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

Value chain analysis as a tool for assessing food safety risks in the Nairobi pork food system

In Nairobi, with 3.1 million consumers and 30,000 pigs, the pork system may represents a major source of zoonotic pathogens. Yet, this system and its public health risks have not been described. The study used value chain analysis, a well-known method in economics, to investigate zoonosis and food safety risks practices in the Nairobi pork food system. A cross-sectional study of the Nairobi pork system collected data through 25 focus group discussions and 436 individual interviews with farmers, traders, abattoir owners, large companies’ managers, retailers, government officers and consumers. Data were analysed to identify, describe and quantify the main pork chain profiles, their associated zoonosis and food safety risks practices and their link to governance, the distribution of benefits and barriers to improving the system. Six pork chain profiles were identified with the ‘large integrated company’ profile accounting for 62% of pork marketed through abattoirs. Pigs in slums were channelled directly to consumers and butchers or through less integrated markets. Main zoonosis and food safety risk practices for city pig keepers were: handling and consumption of sick pigs; and swill and scavenging feeding. In less integrated abattoirs these risks were: lack of traceability, cold chain systems and adequate cleaning and sterilising practices and equipment. For the retailers, there was a lack of hygiene linked to poor infrastructure, scarcity of water and cleaning practices. Large companies govern the high end market for pork where barriers to improvements were less. In the lower end poor profit margins and unequal benefit distribution led to issues on around investments in infrastructure, cold chains and human capacity building plus difficulties with meeting feeding and animal health costs. Conclusions This study identified the main zoonoses and food safety risk practices and the people involved in risk taking activities to help future control programmes in the Nairobi pork system. The integration of value chain and analysis of risks practices proved useful and represent the way forward for epidemiologist working in developing countries

Beef, sheep and goat food chains supplying Nairobi: Analysis of 'value chain profiles' to investigate food security and safety risks

Introduction: Beef, sheep and goat meat consumption provides essential nutrients in highly bioavailable form, and poses a zoonotic pathogen threat. In Nairobi, these luxury products are difficult to access by poor households, yet little is known on the city’s food system in terms of food safety and security risks. An understanding of the food systems is essential to assess and contextualize the chains supplying poor households and to determine population exposure to hazards. Mapping is therefore crucial to assess food security and food safety risks. The present study characterised the Nairobi beef, sheep and goat food systems using value chain analysis. Methods: Data collection targeted the different stakeholders involved in beef, sheep and goat meat food systems from: (1) urban and periurban farmers; (2) livestock and meat traders, abattoir/market owners and workers, and livestock and meat transporters in all Nairobi markets; (3) managers of the main beef, sheep and goat meat processing companies; (4) urban and periurban retailers; (5) 205 low income consumers and (6) government/regulatory officers. Data were collected through focus groups discussion and individual interviews, and complemented with secondary data. Qualitative data were obtained on people, animals, products and chains interactions to identify all the existing stakeholders and chains, and assess their organizational, spatial and temporal structure. Quantitative data were collected to assess flow of products in the different chains and their contribution to the supply of these commodities to Nairobi. Data were recorded and entered in thematic templates for analysis. Mapping analysis was done through the creation of 'Chain profiles', which groups patterns of operations/flows of commodities. Mapping of these profiles was done at 3 levels: (1) people chain profile (map interactions of actors); (2) Geographical chain profiling (map of routes of animals and products); and (3) Product profiling. Findings and interpretations: Eight chain profiles that make up the beef, sheep and goat meat food systems were identified. A critical profile was the ‘less integrated terminal markets’, composed of chains where no group or person own a large proportion of different activities. This profile represents three quarters of the city’s beef, sheep and goat meat supply and contains two significant markets (Figure 1). Large companies integrate market, product transport and distribution, and mainly export or supply to high class retailers and consumers. Six beef keeping activities were identified in the city, mainly as temporary settlements. Sheep and goat keeping was mainly small scale (1-5 animals) and their animals are mostly slaughtered in households for festive occasions. In low income households beef was obtained from butcheries (83%), while goats were obtained from butcheries (51%) and markets (40%). This study shows the importance of specific chains to the food security of a city, and describes the dimensions of urban human-livestock interactions. In combination with an understanding of chains governance and barriers, this study provides a powerful approach, missing to date, for the investigation of nutrition and food safety risks

The APOB insertion/deletion polymorphism (rs17240441) influences postprandial lipaemia in healthy adults

BACKGROUND: Apolipoprotein (apo)B is the structural apoprotein of intestinally- and liver- derived lipoproteins and plays an important role in the transport of triacylglycerol (TAG) and cholesterol. Previous studies have examined the association between the APOB insertion/deletion (ins/del) polymorphism (rs17240441) and postprandial lipaemia in response to a single meal; however the findings have been inconsistent with studies often underpowered to detect genotype-lipaemia associations, focused mainly on men, or with limited postprandial characterisation of participants. In the present study, using a novel sequential test meal protocol which more closely mimics habitual eating patterns, we investigated the impact of APOB ins/del polymorphism on postprandial TAG, non-esterified fatty acids, glucose and insulin levels in healthy adults. FINDINGS: Healthy participants (n = 147) consumed a standard test breakfast (0 min; 49 g fat) and lunch (330 min; 29 g fat), with blood samples collected before (fasting) and on 11 subsequent occasions until 480 min after the test breakfast. The ins/ins homozygotes had higher fasting total cholesterol, LDL-cholesterol, TAG, insulin and HOMA-IR and lower HDL-cholesterol than del/del homozygotes (P < 0.017). A higher area under the time response curve (AUC) was evident for the postprandial TAG (P < 0.001) and insulin (P = 0.032) responses in the ins/ins homozygotes relative to the del/del homozygotes, where the genotype explained 35% and 7% of the variation in the TAG and insulin AUCs, respectively. CONCLUSIONS: In summary, our findings indicate that the APOB ins/del polymorphism is likely to be an important genetic determinant of the large inter-individual variability in the postprandial TAG and insulin responses to dietary fat intake

Value chain analysis and sanitary risks of the camel milk system supplying Nairobi city, Kenya

The camel milk trade in Kenya has evolved significantly from a small-scale business undertaken in local villages to its current status involving a large number of different stakeholders supplying urban towns, particularly Nairobi City. Despite the evident growth pattern, the supply of camel milk to Nairobi has largely remained informal, with minimal enforcement of regulations. The aim of this study was to characterise the camel milk system supplying Nairobi and assess its governance, main challenges and the potential food safety risk practices. A value chain analysis framework was used to carry out data collection between August 2014 and July 2015. Qualitative and quantitative data were collected through focus group discussions and key informant interviews with stakeholders operating in different nodes of the value chains. Three milk value chains supplying Nairobi were identified and mapped: the Isiolo chain, the Kajiado chain and the camel milk processing company chain. Overall, the results indicate that 94% of the milk supplied to Nairobi city is informally traded (traded without any effective regulation), while 6% originates from a formal milk processing company. In the informal chains, milk traders (mostly women) were reported to play a pivotal role in the organisation and daily functioning of the chains. The processing company had partly integrated activities and reported exporting 5% of their products to regional and international markets. Food safety themes identified were associated with i) lack of cold chain, ii) gaps in hygiene practices, particularly at farm and market levels, iii) consumption of raw camel milk, and iv) lack of food safety training, among other issues. Low level involvement by government agencies in enforcing stipulated food safety measures were reported in the informal chains, as these concentrate efforts in the regulation of dairy milk chains. Isiolo milk traders were identified as the dominant group, setting milk prices and providing sanctions. The framework and findings obtained can help future research and policy makers to reach informed decision about what to regulate, where to target and importantly how to make the camel milk value chain more efficient and safer

Identification of production challenges and benefits using value chain mapping of egg food systems in Nairobi, Kenya

Commercial layer and indigenous chicken farming in Nairobi and associated activities in the egg value chains are a source of livelihood for urban families. A value chain mapping framework was used to describe types of inputs and outputs from chicken farms, challenges faced by producers and their disease control strategies. Commercial layer farms were defined as farms keeping exotic breeds of chicken, whereas indigenous chicken farms kept different cross breeds of indigenous chicken. Four focus group discussions were held with producers of these chickens in peri-urban area: Dagoretti, and one informal settlement: Kibera. Qualitative data were collected on interactions between farmers, sources of farm inputs and buyers of poultry products, simple ranking of production challenges, farmers' perception on diseases affecting chicken and strategies for management of sick chicken and waste products. Value chain profiles were drawn showing sources of inputs and channels for distribution of chicken products. Production challenges and chicken disease management strategies were presented as qualitative summaries. Commercial layer farms in Dagoretti kept an average of 250 chickens (range 50–500); while flock sizes in Kibera were 12 chickens (range 5–20). Farms keeping indigenous chicken had an average of 23 chickens (range 8–40) in Dagoretti, and 10 chickens (range 5–16) in Kibera. Commercial layer farms in Dagoretti obtained chicks from distributors of commercial hatcheries, but farms in Kibera obtained chicks from hawkers who in turn sourced them from distributors of commercial hatcheries. Indigenous chicken farms from Dagoretti relied on natural hatching of fertilised eggs, but indigenous chicken farms in Kibera obtained chicks from their social connection with communities living in rural areas. Outlets for eggs from commercial layer farms included local shops, brokers, restaurants and hawkers, while eggs from indigenous chicken farms were sold to neighbours and restaurants. Sieved chicken manure from Dagoretti area was fed to dairy cattle; whereas non-sieved manure was used as fertilizer on crops. Production challenges included poor feed quality, lack of space for expansion, insecurity, occurrence of diseases and lack of sources of information on chicken management. In Kibera, sick and dead chickens were slaughtered and consumed by households; this practice was not reported in Dagoretti. The chicken layer systems contribute to food security of urban households, yet they have vulnerabilities and deficiencies with regard to disease management and food safety that need to be addressed with support on research and extension

The broiler meat system in Nairobi, Kenya: using a value chain framework to understand animal and product flows, governance and sanitary risks

Livestock food systems play key subsistence and income generation roles in low to middle income countries and are important networks for zoonotic disease transmission. The aim of this study was to use a value chain framework to characterize the broiler chicken meat system of Nairobi, its governance and sanitary risks. A total of 4 focus groups and 8 key informant interviews were used to collect cross-sectional data from: small-scale broiler farmers in selected Nairobi peri-urban and informal settlement areas; medium to large integrated broiler production companies; traders and meat inspectors in live chicken and chicken meat markets in Nairobi. Qualitative data were collected on types of people operating in the system, their interactions, sanitary measures in place, sourcing and selling of broiler chickens and products. Framework analysis was used to identify governance themes and risky sanitary practices present in the system. One large company was identified to supply 60% of Nairobi’s day-old chicks to farmers, mainly through agrovet shops. Broiler meat products from integrated companies were sold in high-end retailers whereas their low value products were channelled through independent traders to consumers in informal settlements. Peri-urban small-scale farmers reported to slaughter the broilers on the farm and to sell carcasses to retailers (hotels and butcheries mainly) through brokers (80%), while farmers in the informal settlement reported to sell their broilers live to retailers (butcheries, hotels and hawkers mainly) directly. Broiler heads and legs were sold in informal settlements via roadside vendors. Sanitary risks identified were related to lack of biosecurity, cold chain and access to water, poor hygiene practices, lack of inspection at farm slaughter and limited health inspection in markets. Large companies dominated the governance of the broiler system through the control of day-old chick production. Overall government control was described as relatively weak leading to minimal official regulatory enforcement. Large companies and brokers were identified as dominant groups in market information dissemination and price setting. Lack of farmer association was found to be system-wide and to limit market access. Other system barriers included lack of space and expertise, leading to poor infrastructure and limited ability to implement effective hygienic measures. This study highlights significant structural differences between different broiler chains and inequalities in product quality and market access across the system. It provides a foundation for food safety assessments, disease control programmes and informs policy-making for the inclusive growth of this fast-evolving sector

TRANSPOSISI ARTERI BESAR PADA DEWASA

AbstrakSeorang laki-laki umur 50 tahun dirawat di Emergensi Penyakit Dalam RSUP Dr. M. Djamil Padang dengan keluhan utama sesak nafas meningkat sejak 1 hari yang lalu. Sesak nafas semakin meningkat jika beraktifitas, dan berkurang jika istirahat dengan posisi bantal yang ditinggikan. Jika sesak nafas sering diikuti dengan bibir dan kuku yang membiru. Pasien sudah dikenal menderita penyakit jantung bawaan, awalnya lahir dengan kulit kebiruan dan mudah tersedak jika menyusu. Dari pemeriksaan fisik didapatkan: Clubbing finger, sianosis, peningkatan Vena Jugolaris, kardiomegali, dan pitting oedema. Dari laboratorium didapatkan: Hemoglobin: 17,1 gr/dl, Hematokrit : 62%, Ureum : 39 mg/dl, Kreatinin : 2,0 mg/dl, TKK :31, Echo Cardiography: Transposisi Arteri Besar, Large Ventrikel Septal Devect, trikuspit regurgitasi dengan hipertensi pulmonal dan moderat Mitral Regurgitasi. Pasien di diagnosa dengan Congestive Heart Failure Functional Class IV LVH- RVH, irama RBBB karena transposisi Arteri Besar dengan Ventrikel Septal Defek.Kata kunci: Transposisi Arteri Besar, Kelainan Jantung Bawaan.AbstractHas been treated a 50 years old man was hospitallized in Internal emengency Department of Dr. M. Djamil Hospital Padang with cief complaints of shortness of breath influenced activity, frequent night waking due to shortness of breath, and an elevated bed with a pillow. On physical examination found: clubbing, cyanosis, increased Jugolaris veins, cardiomegaly, and pitting edema. From the laboratium: Hemoglobin: 17,1 gr/dl, Hematokrit : 62%, Ureum : 39 mg/dl, Kreatinin : 2,0 mg/dl, TKK :31, Echo Cardiography shows: Transposition of the Great Arteries, Large Ventricle Septal Defect, Tricuspid Regurgitation with pulmonary hypertension, and moderate Mitral Regurgitation. Patients with definitife diagnosis: Congestive Heart Failure Functional Class IV LVH- RVH, RBBB rhythm Cause By Transposition of the Great Arteries with a Ventrikel Septal Defec.Key word : Transposition of the Great Arteries, Kongenital Heart Desease.</p