Report of the International training course on

Rodents and

Rodent-borne disease

6-10 October 2018

Akanlu, Kabudar Ahang, Hamadan, Iran

Contents Introduction .................................................................................................................................................. 2

Outlines of the Course .................................................................................................................................. 2

Duration and Venue of the course ................................................................................................................ 3

Accommodation ............................................................................................................................................ 3

Team of instructors ....................................................................................................................................... 3

Participants ................................................................................................................................................... 4

Course Manual, PPTs and pictures ............................................................................................................... 6

Monitoring and Evaluation of the course ..................................................................................................... 6

Results of Pre-Post Tests ........................................................................................................................... 6

Course Evaluation Results ......................................................................................................................... 7

Course Concluding ........................................................................................................................................ 8

Social Events ................................................................................................................................................. 9

Visiting Sa'dabad Museum and Milad Tower of Tehran ........................................................................... 9

Participate in the Grape and Handicraft Festival ...................................................................................... 9

Visiting Hamedan City ............................................................................................................................... 9

Visiting the health centre of the village .................................................................................................. 10

Visiting Alisadr Cave and Lalejin district ................................................................................................. 10

Selected photos .......................................................................................................................................... 11

Some information about the Research Center for Emerging and Re-emerging infectious Diseases ......... 12

Schedule of the course................................................................................................................................ 14

Introduction

The International training course on Rodents and Rodent-borne disease was organized by Research Centre for Emerging and Reemerging infectious diseases of Pasteur Institute of Iran and by collaboration of Centre for Communicable Diseases Control and Prevention of Iran Ministry of Health, World Health Organization (Geneva), World Health Organization (EMRO), National Museum of Natural History of Paris, Slovenian Museum of Natural History, Swedish University of Agricultural Sciences, and Ferdowsi University of Mashhad.

The target audience of the course were Health care professionals in charge of hygiene and rodents. The course was specifically designed for health personnel, including medical and health professionals, policy makers, veterinary scientists, and infectious disease researchers interested in expanding their knowledge of the techniques available for study and control of rodents and for predicting the impact of rodent control programs.

Due to great importance of rodent-borne diseases effects on public health burden, this course was designed to provide the necessary knowledge on rodent ecology and behaviour for both ground staff and policy planners to plan and implement appropriate programs to mitigate damage and control disease transmission.

The course was sponsored by the World Health Organization.

At the beginning of this course, Dr. AliReza Biglari, the director of the Pasteur Institute of Iran, welcomed the participants and announced the readiness of the Pasteur Institute of Iran to help countries participating in the course to investigate rodent-borne diseases. Dr. Mahmoud Soroush and Dr. Hossein Erfani, representatives of the centre for communicable disease control in Ministry of health, also welcomed the participants.

Outlines of the Course

Rodents - An overview of rodent diversity (systematics, cryptic diversity) - Population dynamic of rodent (outbreaks, cyclicity, seasonal variations, spatial synchrony

etc.) - Synanthropy of small rodents - How can we detect and sample rodents in the field? - Monitoring techniques for rodents - Human and rodent interactions: positive and negative (public health, crop problems)

interactions

Rodents and zoonotic diseases - Leishmaniasis, Leptospirosis, Plague, Tularemia, Lassa Fever, Toxoplasmosis, and

Hantaviruses

Factors affecting the distribution of rodents and rodent borne diseases - Urbanization, and Climate change

Ecologically-based rodent management - Rodenticides - Physical control - Ecological Management - Biological Control - Urban rodent control

Surveying for rodent disease

Duration and venue of the course

The course took place in five working days (6-10 October 2018).

It was held in the Research Centre for Emerging and Reemerging infectious diseases which is the national reference center for diagnosis and research on Plague, Tularemia and Q fever in Iran. It is a branch of Pasteur Institute of Iran located in Western Iran.

Accommodation

The accommodation was in 2-6 bed rooms having free access to high speed internet.

Team of instructors - Dr. Ehsan Mostafavi, Epidemiologist, Director of the course, Director of Research

centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran.

- Dr. Mohammad Mehdi Gouya, Infectious disease specialist, Director of center for communicable disease control, Ministry of Health, Tehran, Iran.

- Dr. Eric Bertherat, Specialist in Public Health and Tropical medicine, World health Organization, Geneva.

- Dr. Peter Mala, Epidemiologist, World health Organization, EMRO, Cairo. - Dr. Violaine Nicolas, Institut de Systématique, Évolution, Biodiversité, National

Museum of Natural History in Paris, France.

- Dr. Frauke Ecke, Landscape ecologist, Department of Wildlife, Fish, and Environmental Studies, Swedish University of Agricultural Sciences, UMEÅ, Sweden.

- Dr. Jean-Pierre Hugot, Parasitologist, National Museum of Natural History in Paris, France.

- Dr. Boris Krystufek, Rodentologist, The head of Vertebrate department of the Slovenian Natural History, Slovenia.

- Dr. Roohollah Siahsarvie, Rodentologist, Director of the Rodentology Research Department, Ferdowsi University of Mashhad, Mashhad, Iran.

- Dr. Mahdi Rohani, Bacteriologist, Research centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran.

- Dr. Saied Reza Naddaf, Entomologist, Department of Parasitology, Pasteur Institute of Iran, Tehran, Iran.

- Dr. Alireza Zahraei Ramazani, Medical Entomologist, Department of Medical Entomology and Vector Control Campaign, School of Public Health, Tehran University of Medical Sciences

- Dr. Mostafa Salehi-Vaziri, Virologist, Department of Arboviruses and Viral Hemorrhagic Fevers, Pasteur Institute of Iran, Tehran, Iran.

- Dr. Ahmad Mahmoudi, Rodentologist, Department of Epidemiology and Biostatistics, Research centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran.

Participants Applicants who had bellow criteria were evaluated to participate in the course:

- Work experience of at least 5 years in the field of Public Health; - Health personnel, preferably engaged in infectious diseases and a degree or

proficiency in:

Public Health;

Veterinary/Human Medicine;

Epidemiology;

Microbiology;

Biology;

Environmental health sciences

70 applications were received to attend the course and finally, 30 persons attended from 14 countries, including France, Switzerland, Madagascar, Sudan, Tunisia, Libya, Egypt, Afghanistan, Pakistan, Qatar, Singapore, Sweden, Slovenia and Iran.

The participants improve their knowledge and practice regarding surveillance, diagnosis, and clinical management of rodent born disease and enhanced their abilities to investigate the impact of these disease on public health burden in their countries.

Scholarships were awarded for participants to partially or fully meet travel, accommodation and or registration fees.

The below list participated this course:

Name Position Country

Nada Abdelgalil Gaafar Osman Participant Sudan

Ezzadin Areaf Franka Participant Libya

Md. Mzaharul Islam Participant Qatar

Moin Iqbal Participant Pakistan

Tan Jason Participant Singapore

Jalal Faisal Kaal Participant Libya

Noureddin Mohamed Rashid Participant Libya

Wissem Ghawar Participant Tunis

Ahad Fayyaz Participant Pakistan

Abdul Ghani IBRAHIMI Participant Afghanistan

Rémi BEAU Participant France

Ramasindrazana Beza Participant Madagascar

Aliya Jabeen Participant Pakistan

AbdolReza Mirolyaei Participant Iran

Boris Krystufek Instructor Slovenia

Eric Bertherat Instructor Switzerland

Frauke Ecke Instructor Sweden

Jean-Pierre Hugot Instructor Egypt

Peter Mala Instructor France

Violaine Nicolas Instructor France

Ehsan Mostafavi Scientific Director Iran

Mostafa Salehi-Vaziri Instructor Iran

Saied Reza Naddaf Instructor Iran

Alireza Zahraei Ramazani Instructor Iran

Ahmad Mahmoudi Instructor Iran

Mahdi Rohani Instructor Iran

Ali Mohammadi Participant and Assistant Instructor Iran

Hamed Hanifi Assistant Instructor Iran

Amir Hesam Nemati Participant and Assistant Instructor Iran

Field and laboratory activities Participants in this course practiced rodent and wildlife sampling methods, getting ectoparasites (such as fleas and ticks), and conducting laboratory experiments related to the diagnosis of rodent borne diseases.

Course Manual, PPTs and pictures

The course materials including the SOPs, and PowerPoints; and photos of the course which were provided during the course were shared with the participants at the end.

Monitoring and Evaluation of the course

There were two evaluations during the course:

To evaluate and compare the participants’ knowledge in the beginning and at the end of the course, they took 25 questions as pre and post tests. The scores for "True" and "False" were 1 and 0, respectively, and the maximum score was weighted to be 20.

Moreover, participants filled out an evaluation form about the presentations, and teaching skills during the course.

Results of Pre-Post Tests

Finally, we individually matched the data from 25 participants and analyzed their responses using Paired-T test.

The mean of the post-test score was 15.85 (95% CI: 14.86 - 17.84) out of 20; it was significantly higher than the pre-test score (9.36, 95% CI: 8.62 – 10.09) (Figure 1).

Figure 1 - The mean of the pre-test and post-test score (The maximum score is 20).

Course Evaluation Results

Participants were satisfied from the course based on their feedbacks. In all aspects the course, obtained scores were greater than 90%. Figure 2 presents the score of two main technical aspects of the course.

Figure 2 - Satisfaction scores for different aspects of the course (out of 20).

Organization (Transportation, accommodation, social events and meals) were in high quality and the mean score of these items was 9.25 out of 10.

Outcomes of the course Holding this international course along with the transfer of updated experience and knowledge in the field of rodents and rodent borne diseases, the development of scientific communication and social cooperation followed the approach of representing the true face of the country to foreigners.

Creating an international experience for participants, improving the prospects of job opportunities, developing academic interactions with overseas universities, expanding new areas for expert exchange and building competition among students are among the benefits of setting up such courses.

0

5

10

15

20

Pre-test Post-test

Pvalue<0.001

18.9 19.5

02468

101214161820

Teaching Response to Questions

Course concluding

Dr. Eric Bertherat, who attended the course from the World Health Organization headquarters in Geneva, praised the capabilities of the Pasteur Institute of Iran and the research centre for emerging and reemerging infectious diseases and described this centre as an exceptional center for holding similar courses in the future.

Dr. Peter Mala, an expert from the Eastern Mediterranean Office of the World Health Organization, also commended the capabilities of the Pasteur Institute of Iran in Akanlu and cited the course at the level of the first world level courses.

At the end, participants were given a certificate with souvenirs.

Social Events

Visiting Sa'dabad Museum and Milad Tower of Tehran

Participants visited the Sa'dabad Complex on the first day of their arrival in Iran, before they were deployed to the course venue, then they drove from the top of the Milad Tower to Tehran, from a handicrafts shop, bought Iranian handicrafts, and after taking lunch in a traditional restaurant, dispatched to Akanlu.

Participate in the Grape and Handicraft Festival Participants participated in the second day at the Akanlu Grape and Handicraft Festival, and after buying the village products, took lunch in a village home and had this opportunity to closely meet the lifestyle of the villagers.

On the way back to the center, they also visited a village historic bath.

Visiting Hamedan City

On the fourth day of the workshop, the participants went to the city of Hamedan for the afternoon and visited the mausoleums of Bu-Ali Sina and Poet Baba Tahir.

Visiting the health centre of the village

They also visited the comprehensive health house of Akanlu village to be familiar with referral system and treatment services in the villages in Iran.

Visiting Alisadr Cave and Lalejin district In the 6th day and after finishing the course, the participants visited the Alisadr Cave and Lalejin district.

This cave is the world's largest water cave which attracts millions of visitors every year. The cave is located 75 kilometers northwest of Hamadan and 70 km from Akanlu village.

Lalejin is one of the main centers of production of ceramic and pottery products in Iran, the Middle East and the world. It is about 100 km from Akanlu village.

Approximately 80% of the population of Lalejin is engaged in the pottery industry, including painting pottery, packaging, and the sale of pottery/ceramic products.

Selected photos

Some information about the Research Center for Emerging and Re-

emerging infectious Diseases

In 1946, together with the new program of activities of Pasteur Institute of Iran, the epidemiology department of Pasteur Institute of Iran started its activities under the supervision of Dr. Marcel Baltazard, the general director of the institute. Although Kurdistan had a history of plague, it was due to the plague epidemic in Kurdistan at that time that the research teams of Pasteur institute of Iran were dispatched to the plague epidemic centers to control the outbreak via quarantining the foci and epidemiologic procedures on the humans and rodents.

Studies of the plague foci in this region and the significance of this disease motivated the Pasteur institute team to conduct extensive scientific and epidemiologic studies in this region.

During the nine plague epidemics in Kurdistan and Azerbaijan between 1946 and 1965, many infected people survived from the disease by the efforts of the dispatched teams of Pasteur Institute of Iran; however, 156 died.

In 1952, the first laboratory was founded in Akanlu village, near the plague foci in Kurdistan. At this research center, currently called "The Research Center for Emerging and Reemerging infectious Diseases", Dr. Baltazard and his perseverant colleagues conducted extensive research on plague and established this center as one of the world reference laboratories and research centers for plague.

Since 1952, research teams could base themselves in the area for months at a time and conduct detailed research on rodents under more favorable conditions. During that time, the integration of field and laboratory collaborations was a key to effective epidemiologic actions and led to great research hypotheses.

During the development of this research center, many international scientists visited the center, lecturing, studying and/or researching in their fields.

The achievements of Pasteur Institute of Iran regarding plague research attracted the global attention and such a success motivated them to assign Iranians international plague research. The experts and researchers of Pasteur Institute of Iran, known as WHO experts, continued to conduct related research in many neighboring countries such as Turkey, Syria, Iraq and Yemen, Southeast Asia (India,

Indonesia, Thailand), Burma, Brazil, and Africa (Zaire, Tanzania); they published all of their research results to be used by others. Most of these researches were financially supported by WHO. In 1972, a WHO meeting on plague was held in this center with many participants from all over the world.

It is noteworthy that one of the main responsibilities assigned to Pasteur Institute of Iran and the Akanlu Research Center in the following years was to conduct research about diagnosis and epidemiology of plague.

Research Center for Emerging and Reemerging infectious Diseases can be regarded as the pioneer center for field epidemiology in Iran. This center is doing also important researches on tularemia in addition to plague studies. The dedicated laboratories for rodentology, serology, molecular studies and culture, seminar halls and guest accommodation offer a suitable environment for research and education in this region.

The center is the national reference laboratory for plague, tularemia and Q fever.

Research Center for Emerging and Reemerging infectious Diseases has close international collaboration with Pasteur Institute of Madagascar, Pasteur institute of Paris, World Health Organization, National Museum of Natural History in France, University of Oslo, Institute of pathology and biology in France, Veterinary Medical Research Institute in Hungary and Friedrich-Loeffler-Institut, Germany.

Schedule of the course

Presenter Program Hour Day

Breakfast in the Hotel and doing checkout 7:00 – 7:45

Tehran Tour 8:00 – 13:00

5th

Oct

.

Lunch 13:00 – 14:00

Going to Akanlu by bus 14:00 – 20:00

Dinner in Akanlu 21:00 – 21:30

Breakfast 7:00 – 7:30

6th

Oct

.

- Opening and welcome, Introducing of the participants 8:00 – 8:30

AliReza Biglari, Director of Pasteur institute of Iran

Welcome and introducing the Pasteur Institute of Iran 8:30 – 9:00

Ehsan Mostafavi An Introduction to Research Centre for Emerging and Reemerging infectious diseases 9:00 – 9:45

Pre-Test 9:45 – 10:15

Peter Mala The global situation of Rodent-borne diseases 10:15 – 11:15

Refreshments 11:15 - 11:45

JP Hugot An overview of rodent diversity (systematics, cryptic diversity), Section 1 11:45 – 12:15

Group Photo 12:15 – 12:30

Lunch 12:30 – 14:30

JP Hugot & Boris Krystufek An overview of rodent diversity (systematics, cryptic diversity), Section 2 14:30 – 15:30

Frauke Ecke Population dynamic of rodent (outbreaks, cyclicity, seasonal variations, spatial synchrony etc.) 15:30 – 16:45

Refreshments 16:45 – 17:00

Roohollah Siahsarvie Sampling and identification of the rodents in the field? 17:00 – 18:00

Country representatives Country presentation (Pakistan, Tunisia, Libya, Iran, Sudan) 18:00 – 19:00

Sports: Football, Table tennis, Darts, Badminton 19:00 – 20:30

Dinner 20:00 – 20:30

Breakfast 7:00 – 7:30

7th

Oct

.

Country representatives Country presentation (Singapore, France, Afghanistan, Qatar, Madagascar, Syria) 8:00 – 9:15

Ehsan Mostafavi The Epidemiology of Plague and Tularemia in the world 9:15 – 10:00

Refreshment 10:00 – 10:15

Ahmad Mahmoodi Reservoirs of Plague and Tularemia in the nature 10:15 – 11:00

Saeid Reza Naddaf & JP Hugot Arthropods and their Role in transmission of diseases from the rodents 11:00 – 12:00

Social event: Visiting the rural homes of the region and taking lunch 12:00 – 15:00

E. Mostafavi, S.R. Naddaf, A. Mahmoodi, R. Siahsarvie, A. Mohammadi

Group 1: Practical work Field Operations, Trap Shooting, Identifying vectors and rodents, Blood sampling and tissue Sampling

15:00 – 19:00

Mehdi Rohani, M. Salehi Vaziri Saber Esmaeili, Ahmad Ghasemi

Group 2: Theoretical and Practical

Orientation and Performing Serological and Molecular Tests for rodent-borne diseases 15:00 – 19:00

Dinner 20:30 – 21:00

Breakfast 7:00 – 7:30

8th

Oct

.

Mahdi Rohani/ M. Salehi Vaziri Specimen Collection and Safe Transportation 8:00 – 8:30

M. Rohani, M. Salehi Vaziri S. Esmaeili, A. Ghasemi

Group 1: Practical work Orientation and Performing Serological and Molecular Tests for rodent-borne diseases

8:30 – 12:30

E. Mostafavi, S.R. Naddaf, A. Mahmoodi, R. Siahsarvie, A. Mohammadi

Group 2: Practical work

Field Operations, Trap Shooting, Identifying vectors and rodents, Blood sampling and tissue Sampling

8:00 – 12:30

Lunch 12:30 – 13:30

Frauke Ecke Monitoring techniques for rodents 14:00 – 15:00

Alireza Zahraei Ramazani Leishmaniosis Rodents and zoonotic diseases, epidemiology, challenges to detect and control

15:00 – 16:00

Eric Bertherat Leptospirosis, Rickettsioses 16:00 – 17:00

JP Hugot and Mostafa S. Vaziri Lassa Fever, CCHF 17:00 – 18:00

Frauke Ecke & JP Hugot Hantaviruses 18:00 – 19:00

Dinner 20:00 – 20:30

Breakfast 7:00 – 7:30

9th

Oct

. JP Hugot and Frauke Ecke Human and rodent interactions: positive and negative (public health, crop problems) interactions

8:00 – 9:30

Frauke Ecke Factors affecting the distribution of rodents and rodent borne diseases (Urbanization and Climate change)

9:30 – 10:15

Refreshment 10:15 – 10:30

Roohollah Siahsarvie Rodenticides: characteristics, resistance, pros and cons 10:30 – 11:15

Social event: Visiting Hamadan city 11:30 – 22:00

Dinner 20:00 – 20:30

Breakfast 8:00 – 8:30

Violaine Nicolas Ecologically-based rodent management (Rodenticides, Physical control, Ecological Management, Biological Control, Urban rodent control), section 1

8:30 – 10:15

10

th O

ct.

Refreshments 10:15 – 10:30

Violaine Nicolas Ecologically-based rodent management (Rodenticides, Physical control, Ecological Management, Biological Control, Urban rodent control), section 2

10:30 – 11:30

Boris Krystufek History of species delimitation in European rodents 11:30 – 12:30

Lunch 12:30 – 13:30

Eric Bertherat An Experience of Plague outbreak in Madagascar 13:30 – 14:15

Eric Bertherat Re-emergence of plague in Oran region, Algeria 14:15 – 15:00

Refreshments 15:00 – 15:15

Post-test and evaluation of the course 15:15-16:15

Peter Mala Concerns and Hopes for the Future 16:15-16:45

Ehsan Mostafavi Course Concluding and Closing Program 16:45 – 17:45

Visiting the health sector of Akanlu village 18:00 – 19:30

Dinner 21:30- 22:00

Breakfast 6:30 – 7:30

11

th O

ct.

Social event: Visiting Alisadr Cave & Laleh Jin Region 7:30 – 13:30

Lunch in Laleh Jin 13:30 – 14:00

Coming back to Tehran by bus 15:00 – 20:00