Assessing Ugandan pork butchers’ practices and their perception of customers’ preferences: A best-worst approach

Food-borne diseases are a major concern of developing countries. Among the drivers, rapidly increasing pork consumption deserves increased attention. Yet there is little documentation in Uganda on the context in which pork is produced, marketed and consumed and the implications this may have on public health. This study attempts to assess the current knowledge, attitudes and practices and looks more into butchers’ beliefs about customer preferences. Sixty pork butcheries out of 179 mapped in Kampala were randomly selected. In July 2014 on-site observations were undertaken and butchers were interviewed what they think is the most and the least important attributes to their clients when buying pork meat. Best-worst method with a set of previously identified thirteen attributes was used. Half of the pork purchased by the butchers came from pigs slaughtered in backyards or non-gazetted abattoirs. Raw pork accounted for half of the total pork sold by pork butcheries. The other half was served as cooked pork and usually consumed on-site accompanied by raw vegetables. The majority of butchers use a wooden stump as a cutting surface. Pest animals are present in most butcheries including rodents, birds and flies. Best-worst scores showed that among the attributes butchers revealed as the most important for their customers were: “Meat from the same day”, “Cleanliness in the butchery” and “Trust in butcher“ while “Presence of flies in butchery”, “Age of the animal”, “Pest animals in butchery” and “Fat layer of meat“ were the least significant qualities. Others varied in-between such as “Price”, “Colour of meat”, “Bony meat”, “Butcher wearing coat”, “Type of building structure” and “Butchery close to main road”. The results indicate the need to improve food hygiene in order to mitigate food contamination risks but they also show sellers’ believes which need to be taken into account and addressed. Bringing this research into use will allow targeted interventions and empower butchers to improve the conditions in their shops, strengthen their businesses, and therefore contribute to healthier clients and public health. The research was carried out with the financial support of the Federal Ministry for Economic Cooperation and Development (BMZ), Germany, and the CGIAR Research Programs on Agriculture for Nutrition and Health, and on Policies, Institutions and Markets led by the International Food Policy Research Institute, through the Safe Food, Fair Food project at ILRI

Oral voclosporin: novel calcineurin inhibitor for treatment of noninfectious uveitis

Voclosporin, a novel immunomodulatory drug inhibiting the calcineurin enzyme, was developed to prevent organ graft rejection and to treat autoimmune diseases. The chemical structure of voclosporin is similar to that of cyclosporine A, with a difference in one amino acid, leading to superior calcineurin inhibition and less variability in plasma concentration. Compared with placebo, voclosporin may significantly reduce inflammation and prevent recurrences of inflammation in patients with noninfectious uveitis. Future studies have to show if these advantages are accompanied by greater clinical efficacy and fewer side effects compared with the classic calcineurin inhibitors

Occurrence of Salmonella spp. in flies and foodstuff from pork butcheries in Kampala, Uganda

Food-borne diseases such as salmonellosis are a major cause of human gastroenteritis worldwide, especially in the developing world due to poor sanitary conditions. Flies feed on food and breed in feces and other organic material. As such they are known vectors of Salmonella spp. Given that pork consumption in Uganda is rapidly increasing while good food safety practices remain absent, this study aims to assess the occurrence of Salmonella spp. in pork butcheries as a contribution to improve hygiene. Seventy-seven pork butcheries out of 179 mapped in a previous survey in Kampala were randomly selected. From June–October 2014, samples of house flies, foodstuff and equipment were collected from all butcheries. Cultural isolation of Salmonella spp. was performed according to ISO 6579:2002. Among 693 samples, 64 (9%) tested positive for Salmonella enteritidis. Among the positives, 32% were samples of raw pork (25), 25% flies’ midguts (19), less than 9% water (7), tomatoes (6), cabbage (4), onions (2) and one case on roasted pork1, respectively. Positive flies coincided with contaminated foodstuff in 29% of the butcheries. All 154 samples from either butchers’ hands or their equipment were negative for Salmonella spp. The prevalence of S. enteritidis, especially on raw pork and in flies, illustrates the need for improving food safety in pork butcheries. Further research is required clarifying the gaps; especially the role of flies as microbiological carriers. In this context investigations are ongoing to identify Salmonella serotypes and their antimicrobial drug-resistance situation. However, these findings merit increased attention and can be used to improve knowledge, attitudes and practices amongst butchers. The research was carried out with the financial support of the Federal Ministry for Economic Cooperation and Development (BMZ), Germany, and the CGIAR Research Program on Agriculture for Nutrition and Health, led by the International Food Policy Research Institute, through the Safe Food, Fair Food project at ILRI. Martin Heilmann got a scholarship from the German Academic Exchange Service (DAAD)

Participatory survey of risk factors and pathways for Rift Valley fever in pastoral and agropastoral communities of Uganda

To assess pastoralists’ and agropastoralists’ knowledge on Rift Valley fever (RVF), participatory epidemiological studies were conducted with 215 livestock keepers and 27 key informants in Napak, Butebo, Isingiro and Lyantonde districts, Uganda, between January and February 2022. Livestock keepers in all four districts had knowledge of RVF and even had local names or descriptions for it. Pastoralists and agropastoralists possessed valuable knowledge of RVF clinical descriptions and epidemiological risk factors such as the presence of infected mosquitoes, living in flood-prone areas, and excessive rainfall. RVF was ranked among the top ten most important cattle diseases. Pastoralists called RVF Lonyang, symbolizing a disease associated with jaundice, high fever, abortions in pregnant cows, and sudden death in calves. Key informants identified infected domestic animals, the presence of infected mosquitoes, livestock movement and trade, and infected wild animals as risk pathways for the introduction of RVF into an area. Drinking raw blood and milk was perceived as the most likely pathway for human exposure to RVF virus; while the highest consequence was high treatment costs. The results indicate that pastoralists provided key epidemiological information that could be essential for designing an effective national RVF surveillance and early warning system

Antimicrobial resistance of Salmonella enterica in pork and vegetable servings at pork joints in Kampala, Uganda

The aim of this study was to investigate the prevalence and antimicrobial resistance of Salmonella enterica subsp. enterica serovars including the presence of shared plasmids in pork and related fresh vegetables served in pork joints in Kampala, Uganda. Pork butcheries in three of the five administrative divisions of Kampala were included for the survey. Samples included raw pork, roasted pork, water, onions, tomatoes, cabbage, butcher’s hands (swabs), utensils (swabs) and fly midgut extracts. A total of 693 samples were collected from 77 pork butcheries from June- October 2014. Overall 53.2% pork joints had samples positive for Salmonella enterica subsp. enterica serovars. Isolation rates ranged from 31.2% (24/77) for raw pork, 1.3% (1/77) for roasted pork, 7.8% (6/77) for tomatoes, 2.6% (2/77) for onions, 5.2% (4/77) for cabbage, 9.1% (7/77) in water, and 22.1% (17/77) from fly midguts. Swab samples taken from utensil and butcher’s hands swabs were found negative (Heilmann et al., 2015). In the isolates obtained, resistance towards 22 antibiotics was tested. Resistances were found towards 11 out of the 22 antibiotics tested. High resistances were found to Cephazolin (97%), Cefotixime (93%), Gentamicin (88%), and Ceftazidime (86%). Intermediate resistance was found to Ciprofloxacin (59%) and Amoxicillin-Clavulanic acid (57.6%). Most isolates (85%) were susceptible to Levofloxacin, Ofloxacin, Sulfamethoxazole and Trimethoprim. Identification of plasmids by PCR-based replicon typing was performed recognizing FIA,FIB,FIC,HI1,HI2,I1- 1ᵞ,L/M,N,P,W,T,A/C,K,B/O,X,Y,F and FIIA. Six incompatibility groups were identified: FIA, W, FIC, FIB, P, Y with more than one incompatibility group existing among different isolates. A high resistance rate among Salmonella strains was found while the total number of incompatibility groups detected was with approximation 2.4. Thus, even though the total number of plasmids per strain is low, resistance rates detected remain high. The high resistance rates are probably resulting from intensified food animal production driving a greater use of antibiotics, which is a crucial aspect of public health concern

Knowledge, attitudes and practices among customers at pork butcheries in Kampala, Uganda

Of all East African countries, Uganda boasts the highest pork consumption at 3.4 kg per capita per year (2011). Yet, there is little documentation how pork is produced, marketed and consumed, or on the implications this may have on public health. Up to 70% of produced pork is estimated to be consumed in urban/periurban areas mainly through informal butcheries and so-called pork joints, which are a combination of road-side butchery selling raw pork and a bistro for cooked pork often served with alcoholic drinks. This study was aimed at gaining better insight into this increasing pork business at the consumer level. Between June and July 2014, a baseline survey was conducted with 240 customers in 60 randomly selected pork butcheries in Kampala to assess their knowledge, attitudes and practices. Data was collected during face-to-face interviews by enumerators trained to conduct structured questionnaires in both English and the local language Luganda. Pork was most commonly purchased raw (48%), followed by fried (38%), roasted (9%) and cooked (5%). It was the second most common meat consumed at home after beef, followed by poultry, sheep, goat and fish. Pork was consumed on average 2.18 times per week. One third of households bought raw pork occasionally, while rates of “once per two weeks” (20%), “once a week” (20%), a few times a week (15%) or every day (15%) were also noted. Most (82%) customers ate their pork with raw and cooked vegetables, including matoke (59%), cassava (51%), tomatoes (9%), cabbage (5%), Irish potatoes (4%), onions (3%), greens (2%) and others. The main source of information for customers were television (68%), radio (29%), newspaper (15%), internet (10%), friends (9%), colleagues (2%) or others. Health aspects influenced the majority of respondents’ purchase decisions a lot (89%), while 9% stated “a bit” and 2% “not at all”. The high demand for pork along with the potential for cross contamination between raw pork and vegetables, indicates a food safety risk at not just pork butcheries but also at household level. Promotion of health aspects through public information channels can be used to influence purchase decisions and contribute to healthier clients and improved public health. This research was carried out with the financial support of the Federal Ministry for Economic Cooperation and Development, Germany, and the CGIAR Research Program on Agriculture for Nutrition and Health, led by the International Food Policy Research Institute, through the Safe Food, Fair Food project at ILRI

Food safety metrics relevant to low- and middle-income countries

London School of Hygiene and Tropical MedicineRoyal Veterinary College, LondonWorld Health OrganizationFood and Agriculture Organization of the United Nation

Longitudinal Study of Selected Bacterial Zoonoses in Small Ruminants in Tana River County, Kenya

Brucellosis, Q fever, and leptospirosis are priority zoonoses worldwide, yet their epidemiology is understudied, and studies investigating multiple pathogens are scarce. Therefore, we selected 316 small ruminants in irrigated, pastoral, and riverine settings in Tana River County and conducted repeated sampling for animals that were initially seronegative between September 2014 and June 2015. We carried out serological and polymerase chain reaction tests and determined risk factors for exposure. The survey-weighted serological incidence rates were 1.8 (95% confidence intervals [CI]: 1.3–2.5) and 1.3 (95% CI: 0.7–2.3) cases per 100 animal-months at risk for Leptospira spp. and C. burnetii, respectively. We observed no seroconversions for Brucella spp. Animals from the irrigated setting had 6.83 (95% CI: 2.58–18.06, p-value = 0.01) higher odds of seropositivity to C. burnetii than those from riverine settings. Considerable co-exposure of animals to more than one zoonosis was also observed, with animals exposed to one zoonosis generally having 2.5 times higher odds of exposure to a second zoonosis. The higher incidence of C. burnetii and Leptospira spp. infections, which are understudied zoonoses in Kenya compared to Brucella spp., demonstrate the need for systematic prioritization of animal diseases to enable the appropriate allocation of resources

Longitudinal Study of Selected Bacterial Zoonoses in Small Ruminants in Tana River County, Kenya

Brucellosis, Q fever, and leptospirosis are priority zoonoses worldwide, yet their epidemiology is understudied, and studies investigating multiple pathogens are scarce. Therefore, we selected 316 small ruminants in irrigated, pastoral, and riverine settings in Tana River County and conducted repeated sampling for animals that were initially seronegative between September 2014 and June 2015. We carried out serological and polymerase chain reaction tests and determined risk factors for exposure. The survey-weighted serological incidence rates were 1.8 (95% confidence intervals [CI]: 1.3-2.5) and 1.3 (95% CI: 0.7-2.3) cases per 100 animal-months at risk for Leptospira spp. and C. burnetii, respectively. We observed no seroconversions for Brucella spp. Animals from the irrigated setting had 6.83 (95% CI: 2.58-18.06, p-value = 0.01) higher odds of seropositivity to C. burnetii than those from riverine settings. Considerable co-exposure of animals to more than one zoonosis was also observed, with animals exposed to one zoonosis generally having 2.5 times higher odds of exposure to a second zoonosis. The higher incidence of C. burnetii and Leptospira spp. infections, which are understudied zoonoses in Kenya compared to Brucella spp., demonstrate the need for systematic prioritization of animal diseases to enable the appropriate allocation of resources