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

Toxicity and metabolism of acephate in adult and larval insects

Adult and larval insects from the terrestrial and aquatic environments were exposed to acephate. The chemical was more toxic to adult insects than to larvae, and was a poor insect cholinesterase inhibitor in vitro compared to methamidophos which was a much stronger inhibitor. Both acephate and methamidophos inhibited the adult cholinesterase in vitro much more strongly than they did the larval enzymes. Acephate was metabolized by the insects to methamidophos which did not appear to be the only metabolite, although no other metabolites were looked for. The cholinesterase of insects exposed to sublethal levels of acephate was inhibited, but this inhibition appeared to be due to the combined effect of acephate and methamidophos and not to any hypothetical substance with greater anticholinesterase activity. This was bourne out when acephate was incubated with mixed function oxidases (MFO). No activated product with potent anticholinesterase activity was identified. Methamidophos was not produced by the MFO system but by some other unidentified mechanism