Community bat monitoring agents help their communities reduce the risks of viruses from bats spilling over into humans in Bundibugyo, Uganda

As Alex Sekalombi, 38, walks in the hilly landscape of the remote villages of Ntandi in Bundibugyo district, Uganda, he is greeted with smiles as he passes through rows of small homesteads. He is a familiar face in these villages, which have previously suffered Ebola outbreaks.

He has walked for hours through bushes, footpaths, and cacao plantations to reach different bat roosts in his community.

Alex is one of the 15 community-based bat monitoring agents that were trained by STOP Spillover to monitor key human-bat interactions within their communities. STOP Spillover is a USAID- funded project implemented by a consortium of organizations led by Tufts University. In his role as a monitoring agent, Alex conducts bi-monthly observations of bats at seven different roosts including trees, a mosque, a health center, and a school using an Open Data Kit (ODK) tool [gadget] on an Android mobile device. This is an open-source software for collecting and managing data. Data is collected from different roost types which include caves, trees, households, churches, and schools. In addition, Alex also talks with his community to learn about the uses of bats, including hunting, and bat consumption practices.

“I use the gadget provided by the STOP Spillover team to conduct direct observations of bat roosts, and population counts of bats. In the gadget, I put in the type of bat roost, local names of bats, bat size, number, color, and behaviors observed such as sleeping, resting, or flying,” he says.

Alex further explains, as he supports a fellow agent with the tool.

“I often carry out bat counting in the evening when bats are leaving roosts to feed, or in the mornings when they are returning.”

For Alex, this is a typical day working as a community bat monitoring agent for STOP Spillover. As a former game ranger with the Uganda Wildlife Authority, Alex says his role as a community bat monitoring agent gave him another chance to interact with the community on issues relating to zoonotic diseases, something he is passionate about. He also mentioned that his basic monthly allowance as a bat monitoring agent enhanced his income since he had just moved out of active service.

Since 2022, the STOP Spillover Uganda country team has been implementing a participatory community bat-human interaction monitoring program in three sub-counties of Bundibugyo - Burondo, Harugale, and Ntandi town council. The program aimed to identify locations where humans are exposed to bats and associated potential risk factors for viruses from bats. This effort focused on identifying the potential sources of risk to inform the design of risk reduction interventions.

To learn more about the community bat monitoring program, read the report here.

Image above: Alex Sekalombi, community bat monitor. Below left: Alex and another community monitor collect data. Below right: Alex investigates a bat roost. Photo credits: STOP Spillover Uganda.

STOP Spillover Uganda Participatory Epidemiology Assessment Lays Foundation for Future Work

As part of STOP Spillover’s activities in Uganda, the project conducted a participatory epidemiology (PE) training and assessment in Bundibugyo District in the western region of the country.

PE uses a combination of practitioner communication skills and participatory methods to increase the involvement of community members in the analysis of local problems, and the design, implementation, and evaluation of programs and policies.

This training and assessment consisted of several activities. First, community members investigated bat host ecology and human behavioral risk factors associated with human-bat interaction. They then explored behavioral, sociocultural, gender-specific, and economic risk factors. Lastly, a bat-human interface monitoring program for zoonotic spillover early warning and response was developed.

The training sought to equip participants with knowledge and skills in participatory epidemiology. Community meetings introduced the project and laid a foundation for the activities. Community members were then tasked with applying the concepts of participatory epidemiology and using combined methods like interviewing, scoring and ranking, and visualization. The visualization methods include mapping (natural resource maps, social maps, service maps), seasonal calendars, and transect walks (a walk taken by researchers with stakeholders to produce a shared map with issues and opportunities regarding the spatial environment and the community).

Scoring and ranking methods included matrix scoring and proportional piling–a simple technique for visualizing quantities that can help to prioritize community challenges. This helped community members to better understand social, behavioral, cultural, and traditional practices that drive human and bat interactions and the risks of spillover.

Community members and OH-DReaM teams were trained in participatory epidemiology, and participatory assessments were used to identify all uses of and contacts with bats in the community. This laid a foundation for a participatory surveillance program and the community bat monitoring program implemented by STOP Spillover in Bundibugyo.

Participatory efforts like these enhance local ownership of strategies to address spillover risks. They involve the community in identifying the spillover risks and the behaviors that drive them. In Bundibugyo, community members learned how to use participatory methods to better understand these risks in their community, and could apply these methods to address other challenges in their community in the future.

Read the report here.

Image above: Group discussion during participatory epidemiology training. Image below: Participants prioritize community challenges through matrix scoring and proportional piling. Photo credits: STOP Spillover Uganda.

Reflections on STOP Spillover Uganda by Country Team Lead Ms. Doreen Birungi

What do you think was the most impactful part of the work done by STOP Spillover in Uganda?

We held various training at the national and local levels including the ecological and spatial modeling training and participatory surveillance (PS) using participatory epidemiology (PE) methods. The training imparted skills to participants and I believe that there will be knowledge transfer of the skillset to other stakeholders. It was from these engagements that community members started to understand spillover risks associated with poor food safety and hygiene practices.

What were the biggest challenges the team saw in implementing this work in the community and with training community members on bat monitoring techniques?

The country team had no means of validating the indigenous beliefs that the communities associated with bats, such as consumption of bat blood to treat anemia.The challenging terrain also affected the timely execution of the program, as bat roosts within caves in mountainous areas were difficult to locate.

In what ways do you think community members have a better understanding of the risks associated with contact with bats? Do they have a better understanding of how to protect themselves?

The Village Health Teams educated communities about bats and the dangers that result from close association. Communities are more knowledgeable about bats and notified the country team that after learning about the risks posed by contact with bats, they now avoid consuming fruits that have marks indicating contamination by bats. Some community members reported adopting improved hygiene practices to protect themselves, such as cleaning the guano from their houses and school structures, covering food, and boiling water.

How has capacity for bat monitoring been increased in the community and how do you see this benefiting the community in the future?

Monitoring agents were trained in participatory surveillance and use of the ODK tool to collect data. This know-how will be used to continue monitoring bat populations in various roosts to provide an early warning mechanism for zoonotic spillover from bats. Communities acquired technical knowledge about the dangers and benefits of bats and became more aware of the presence of bats within their locality.

How do you see the work done and foundation laid by STOP Spillover moving into the future in a sustainable way? Are there any existing opportunities for other development or research organizations to take on this work and pick up where STOP Spillover left off?

STOP Spillover laid a foundation which I believe the district local government will consider for continuation of various activities. For example, the Uganda Wildlife Authority distributes seedlings monthly to communities. After discussing bat repellent plants, they plan to incorporate them into seedling distribution. The district local government is currently drafting budgets and officials encouraged subcounty chiefs to consider the activities that had been initiated by STOP Spillover in developing annual workplans. Furthermore, the District Education office will consider budgeting for training school headteachers on reducing bat-human interactions in schools. Other projects are interested in the work they saw in reports and are considering incorporating bat surveillance into ongoing event-based surveillance.

Edited for length and clarity.

Image above: Ms. Doreen Burungi, STOP Spillover Uganda Country Team Lead. Image below: Ms. Doreen Burungi speaks with Local Chairperson of Bundibugyo district during the STOP Spillover Uganda close-out meeting. Photo credit: STOP Spillover Uganda.

Bundibugyo district officials urge its implementing partners to integrate zoonotic spillover risk reduction measures into ongoing community interventions

On May 10, 2023, the STOP Spillover Uganda team convened a project close-out meeting in Bundibugyo district in Uganda. This event gathered stakeholders at the district level to discuss a way forward and the possibility of handing over project activities to the district local government. A total of 57 stakeholders (34 men and 23 women) attended the meeting. The stakeholders included district officials, sub county officials, implementing partners and community representatives.

“We have many community level programs in the district and budgeting at sub-county level is also approaching. We could add in aspects that help reduce human interactions with bats at community level,” said Ms. Edith Katumba, the Deputy Chief Administrative Officer at Bundibugyo district. “We should not leave the seeds that have been propagated by STOP Spillover to die prematurely and so we’re calling upon our implementing partners in the district to embrace the reality and act in ways that take forward this work.”

The STOP Spillover project, which was initiated in Uganda in 2021, has been working in Bundibugyo district at the bat-human interface to improve understanding of the risk factors for viral zoonotic disease spillover, and develop interventions to reduce human exposure to bats.The project will close out on the 30th of June 2023. Speaking at the closure event, Ms. Doreen Birungi, Country Team Lead for STOP Spillover in Uganda, thanked the district and community stakeholders for being involved with the project.

“We’ve worked as a team this far. We have achieved what we achieved together. We appreciate your commitment to this project and look forward to seeing this work carried forward,” said Ms. Birungi. Ms. Birungi also handed over an updated infrastructure map of the three project sub counties of Burondo, Harugale, and Ntandi town council to the district officials. The updated infrastructure map was developed by STOP Spillover in collaboration with Bundibugyo district and the Humanitarian OpenStreetMap Team. The interactive maps can be accessed here https://bit.ly/StopSpillOverUg.

The stakeholders thanked USAID and STOP Spillover for choosing Bundibugyo as a beneficiary of the project. The stakeholders appreciated the local capacity built by the project in monitoring key human-bat interactions. They noted that the project increased their understanding and recognition of risk factors for potential spillover of viruses from bats to humans. They were hopeful that some of the project activities could be carried forward by other implementing partners in the district.

Read highlights of the closeout meeting here.

Image above: Ms. Doreen Birungi hands over an updated infrastructure map of Bundibugyo to Ms. Katumba, the Deputy Chief Administrative Officer, Bundibugyo district. Image below: STOP Spillover’s Dr. Charles Kato presents an overview of the project at the closeout meeting. Photo credits: STOP Spillover Uganda

On Friday May 12th, one of the members of the STOP Spillover Interim Leadership Team, Dr. Hellen Amuguni, presented at the 2023 Massachusetts Medical Society Annual Education Program. The Annual Education Program’s theme was titled “The Changing Nature of Infectious Disease: What Every Clinician Needs to Know”.

Dr. Amuguni, DVM, MA, Ph.D. gave a presentation on zoonotic spillover and the potential of the One Health approach to address increasing threats posed by emerging infectious diseases and their many drivers. She highlighted how climate change, wildlife trade, habitat destruction, and human behaviors are accelerating the emergence of infectious diseases

She described climate change and pandemics as wicked problems which have “no single definition, but more than one explanation, and no model solution, with causes that have roots in different fields of science.” Additionally, “every wicked problem is a symptom of another problem.” Due to their complexity, these issues require multidimensional approaches. She asserted that as a transdisciplinary approach, One Health is well positioned to address the world’s wicked problems. 

The Massachusetts Medical Society is the state’s largest physician-led organization and a leading voice in healthcare policy, public health, and clinical medical education. The 2023 Annual Education Program allowed health professionals to discuss the changing nature of infectious disease and what could be done to live safely with emerging infectious threats. Read the full meeting description here.

Image above: Dr. Hellen Amuguni, STOP Spillover Interim Project Co-Director. Image below: Dr. Amuguni's title slide for the Massachusetts Medical Society Annual Education Program. Photo Credit: Dr. Hellen Amuguni.