How Human Brucellosis Incidence in Urban Kampala Can Be Reduced Most Efficiently? A Stochastic Risk Assessment of Informally-Marketed Milk

In Kampala, Uganda, studies have shown a significant incidence of human brucellosis. A stochastic risk assessment involving two field surveys (cattle farms and milk shops) and a medical record survey was conducted to assess the risk of human brucellosis infection through consumption of informally marketed raw milk potentially infected with Brucella abortus in Kampala and to identify the best control options.In the cattle farm survey, sera of 425 cows in 177 herds in the Kampala economic zone were sampled and tested for brucellosis using a competitive enzyme-linked immunosorbent assay (CELISA). Farmers were interviewed for dairy information. In the milk shop surveys, 135 milk sellers in the urban areas were interviewed and 117 milk samples were collected and tested using an indirect enzyme-linked immunosorbent assay (IELISA). A medical record survey was conducted in Mulago National Referral Hospital for serological test results. A risk model was developed synthesizing data from these three surveys. Possible control options were prepared based on the model and the reduction of risk was simulated for each scenario. Overall, 12.6% (6.8-18.9: 90%CI) of informally marketed milk in urban Kampala was contaminated with B.abortus at purchase and the annual incidence rate was estimated to be 5.8 (90% CI: 5.3-6.2) per 10,000 people. The best control option would be the construction of a milk boiling centre either in Mbarara, the largest source of milk, or in peri-urban Kampala and to ensure that milk traders always sell milk to the boiling centre; 90% success in enforcing these two options would reduce risk by 47.4% (21.6-70.1: 90%CI) and 82.0% (71.0-89.0: 90%CI), respectively.This study quantifies the risk of human brucellosis infection through informally marketed milk and estimates the incidence rate in Kampala for the first time; risk-based mitigation strategies are outlined to assist in developing policy

Aflatoxin B1 and M1 contamination of animal feeds and milk from urban centers in Kenya

Background: Aflatoxin M1 (AFM1) is the principal hydroxylated AFB1 metabolite present in milk of cows fed with a diet contaminated with AFB1and excreted within 12 hours of administration of contaminated feeds. Objective: This study was initiated to assess the knowledge and practices of urban dairy farmers and feed millers about aflatoxin in feeds and milk, determine the prevalence and quantify the levels of AFB1 and AFM1 in animal feeds and milk respectively from urban environs in Kenya. Methods: This work was carried out in the Department of Public Health Pharmacology and Toxicology, University of Nairobi, Kenya, between February 2006 and March 2007. Results: A total of 830 animal feed and 613 milk samples from four urban centers were analyzed for aflatoxin B1 and M1 respectively using competitive enzyme immunoassay. Eighty six percent (353/412) of the feed samples from farmers were positive for aflatoxin B1 and 67% (235/353) of these exceeded the FAO/WHO level of 5µ gKg-1. Eighty one percent (197/243) of the feed samples from feed millers and 87% (153/175) from agrochemical shops were positive, while 58% (115/197) and 66% (92/153) of the positive samples exceeded the FAO/WHO limits respectively. Seventy two percent (315/439) of the milk from dairy farmers, 84% (71/85) from large and medium scale farmers and 99% (88/89) of the pasteurized marketed milk were positive for aflatoxin M1, and 20%, 35% an 31% of positive milk from dairy farmers, medium and large scale farmers and market outlets respectively, exceeded the WHO/FAO levels of 0.05µ g/Kg-1. Sixty seven percent of the urban smallholder dairy farmers had no knowledge that milk could be contaminated with aflatoxin M1 and neither knew how they could mitigate against this exposure. Feed millers knew about aflatoxin B1 in grains and excretion of aflatoxin M1 in milk, but were not alleviating exposure to animals. Conclusion: There is need to create awareness and establish routine monitoring of animal feeds and milk to reduce animal and consequently human response

Gender, perceptions and behaviour towards health risks associated with urban dairy farming in Dagoretti Division, Nairobi, Kenya

No Abstract. East African Medical Journal Vol. 84 (11S) 2007: pp. S57-S6

Urban and peri-urban family-based pig-keeping in Cambodia : Characteristics, management and perceived benefits and constraints

Keeping pigs in urban and peri-urban areas may not only provide many benefits for the urban households, but may also be challenging and a potential health hazard. The aim of this cross-sectional study was to describe household characteristics and to evaluate perceived benefits and constraints among pig-keepers in the urban and peri-urban areas of Phnom Penh, Cambodia. The study included 204 households and a structured questionnaire was used to interview the household member responsible for taking care of the pigs. Descriptive analyses showed that most households kept between 5 and 15 pigs and that all households kept their pigs in confinement. About 97% of the households owned the pigs themselves and the pigs were generally managed by female household members (43%). Pigs were mainly kept for commercial purposes and more than 60% of the households stated that income from pig-keeping was the main or one of the main sources of revenue for the household. More than 82% reported that they had experienced disease outbreaks among their pigs during the past three years and disease outbreaks were more commonly reported in households with lower socio-economic position (P = 0.025). Disease outbreaks were considered one of the main constraints, along with expensive feed and low payment prices for the slaughter pigs, but few households considered sanitary or other public health issues problematic. Thus, pig-keeping makes an important contribution to the livelihoods of urban and peri-urban households, but many households face external constraints on their production, such as diseases and low revenues, which may have a negative impact on their livelihoods