Prevalence of Intestinal Parasites among Tuberculosis and Non-Tuberculosis Patients Attending Hospitals in Yola, Adamawa State, Nigeria

Tuberculosis and intestinal parasites are mostly affecting poor people. They are in a vicious cycle since one is the risk factor for the other. A hospital based cross-sectional study was carried out on the prevalence and co-infection of intestinal parasites on tuberculosis and non-tuberculosis patients in Specialist Hospital, Jimeta and Federal Medical Centre, Yola, between April-July, 2021. Demographic data was collected using structured questionnaire, while stool samples was collected and processed using wet mount and formol ether concentration technique for the detection of intestinal parasites. Data was analyzed using SPSS Version 26.0 software packages. Chi-squared test at 95% level of significance was used to measure the strength of an association. Out of the 250 participants, 150 (60%) had tuberculosis, while 100 (40%) were non-TB patients. A total of 34 (13.6%) were infected with intestinal parasites: 8.4% of TB patients and 5.2% of non-TB patients were positive for intestinal parasites. There was no statistically significant difference in the prevalence of infection between the patient’s (p>0.05). Ascaris lumbricoides was the highest occurring parasite (4.4%), followed by Schistosoma mansoni and Entamoeba histolytica, both having a prevalence of 2.8% each, Hymenolepsis nana (2.0%), Trichomonas hominis (1.2%) and  Entamoeba coli being the least with a prevalence of 0.4%. Age related infection showed that the 21-30 year old had the highest prevalence of infection (4.0%) with the least among the 11-20 year old age group (0.4%). There was a statistically significant difference in the association between the age groups and infection (p<0.05). Males had the higher prevalence of infection (8.4%) compared to their female counterpart (5.2%), there was no statistically significant difference in the association between infection and gender (p>0.05). With respect to patient’s occupation and level of education, those with tertiary education and farmers had the highest prevalence (6.0%, 5.9%), respectively. The prevalence of intestinal parasites was higher in persons with tuberculosis, and there was evidence that tuberculosis increased susceptibility to intestinal parasites in this study. Though the prevalence in this study is low, the lack of knowledge of the mode of transmission of these parasite can lead to further infection of both those already infected and those not infected

The Role of Abdominal Ultrasound and |Chest Radiography in Management of Breast Cancer Patients in a Low Resource Country: A Case of Tanzania

Background: Breast cancer is among the commonest cancers affecting women in Tanzania. Most of them seek hospital treatment when the disease has reached an advanced stage. Hence widely available modalities like ultrasound (LUS) and chest radiograph (CXR) can be used to establishmetastasis in newly diagnosed patients. The main objective of this study was to determine the role of abdominal ultrasound and chest radiography in detection of liver and lung metastasis in newly diagnosed breast cancer patients.Methods: This was a descriptive cross sectional study in which 103 new breast cancer patients attending Ocean Road Cancer Institute (ORCI) were recruited consecutively. All participants were investigated for liver and lung metastases using abdominal ultrasound and chest x-ray respectively.Standardized questionnaires were used to obtain socio-demographic and to document examination findings.Results: Participants were aged between 26 – 77 years, with a mean of 48±11.22. The prevalence of metastasis to the liver and lungs were 18.4% and 20.4% respectively. Majority of patients with breast cancer had locally advanced breast cancer disease that is either TNM stage three (59.2%) or four (32%) disease upon arrival to ORCI.Conclusion: This study has demonstrated a high detection rate of LUS and CXR for liver and lung metastasis in patients with locally advanced breast cancer

Mapping Nairobi's dairy food system: An essential analysis for policy, industry and research

Demand for dairy products in sub-Saharan Africa, is expected to triple by 2050, while limited increase in supply is predicted. This poses significant food security risk to low income households. Understanding how the dairy food system operates is essential to identify mitigation measures to food insecurity impact. This study aims to determine the structure and functionality of Nairobi's dairy system using a value chain mapping approach

Using a value chain framework for food safety assessment of broiler and indigenous chicken meat systems of Nairobi

Purpose: Research on livestock food systems in developing countries remains limited, yet this context needs to be understood to investigate the epidemiology of zoonoses. The aim of this study was to use a value chain framework to characterize the broiler and indigenous chicken meat systems of Nairobi and their food safety risks. Methods: Using such a framework for food safety characterisation at system level is novel and has significant potential in developing countries. Data collection involved 18 focus group discussions and 236 interviews with various poultry meat value chain stakeholders in Nairobi. Analysis included chain mapping and identification of governance and food safety challenges. Results: The study identified 10 chain profiles, characterising the broiler and indigenous chicken systems, and production-retailing continuum. Food safety risks identified were related to lack of biosecurity, cold chain and access to water, poor cleaning and hygiene practices, consumption of sick animals, significant environmental contamination of by-products, and lack of inspection at farm slaughter. Large companies dominated the governance of the broiler system through the control of day-old chick production. Overall government control was relatively weak leading to minimal official regulatory enforcement. Large companies and brokers were identified as dominant groups in market information dissemination and price setting. No dominant group was identified for indigenous chicken profiles, farming being at household level for local consumption, with quasi non-existent regulations. Lack of industry association was system-wide, creating a barrier for access to capital. Other system barriers included lack of space and expertise, leading to poor infrastructure and limited ability to implement effective hygienic measures. Conclusions and relevance: Optimal food safety and disease control strategies should consider the structure of the poultry meat system and stakeholder interactions to ensure effective programmes. This study provides a new perspective for epidemiologists and public health officers to address food safety risks in full understanding of the food system context

Planning for changes in complex food systems: Value chain mapping of different poultry production systems in Nairobi as a first step to food safety, livelihood improvement and micronutrient supply assessments

Introduction: Research on livestock food systems in developing countries remains limited yet these systems are undergoing rapid and ongoing changes. Poultry meat in Nairobi is a good case study to investigate the changes that result from increasing demand for animal protein1, in particular how different systems affect the supply of macro and micronutrients, livelihood improvement and food safety risks. The aim of the current study was to map the broiler and indigenous chicken meat value chains of Nairobi to provide a thorough context (milieu) for future food safety and socio-economic assessments of the wide poultry meat system. Methods: Focus groups and individual questionnaires were used to collect data from: - Broiler and indigenous farmers (in Dagoretti, reflecting peri-urban chains, and Kibera informal settlement, for urban chains); - Retailers in Viwandani, Korogocho (informal settlements), and Dagoretti; - Three larger broiler production companies; - Livestock production and public health officers, meat inspectors, city council, National Environment Management Authority, and a village chief. The following data were collected for each chain and entered in templates: - Categories of farms, retailers, products and consumers; production practices and performance; relative flows of birds and products, their sources and seasonality; market outlets; regulations enforcement and institutional context; interactions and involvement of people in the chains’ nodes; biosecurity measures. Analysis allowed detailed characterisation and graphical representation of the food system. Within the system the following “chain profiles” were identified: 1) peri-urban and 2) urban broilers; 3) peri-urban and 4) urban indigenous chickens; 5) large and 6) medium integrated companies; 7) live and 8) meat poultry markets; 9) main poultry chains in each sub-county; 10) characterisation of poultry retailer types. Each profile has a distinct set of flows, interactions, market potentials, risk practices, production and distribution characteristics, useful for food safety, food security and governance assessments. Findings and interpretation: Within the poultry meat food system the chains in urban areas had fewer intermediaries and smaller geographic span than those in peri-urban areas – overall they were “shorter”. The limited space in urban areas appeared to reduce flock size and hence increase one-off transactions. Use of brokers in peri-urban chains made transport of meat, rather than birds, more practical. Greatest homogeneity was seen in the chains with commercial broiler chickens (birds for meat production) with one large company supplying 60% of Nairobi’s day-old chicks to small-scale farmers. A small number of larger companies supply broiler chicken meat to high-end retailers across Nairobi, yet there are many more small-scale broiler farmers who sell birds close to their farms, or in Nairobi markets. Indigenous breed chickens are kept in backyard farming systems and are kept for home or local consumption. Birds are also sourced from remote areas of Kenya. Different meat products reach different consumers, based on their value. The lowest value products are heads and legs from broilers of large-scale and peri-urban small farms, which are sold in informal settlements via roadside vendors. The description of the chicken meat food system provides the context for further food safety and food security analysis

Value chain analysis for products and by-products of egg laying birds in peri-urban areas of Nairobi City

Livestock keeping in urban areas is a source of livelihoods for poor urban families, but it also poses public health challenges. Purpose This included mapping of value chains for products from commercial layers (CL) and indigenous layers (IL) kept in peri-urban areas of Nairobi City, prioritization of barriers to entry into layer farming and assessment of disease and food safety management. Methods Data on interaction between people and poultry products, barriers to entry and disease and food safety management were collected through key informant interviews, focus group discussions (FGD) and administration of questionnaires. Twelve FGD were conducted and 250 questionnaires administered to individual farmers. Additional data was obtained from retailers of poultry products and government officers. Results The CL farms kept between 100 and 1,000 birds per flock while for IL farms, flock sizes were between 1 and 50 birds. CL farms obtained day old chicks from distributors of large and small-scale hatcheries and from hawkers, while IL farms obtained chicks from small-scale hatcheries and neighbouring farms. Products from these farms were eggs, spent hens and poultry manure. Eggs from CL farms were sold to shops, consumers and hawkers, while those from IL farms were sold to neighbours, bakeries and restaurants, while some were consumed at home. Spent layers were sold to brokers, neighbours and households. Poultry manure was used on crop farms and as feed for dairy cattle. The barriers to entry included poor quality feeds, poultry diseases, seasonality and scarcity of water and land. The diseases included coccidiosis, Newcastle disease and respiratory problems and these were managed by personnel from “agrovets”, while in slums sick birds were slaughtered and consumed. Furthermore, hawkers and personnel from restaurants and shops were reported to lack training in food safety. Conclusion and relevance Risk for zoonoses exists along poultry value chains and hence with increasing urbanization in developing countries, investigation of food systems in cities should adopt this framework to better understand public health risks

The impact of a school-based hygiene, water quality and sanitation intervention on soil-transmitted helminth reinfection: a cluster-randomized trial.

We conducted a cluster-randomized trial to assess the impact of a school-based water treatment, hygiene, and sanitation program on reducing infection with soil-transmitted helminths (STHs) after school-based deworming. We assessed infection with STHs at baseline and then at two follow-up rounds 8 and 10 months after deworming. Forty government primary schools in Nyanza Province, Kenya were randomly selected and assigned to intervention or control arms. The intervention reduced reinfection prevalence (odds ratio [OR] 0.56, 95% confidence interval [CI] 0.31-1.00) and egg count (rate ratio [RR] 0.34, CI 0.15-0.75) of Ascaris lumbricoides. We found no evidence of significant intervention effects on the overall prevalence and intensity of Trichuris trichiura, hookworm, or Schistosoma mansoni reinfection. Provision of school-based sanitation, water quality, and hygiene improvements may reduce reinfection of STHs after school-based deworming, but the magnitude of the effects may be sex- and helminth species-specific