Risk factors of foot and mouth disease in an endemic area on low vaccination rate in Xayaboury province of Lao People's Democratic Republic (Lao PDR).

In Xayaboury province, located in the northern region of Lao PDR, the foot and mouth disease (FMD) vaccination campaign just began in 2009. Up until now, a small number of farms have been vaccinated. When FMD outbreaks occur, it is interesting to determine the risk factors of FMD, especially in the area where vaccination rates are low. The questionnaire survey, using a case-control design at the household level, was carried out. From 59 villages with a total number of 434 households, 181 households who experienced FMD were assigned as case households, 146 households without FMD occurrence inside the outbreak villages as inside control households, and 107 households without FMD occurrence outside the outbreak villages as outside control households. Household owners were interviewed. The logistic regression model was used to identify the relationship between FMD occurrence (dependent variable) and the collected data (independent variables), including the social status of livestock owners, FMD prevention strategies, and farm locations. A non-parametric test was performed to determine the association of FMD and network parameters of animal movements among villages. In general, results show that a limited number of holders did vaccinate animals before the outbreaks (13.8-17.8%). The results indicated that livestock owners who had known information about FMD before the outbreaks had been less severely affected by the FMD outbreak than the owners who had not known information about FMD (P < 0.01, OR 0.16, 95% CI 0.09-0.29). Before the outbreaks, higher FMD risk was observed in owners who sold the livestock through animal traders (P < 0.01, OR 4.76, 95% CI 1.68-13.50). Spatial data show that households in the community closer to the main roads had higher FMD risk (P < 0.01, OR 4.76, 95% CI 1.68-13.50). In addition, the network parameters including in-degree, out-degree, and betweenness indicated that the villages with high movements of livestock were at high risk of FMD (P < 0.05). The present study emphasized the importance of the government units to distribute the information about FMD to all livestock farmers in Xayaboury. Disease awareness and prevention strategy should be prioritized in areas close to high density communities and in the trading of livestock.