among the many players in the delivery of the vaccine, the issue of ownership was not clear. A number of the veterinarians interviewed were not sure whether KARI or Cooper (K) Ltd owned the vaccine. It was not clear to them which institution would be responsible in the event of vaccine failure. This was making some of them reluctant to get involved, as they feared that farmers might transfer the blame to them. The role of the Government concerning the technology was not clear to them either.
Efficacy of the vaccine
Some veterinarians doubted the efficacy of ITM. This was thought to be related to reactors, whereby some immunized animals contract ECF following immunization. A number of veterinarians wanted the issue of the duration of the protection of the vaccine clarified. They wondered whether immunity lasts for one year, three years or life, as this would affect the cost of the technology.
Carrier state
Some veterinarians believed that, because immunized animals become carriers, it was necessary to immunize all the animals on the farm to keep them from becoming reservoirs for the unimmunized in-contact animals. They were of the view that the movement of immunized animals should be restricted within the farm where immunization had taken place. Otherwise, when immunized animals are taken elsewhere, they might introduce ECF there.
Complexity of the technology
Veterinarians said they found ITM technology overly complex on account of the following.
- Technical know-how is required in order to administer the vaccine.
- Farmers cannot buy it off the counter as they can do with other drugs.
- After immunization, animals need to be monitored for two weeks. Since farmers are scattered over a wide area, this was difficult.
- There might be reactors after immunization that may require treatment.
Financial constraints
Most of the veterinarians had not been able to become involved in ITM because they considered the initial capital outlay to be high. Money is required for the purchase of liquid nitrogen containers, liquid nitrogen, oxytetracycline, the vaccine and transport. Veterinarians who run artificial insemination services could combine artificial insemination and ITM, but so far none were doing so. Some private veterinarians had been provided with liquid nitrogen canisters during the KARI/Department for International Development (UK) ECF project, but they were not currently using them because of the other problems cited. Attempts to get advance payments from farmers before immunization had failed. Some farmers also failed to pay after immunization, thus discouraging the veterinarians.
Packaging of the technology
Most informants felt that ITM technology is inappropriately packaged. Most of the smallholder farmers, the main targets for the technology, have three to five animals, whereas one vial of the vaccine contains 20 doses. Veterinarians who have delivered ITM said that it was difficult to get 20 animals in one place, implying that farmers have to bring their animals in groups, which is difficult to accomplish. They recommended that the vaccine should be packaged in doses of five (or ten at most) for ease of delivery.
Profitability of ITM versus sale of acaricides and drugs
Most private veterinarians interviewed said they found it more profitable to sell acaricides and chemotherapeutic drugs. Some fear that, once ECF is controlled at the farm level by immunization, there would be few cases of ECF. Experts at the National Veterinary Research Centre, Muguga agree with this because research has established that up to 75% of clinical diseases at the farm level were related to ECF (S.K. Mbogo, personal communication). If ITM were to result in significantly less use of acaricides and drugs for treatment of ECF, the pharmaceutical companies were worried about how much loss they might incur.
Who should deliver ITM?
Currently, only veterinarians (private or government) are allowed to deliver ITM. Unfortunately, the density of veterinarians remains low, and farmers generally have less contact with veterinarians than they do with paraveterinarians. Most researchers and government veterinary officers felt that ITM should be delivered by paraveterinarians as long as these are adequately trained and supervised.
Where should ITM be delivered?
At present, the policy of the Department of Veterinary Services is that ITM can only be administered in Coast Province so as to test the concept. Cooper (K) Ltd believes that there is more demand in other areas, such as Central and Rift Valley Provinces, than there is on the coast.
The objective of the study was to evaluate the ex-post impact of ITM, to identify factors that may have contributed to the low adoption in Kenya and to make suggestions on how these constraints might be alleviated in order to enhance adoption.
The biological efficacy of ITM in the control of ECF is not contentious among researchers and farmers. The trials in different parts of the country have adequately demonstrated the efficacy. This was also the view of most of the farmers who had experience with ITM (Ndua et al., 1999, Rapid Appraisal, this paper). They indicated that ITM had reduced mortality and morbidity from ECF. However, a number of veterinarians still feel that this is an issue. It is not clear from the study if these doubts arise from personal experience with ITM or not. The perception that ITM is not efficacious may be partly due to breakthrough cases. It is known that ITM does not protect against all possible strains of T. parva, especially buffalo-derived strains. In areas bordering wildlife reserves or where there is extensive animal movement, it is possible for immune animals to come into contact with a strain of T. parva against which the immunizing parasite is not protective.
A related issue of concern to some veterinarians was the carrier state of the immunized animals. Following infection or immunization with some strains of T. parva, animals become carriers and remain so for life (Young, Leitch and Newson, 1981). Some veterinarians felt that these animals would pose a threat to non-immunized in-contact animals.
This would be true in areas free of ECF, but these areas are not targeted for ITM. However, in ECF endemic areas, the creation of a carrier state may in fact be advantageous. Ticks normally acquire heavy infections from clinically sick animals. These heavy infections almost invariably cause clinical disease if ticks feed on a susceptible animal. On the other hand, when ticks feed on carrier animals, they acquire low infections that rarely lead to clinical diseases when they then feed on other cattle.
There was an indication in the literature of significant demand for ITM among farmers in both coastal and highland Kenya (Research International, 1997; Ndua et al., 1999). The veterinarians were also of the view that there is strong demand (Peeler and Muraguri, 1996). It is difficult to evaluate how much of this expressed interest would translate into actual demand. Properly to assess willingness to pay for ITM requires carefully designed studies employing other techniques, such as the contingent analysis technique. This has yet to be applied to evaluate demand for ITM. This, however, would only be possible if the vaccine were allowed to be sold in the rest of the country.
The view of veterinarians on ITM as a complex technology and the belief that the widespread use of ITM would eventually lead to a marked reduction in ECF morbidity, thereby reducing their service volume and revenues, are a serious matter. The fact that pharmaceutical companies and providers of livestock services also see widespread use of the vaccine as a threat to their acaricide market makes the situation even worse. These are critical issues that must be considered carefully as they may be key to the better adoption of ITM. Due to the nature of the technology, veterinarians are central to the dissemination of the technology, and their fears must be fully addressed. Recent developments in Tanzania, where the use of a 30% oxytetracycline formulation, rather than the 20% commonly employed, completely eliminated reactors (Bakuname and Lynen, 2000). Thus, the removal of the need to monitor immunized animals and the effort to make ITM much safer and cheaper must also be evaluated for general application.
Whatever reasons the Government might have had for the policy of limiting the sale of the technology to only Coast Province, the policy has become unintentionally counterproductive. It has made some people view the vaccine as experimental. The other policy decision that may have had a negative impact is the limitation to veterinarians for the provision of the technology. It is our view that this technology is not too complex for paraveterinarians to distribute.
It is obvious that neither the company that is supposed to market ITM, nor the Government has actively promoted ITM. This could suggest reluctance on the part of some stakeholders in the promotion of this technology.
ConclusionECF continues to represent a major constraint on the development of the livestock industry in Kenya. ITM has the potential to reduce the impact of ECF in a very significant way. A number of policy, technical and institutional issues need to be addressed to improve the delivery of ITM.
