39 research outputs found
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The public health importance and management of infectious poultry diseases in smallholder systems in Africa
Poultry diseases pose major constraints on smallholder production in Africa, causing high flock mortality and economic hardship. Infectious diseases, especially viral diseases like Newcastle disease and highly pathogenic avian influenza (HPAI) and bacterial diseases, especially colibacillosis and salmonellosis, are responsible for most chicken losses, with downstream effects on human nutrition and health. Beyond production impacts, poultry diseases directly harm public health if zoonotic, can give rise to epidemics and pandemics, and facilitate antimicrobial resistance through treatment attempts. HPAI, campylobacteriosis, and salmonellosis are the priority zoonoses. Sustainable solutions for poultry health remain elusive despite recognition of the problem. This review summarises current knowledge on major poultry diseases in smallholder systems, their impacts, and options for prevention and control. We find biosecurity, vaccination, good husbandry, and disease-resistant breeds can reduce disease burden, but practical limitations exist in implementing these measures across smallholder systems. Treatment is often inefficient for viral diseases, and treatment for bacterial diseases risks antimicrobial resistance. Ethnoveterinary practices offer accessible alternatives but require more rigorous evaluation. Multisectoral collaboration and policies that reach smallholder poultry keepers are essential to alleviate disease constraints. Successful control will improve livelihoods, nutrition, and gender equity for millions of rural families. This review concludes that sustainable, scalable solutions for smallholder poultry disease control remain a critical unmet need in Africa
Antimicrobial Resistance of Escherichia coli Isolates from Livestock and the Environment in Extensive Smallholder Livestock Production Systems in Ethiopia.
The objective of this study was to characterize the distribution of antimicrobial resistance (AMR) of Escherichia coli (E. coli) isolated from livestock feces and soil in smallholder livestock systems. A cross-sectional study was carried out sampling 77 randomly selected households in four districts representing two agroecologies and production systems. E. coli was isolated and the susceptibility to 15 antimicrobials was assessed. Of 462 E. coli isolates tested, resistance to at least one antimicrobial was detected in 52% (43.7-60.8) of isolates from cattle fecal samples, 34% (95% CI, 26.2-41.8) from sheep samples, 58% (95% CI, 47.9-68.2) from goat samples and 53% (95% CI, 43.2-62.4) from soil samples. AMR patterns for E. coli from livestock and soil showed some similarities, with the highest prevalence of resistance detected against streptomycin (33%), followed by amoxycillin/clavulanate (23%) and tetracycline (8%). The odds of detecting E. coli resistance to ≥2 antimicrobials in livestock fecal samples were nearly three times (Odd Ratio-OR: 2.9; 95% CI, 1.72-5.17; p = 0.000) higher in lowland pastoral than in highland mixed crop-livestock production systems. These findings provide insights into the status of resistance in livestock and soil, and associated risk factors in low-resource settings in Ethiopia
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Quantitative analysis of knowledge, attitude and practice of workers in chicken slaughter slabs toward food safety and hygiene in Ouagadougou, Burkina Faso
Introduction: In low- and middle-income countries, chicken serves as a cheap source of protein and an income source for many households. It is particularly important in the capital, Ouagadougou, Burkina Faso, where chicken is regularly consumed. However, hygiene standards are very low, posing a significant public health risk.
Methods: To better understand the food safety situation, we conducted a cross-sectional survey of the hygienic practices of 155 randomly selected chicken slaughter outlets and carcass shops with a semi-structured questionnaire.
Results and discussion: Of the outlets visited, 59% are not licensed, and 63% are not regularly inspected, operating in the dominant, largely unregulated informal sector. More than 80% of the chickens are sourced from village production systems, but around 6% of the birds die during transport. The monetary loss due to chicken death during transportation is around four million USD annually. Market hygiene is poor; 86% of the holding pens have no hard floor and are not washed regularly. Almost all (92%) chickens are slaughtered on bare earth floors; bleeding, plucking, and evisceration are done on a wooden table that is rarely washed. On average, the same scalding water is used for 33 birds, seven scalded at a time. Most respondents (49%) thought that plucking and evisceration were the major cause of contamination of carcasses with foodborne pathogens. Most operators only washed their hands and knives with tap water at the beginning of the slaughtering process. Some shops use refrigerators and freezers to store carcasses before selling. However, they store carcasses with other foods like fish, beef and vegetables, facilitating further cross-contamination. There were rats (26%), cats (39%) and dogs (30%) present at outlets, roaming for food, especially roadside outlets. Training schemes on hygienic food handling practices were favoured by outlets as an approach to improve matters; however, improvements in food safety will be limited without significant upgrades in infrastructure and facilities. Slaughter slabs need a standard house with stable energy, adequate airflow, clean water, toilets, detergents and freezers. Also, they need equipment like knives, tables and dishes made of high-quality, easy-to-clean materials
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Assessment of pesticide residues in vegetables produced in central and eastern Ethiopia
Background: In Ethiopia, pesticides are widely used in vegetable production. However, if used incorrectly they may harm consumers of vegetables contaminated with pesticide residues, as well as producers handling the pesticides and lead to ecological damage. We performed a cross-sectional survey to assess pesticide residues in vegetables produced in central and eastern Ethiopia.
Methods: A total of 232 vegetable samples (91 tomatoes, 106 cabbages and 35 Swiss chard) were collected from fields and retail markets, and were screened for 35 pesticides (16 organochlorine, 11 organophosphate, 3 pyrethroids, 2 carbamates and 3 other agrochemicals) using GC–MS analysis.
Results: Pesticides residues were detected in 60% of Swiss chard, 47% of cabbage and 45% of tomato samples. Two or more pesticides were detected in 20% of cabbages, 13% of tomatoes and over half of Swiss chard samples. Bendiocarb, diazinon, endrin, piperonyl butoxide, profenofos and propargite were detected, but only diazinon, propargite and profenofos had residual values above EU Maximum Residue Level (MRL), with diazinon commonly detected at relatively high levels. About 15% of the total analyzed samples, 10% of cabbages and tomatoes, and nearly half of Swiss chard samples had pesticide concentration exceeding EU MRL. However, none of the tested samples had residues exceeding Codex Alimentarius Commission (Codex) MRLs.
Conclusion: This study showed widespread contamination of vegetables with pesticides, mainly organophosphates. We recommend monitoring and regulation of pesticides usage, with promotion of good agricultural practices
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Detection and quantification of pesticide residues in tomatoes sold in urban markets of Ouagadougou, Burkina Faso
Introduction: “What people worry about, and what makes them sick and kills them, are not the same” is maxim for risk communication experts. In Burkina Faso, pesticides are used by vegetable producers to improve productivity. However, consumer concern over pesticide use is high. Of course, if over-used pesticides could have serious health consequences for producers and consumers and also cause ecological damage.
Methods: A cross-sectional survey was conducted to detect and quantify the levels of residues of pesticides in tomatoes sold in urban markets of Ouagadougou. Two samples were collected from each vendor (n = 328 vendors) making a total of 656 tomato samples from 26 markets. Samples were subjected to High-Performance Liquid Chromatography (HPLC) for detection and quantification of six pesticide residues commonly used in West Africa including acetamiprid, chlorpyrifos, lambda-cyhalothrin, deltamethrin, dichlorodiphenyltrichloroethane (DDT), and permethrin.
Results: Overall, 62.2% of tomato samples contained at least one pesticide residue including acetamiprid, chlorpyrifos, lambda-cyhalothrin and DDT. Deltamethrin and permethrin were however not detected in any samples. The highest proportions of samples were contaminated with DDT (32.9, 95%CI: 27.9–38.3%), followed by acetamiprid (31.1, 95%CI: 26.2–36.5%), lambda-cyhalothrin (28.4, 95%CI: 23.6–33.6%) and chlorpyrifos (10.7, 95%CI, 7.6–14.6%). 21.3% of samples exceeded Codex Alimentarius Commission (CAC) Maximum Residue Levels (MRLs) including Acetamiprid (13.1%), DDT (7.3%), lambda-cyhalothrin (2.1%) and chlorpyrifos (0.3%); while 61.3% of sample exceeded European Union (EU) MRLs. Multiple pesticide residues (up to 4) were detected simultaneously in 27.7% of the total samples.
Conclusion: The study suggests that producers and consumers may be exposed to pesticides that can be highly toxic to them and to the environment. We recommend further quantitative risk assessment for consumer exposure and identification of best procedures to reduce residues in vegetables. Meanwhile, monitoring and regulating pesticide use, with the promotion of good agricultural practices, are warranted to prevent consumers, producers and environmental exposure. However, given this may not be effective, promotion of consumer washing and peeling of vegetables may be warranted to at least empower consumers to protect themselves. Moreover, where resources are scarce they should be directed to the highest burden hazards and in Burkina Faso, these are not likely to be pesticides
Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
Ejecta Evolution Following a Planned Impact into an Asteroid: The First Five Weeks
The impact of the DART spacecraft into Dimorphos, moon of the asteroid
Didymos, changed Dimorphos' orbit substantially, largely from the ejection of
material. We present results from twelve Earth-based facilities involved in a
world-wide campaign to monitor the brightness and morphology of the ejecta in
the first 35 days after impact. After an initial brightening of ~1.4
magnitudes, we find consistent dimming rates of 0.11-0.12 magnitudes/day in the
first week, and 0.08-0.09 magnitudes/day over the entire study period. The
system returned to its pre-impact brightness 24.3-25.3 days after impact
through the primary ejecta tail remained. The dimming paused briefly eight days
after impact, near in time to the appearance of the second tail. This was
likely due to a secondary release of material after re-impact of a boulder
released in the initial impact, through movement of the primary ejecta through
the aperture likely played a role.Comment: 16 pages, 5 Figures, accepted in the Astrophysical Journal Letters
(ApJL) on October 16, 202
Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.
BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.
Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.
Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001).
Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication