Epidemiology of Taenia solium cysticercosis in the pig value chain in Uganda

A study was conducted in Kampala district, Uganda to map the distribution of pork retail outlets as well as assess their role in food borne disease transmission. This was the first study to map pork retail outlets and their hygiene in Kampala, a city considered to be a major destination for pigs from different parts of the country. We identified pork outlets by traversing major routes and by asking each outlet encountered about the location of others. Pork outlets were geo-referenced and mapped. Using a structured questionnaire, practices associated with hygiene related to infrastructure (e.g. water, refrigeration), workers (e.g. cleanliness, uniforms), and equipment (e.g. presence, condition) were assessed. Sources of pork were assessed to determine whether pork had undergone inspection, as were socio economic determinants of hygiene outcomes (e.g. gender and years of business operation) and risk factors for foodborne disease (consumption of salads and alcohol) There were 158 pork outlets in the five divisions of Kampala with the highest number (42) in Makindye division. Overall, 68% of the pork eaten in Kampala is from places where slaughtering was not authorized (un-gazetted) and meat inspection not carried out. The overall average hygiene score was 61% with considerable variation between districts. Worker hygiene score was highest (average 71%), followed by infrastructure (68.2%) and equipment (47.3%). There was a significant relation between good hygiene and the presence of a public health certificate (present only in 42% of the outlets). Although some aspects of hygiene in pork retail outlets are good, there is also room for improvement. The lack of meat inspection for most pork presents a risk. Having a public health certificate is an important predictor of good practices

Prevalence and risk factors for brucellosis in prolonged fever patients in post-conflict Northern Uganda

Background: Brucellosis is a disease with significant public and economic implications but strategies for controlling this disease remain problematic.Objectives: This study sought to determine the sero-prevalence of brucellosis in prolonged fever patients and to identify modifiable risk factors for the infection in humans in post conflict Northern Uganda.Methods: The study employed a cross-sectional method among prolonged fever patients who had visited selected health facilities in the study districts in Northern Uganda. Sero-prevalence of brucellosis was calculated for i-ELISA IgG/IgM. A structured questionnaire was used to obtain data on possible risk factors for brucellosis. Associations between sero-prevalence and risk factors were measured using the Odds Ratio.Results: Brucellosis was confirmed in 18.7% of the 251 patients that tested positive for the disease, with the rapid Brucella Plate Agglutination Test, and ages 10-84 years (median age 47+0.86). Sex (p = 0.001; OR 3.79; 95% CI 1.75 - 8.24), rearing livestock (p < 0.005; OR 8.44; 95% CI 2.84-25.03) and consumption of unpasteurised milk (p = 0.023; OR 2.57; 95% CI 1.14-5.80) were factors associated with brucellosis.Conclusion: Control of brucellosis in animals, training and sensitisation of the community on brucellosis is needed to stimulate action on human brucellosis control.Keywords: Brucellosis, human, fever, prevalence, Uganda, zoonosis

Prevalence and risk factors for brucellosis in prolonged fever patients in post-conflict Northern Uganda

Background: Brucellosis is a disease with significant public and economic implications but strategies for controlling this disease remain problematic. Objectives: This study sought to determine the sero-prevalence of brucellosis in prolonged fever patients and to identify modifiable risk factors for the infection in humans in post conflict Northern Uganda. Methods: The study employed a cross-sectional method among prolonged fever patients who had visited selected health facilities in the study districts in Northern Uganda. Sero-prevalence of brucellosis was calculated for i-ELISA IgG/IgM. A structured questionnaire was used to obtain data on possible risk factors for brucellosis. Associations between sero-prevalence and risk factors were measured using the Odds Ratio. Results: Brucellosis was confirmed in 18.7% of the 251 patients that tested positive for the disease, with the rapid Brucella Plate Agglutination Test, and ages 10-84 years (median age 47+0.86). Sex (p = 0.001; OR 3.79; 95% CI 1.75 - 8.24), rearing livestock (p < 0.005; OR 8.44; 95% CI 2.84-25.03) and consumption of unpasteurised milk (p = 0.023; OR 2.57; 95% CI 1.14-5.80) were factors associated with brucellosis. Conclusion: Control of brucellosis in animals, training and sensitisation of the community on brucellosis is needed to stimulate action on human brucellosis control

Stakeholders’ perceptions on performance of the Livestock Disease Surveillance system in Uganda: A case of Pallisa and Kumi Districts

A reliable livestock disease surveillance system should detect changes in health events whenever they occur. Such a system ought to be evaluated regularly to ensure it provides valuable information in an efficient manner. Thus, a cross-sectional study was carried out in 2017 to assess eight attributes of the livestock disease surveillance systems in Pallisa and Kumi districts, Uganda. A total of 772 livestock farmers were interviewed to evaluate the surveillance system at their level, using a structured questionnaire. Guided interviews were also carried out with 13 key informants who included all veterinary staff at the districts and sub-county administrative units, as well as two officials at the Ministry of Agriculture Animal Industry and Fisheries (MAAIF). The stakeholders interviewed at the three different levels of the livestock diseases surveillance system perceived the system as useful, with ability to detect epidemics and initiate their control if they occurred. The surveillance system was perceived to be considerably representative, sensitive and acceptable, with the ability to generate data of good quality. However, key emerging issues that need improvement were noted. These included poor laboratory diagnostic services, inability to work within the means of available resources, slow data transmission and feedback, and nonspecific surveillance forms leading to poor quality of data collected. Poor communication along the surveillance system chain and inadequate staffing were noted as the major challenges faced by the surveillance system in the two districts. Although perceived to be functional, the livestock surveillance requires improvements for efficient disease detection and control. For better performance, the surveillance system could be strengthened by establishing and equipping laboratories for efficient confirmatory diagnosis of diseases; adjusting to work within the means of available resources; improving the reporting process through quick data transmission and quick feedback and designing precise surveillance form to improve quality of data collected

Status of Taenia solium cysticercosis and predisposing factors in developing countries involved in pig farming

Taenia solium cysticercosis is a disease of pigs and humans populations considered endemic in many developing countries of Latin America, Africa, and South East Asia having serious impact on public health and agriculture. We conducted an in-depth comparative analysis of literature on the disease situation and predisposing factors in selected countries known to be at the interface of poverty-emerging livestock systems-zoonoses and with a growing small holder pig industry. Transmission, methods of diagnosis and employed control strategies of T. solium infection in pig and human populations in these countries are also discussed. Limited knowledge on porcine cysticercosis (PC) by various stakeholders expected to be key players in its control has undermined efforts for eliminating this potentially eradicable condition. Poor pig production practices, poor hygiene, and sanitation habits have also been important in the maintenance of the T. solium life-cycle. The major gaps identified in this review include scanty current information on PC prevalence in pigs with hardly any reports on the condition in humans in most developing countries. Factors affecting pattern of the infection and how they interact at the different levels of the pig value chain have not been exhaustively studied. Information on socioeconomic and public health impact is inadequate and not current

Risk factors, perceptions and practices associated with Taenia solium cysticercosis and its control in the smallholder pig production systems in Uganda: A cross-sectional survey

Background Prevalence studies report Taenia solium cysticercosis in pig and human populations in Uganda. However, the factors influencing occurrence in smallholder pig production systems are not well documented and little is known about farmers’ perceptions of T. solium cysticercosis or farmer practices that could reduce transmission. Methods To determine the risk factors, perceptions and practices regarding T. solium cysticercosis, a household survey using a semi-structured questionnaire was conducted in 1185 households in the rural and urban pig production systems in Masaka, Mukono and Kamuli Districts. Logistic regression was used to measure associations of risk factors with infection. Performance scores were calculated to summarise perceptions and practices of farmers regarding taeniosis, human cysticercosis and porcine cysticercosis as well as farmer behavior related to control or breaking transmission. Results Pig breed type, farmers’ knowledge about transmission, sources of water used, and pig keeping homes where family members were unable to use the latrine were all significantly associated with T. solium cysticercosis in pigs. Performance scores indicated that farmers were more aware of taeniosis (63.0%; 95% Confidence Interval 60.0-65.8) than human or porcine cysticercosis; only three farmers (0.3%, 95% CI = 0.1–0.8) had knowledge on all three conditions. More farmers reported that they dewormed pigs (94.1%) than reported deworming themselves and their family members (62.0%). Albendazole was the most commonly used drug for deworming both pigs and humans (85.0 and 81.5% respectively). Just over half (54.6%) of the farmers interviewed had clean water near the latrines for washing hands. Of these, only 41.9% used water with soap to wash hands after latrine use. Conclusion Factors that significantly influenced occurrence of T. solium cysticercosis in pigs were identified. Farmers had some knowledge about the disease but did not link taeniosis, human cysticercosis, and porcine cysticercosis. Therefore, there is need to employ strategies that raise awareness and interrupt transmission

Assessment of hygiene practices of pork retail outlets in Kampala district, Uganda

This study was conducted to map the distribution of pork retail outlets as well as assess their role in food borne disease transmission. Using a structured questionnaire, practices associated with hygiene related to infrastructure, workers, and equipment were assessed. Sources of pork were assessed to determine whether pork had undergone inspection, as were socio economic determinants of hygiene outcomes and risk factors for foodborne disease. There were 158 pork outlets in the five divisions of Kampala. Overall, 68% of the pork was from places where slaughtering was not authorized (ungazetted) and meat inspection not carried out. Worker hygiene score was highest (average 71%), followed by infrastructure (68.2%) and equipment (47.3%). There was a significant relation between good hygiene and the presence of a public health certificate. However only 42% of the outlets had a public health certificate. Holding a public health certificate is an important predictor of good practices