Lynne Hayes

Q Fever Knowledge, Attitudes and Vaccination Status of Australia's Veterinary Workforce in 2014.

Q fever, caused by Coxiella burnetii, is a serious zoonotic disease in humans with a worldwide distribution. Many species of animals are capable of transmitting C. burnetii, and consequently all veterinary workers are at risk for this disease. An effective Q fever vaccine has been readily available and used in Australia for many years in at-risk groups, and the European Centre for Disease Prevention and Control has recently also called for the use of this vaccine among at-risk groups in Europe. Little is known about attitudes towards this vaccine and vaccine uptake in veterinary workers. This study aimed to determine the Q fever vaccination status of veterinarians and veterinary nurses in Australia and to assess and compare the knowledge and attitudes towards Q fever disease and vaccination of each cohort. An online cross-sectional survey performed in 2014 targeted all veterinarians and veterinary nurses in Australia. Responses from 890 veterinarians and 852 veterinary nurses were obtained. Binary, ordinal and multinomial logistic regression were used to make comparisons between the two cohorts. The results showed that 74% of veterinarians had sought vaccination compared to only 29% of veterinary nurses. Barriers to vaccination among those not vaccinated did not differ between cohorts, and included a lack of perceived risk, financial expense, time constraints, and difficulty in finding a vaccine provider. Poor knowledge and awareness of Q fever disease and vaccination were additional and notable barriers for the veterinary nursing cohort, suggesting veterinary clinics and veterinarians may not be meeting their legal responsibility to educate staff about risks and risk prevention. Further evaluation is needed to identify the drivers behind seeking and recommending vaccination so that recommendations can be made to improve vaccine uptake.

Willingness of veterinarians in Australia to recommend Q fever vaccination in veterinary personnel: Implications for workplace health and safety compliance

Q fever vaccine uptake among veterinary nurses in Australia is low, suggesting veterinarians are not recommending the vaccination to veterinary personnel. This study aimed to determine the willingness of veterinarians to recommend Q fever vaccination to veterinary personnel and to identify factors influencing Q fever vaccine uptake by veterinary nurses in Australia. An online cross sectional survey targeted veterinarians and veterinary nurses in Australia in 2014. Responses were analysed using multivariable logistic regression. Factors significantly (p<0.05) associated with a willingness to recommend the vaccination, expressed by 35% (95% CI 31–38%) of veterinarians (n = 828), were (1) being very concerned for colleagues regarding Coxiella burnetii (OR 4.73), (2) disagreeing the vaccine is harmful (OR 3.80), (3) high Q fever knowledge (OR 2.27), (4) working within small animal practice (OR 1.67), (5) disagreeing the vaccine is expensive (OR 1.55), and (6) age, with veterinarians under 39 years most likely to recommend vaccination. Of the veterinary nursing cohort who reported a known Q fever vaccination status (n = 688), 29% (95% CI 26–33%) had sought vaccination. This was significantly (p<0.05) associated with (1) agreeing the vaccine is important (OR 8.34), (2) moderate/high Q fever knowledge (OR 5.51), (3) working in Queensland (OR 4.00), (4) working within livestock/mixed animal practice (OR 3.24), (5) disagreeing the vaccine is expensive (OR 1.86), (6) strong reliance on work culture for biosecurity information (OR 2.5), (7) perceiving personal exposure to Coxiella burnetii to be at least low/moderate (OR 2.14), and (8) both agreeing the vaccine is safe and working within a corporate practice structure (OR 4.28). The study identified the need for veterinarians to take greater responsibility for workplace health and safety promotion, and calls for better education of veterinary personnel to raise awareness of the potential for occupational exposure to C. burnetii and improve the perception of the Q fever vaccine as being important, safe and cost-effective.

Understanding animal health communication networks among smallholder livestock producers in Australia using stakeholder analysis

Smallholder livestock producers are a diverse population with wide ranging motivations for keeping livestock. The biosecurity risk posed by smallholders has been the subject of much conjecture, with comparisons often made between the level of animal health and biosecurity knowledge of smallholders, versus that of commercial livestock producers. This research aimed to gain a better understanding of current knowledge of smallholder production in Australia, particularly in relation to biosecurity and emergency animal disease, and to investigate the relationships that exist between smallholders and the organisations and individuals from which they seek information, assistance and support. Engagement with stakeholders is an important component of an effective biosecurity communication strategy as the dissemination of biosecurity related information from a single source cannot be expected to satisfy the needs of such a broad ranging population. A qualitative study involving a review of literature, semi-structured interviews with government and non-government stakeholders and the development of smallholder and stakeholder influence and interest grids was undertaken. This paper forms part of a broader mixed methods research project among smallholders. Results from the stakeholder analysis showed variation in the parameters used to define smallholders and in the level of stakeholder involvement. Smallholders identified breeding consultants, other producers, private veterinarians and family, friends and colleagues as having a significant to high level of interest and potential to influence their practices. Government agencies were perceived to only have some level of interest but significant influence. Industry stakeholders and rural suppliers were positioned in the quadrant reflecting perceived low levels of interest and influence. The interest and influence grid developed from stakeholders perspectives demonstrate a clustering around the mid points for both interest and influence, with the exception of those from industry who described low levels of interest and influence. Commonwealth and State government stakeholders reported a higher level of interest than influence. Veterinarians, both government and private, reported some to significant levels of interest and influence. In contrast to the results from the smallholder grid, rural suppliers reported relatively high levels of both interest and influence. The current study demonstrates that to maximise the effectiveness of biosecurity communication, there is a need for government and industry organisations to further engage with all stakeholders involved with smallholders.

Insights into the knowledge, practices and training needs of veterinarians working with smallholder livestock producers in Australia

The location of properties holding livestock is fluid; edging towards the boundaries of urban Australia, increasing the likelihood that veterinarians will be exposed to livestock as part of the provision of routine veterinary services. This study was conducted to ascertain the challenges, knowledge level and training needs of veterinarians working within this landscape, with the ultimate aim of informing the development of resources and training to better equip them in this capacity. For this purpose, a cross-sectional study, using a self-administered questionnaire was conducted among Australian veterinarians. The questionnaire comprised a mixture of 47 short closed, semi-closed and open-ended questions and was available for electronic distribution. Data was analysed descriptively and logistic regression analysis was used to identify potential factors associated with knowledge and practices of veterinarians in relation to smallholders. Complete responses were obtained from 91 veterinarians. The main livestock species kept by smallholder clients were sheep, goats, and cattle; with on-farm visits reported the most frequent interaction type, and responding to emergency situations the most frequently performed activity. The challenges experienced by veterinarians when working with smallholders were mostly related to external factors such as; lack of facilities, lack of client knowledge on animal health management and clients financial constraints. Over 95% of respondents provided some level of biosecurity advice and zoonotic disease information as part of their routine veterinary service. Although veterinarians provide advice and support to smallholders, only 14.5% considered themselves to be highly influential on smallholder practices. Confidence level in investigating disease differed by livestock species, with lower confidence reported in pigs, poultry and alpaca. Respondents were open to receiving assistance to support smallholders on matters related to disease, welfare or biosecurity, with other veterinarians (government and private), reported as the most frequently utilised resource. Having access to materials that could be distributed to smallholders was considered to be an effective way in which to provide information. While the risk of zoonotic disease was considered a challenge associated with working with smallholders, respondents use of personal protective equipment (PPE), whilst performing common veterinary activities, was in many instances inadequate. Similarly, vaccination levels among veterinarians and other workers within the veterinary practice to prevent zoonotic diseases were variable. This study provides an insight into the way in which veterinarians engage with smallholders and highlight the importance of providing both groups with the tools necessary to manage the livestock to which are exposed.