14 research outputs found
Performance of the 2007 WHO Algorithm to diagnose Smear-negative Pulmonary Tuberculosis in a HIV prevalent setting
The 2007 WHO algorithm for diagnosis of smear-negative pulmonary tuberculosis (PTB) including Mycobacterium tuberculosis (MTB) culture was evaluated in a HIV prevalent area of Kenya
Working conditions and public health risks in slaughterhouses in western Kenya
Background: Inadequate facilities and hygiene at slaughterhouses can result in contamination of meat and
occupational hazards to workers. The objectives of this study were to assess current conditions in slaughterhouses
in western Kenya and the knowledge, and practices of the slaughterhouse workers toward hygiene and sanitation.
Methods: Between February and October 2012 all consenting slaughterhouses in the study area were recruited.
A standardised questionnaire relating to facilities and practices in the slaughterhouse was administered to the
foreperson at each site. A second questionnaire was used to capture individual slaughterhouse workers’ knowledge,
practices and recent health events.
Results: A total of 738 slaughterhouse workers from 142 slaughterhouses completed questionnaires. Many
slaughterhouses had poor infrastructure, 65% (95% CI 63–67%) had a roof, cement floor and walls, 60%
(95% CI 57–62%) had a toilet and 20% (95% CI 18–22%) had hand-washing facilities. The meat inspector
visited 90% (95% CI 92–95%) of slaughterhouses but antemortem inspection was practiced at only 7% (95% CI 6–8%).
Nine percent (95% CI 7–10%) of slaughterhouses slaughtered sick animals. Only half of workers wore personal
protective clothing - 53% (95% CI 51–55%) wore protective coats and 49% (95% CI 46–51%) wore rubber boots.
Knowledge of zoonotic disease was low with only 31% (95% CI 29–33%) of workers aware that disease could be
transmitted from animals.
Conclusions: The current working conditions in slaughterhouses in western Kenya are not in line with the
recommendations of the Meat Control Act of Kenya. Current facilities and practices may increase occupational
exposure to disease or injury and contaminated meat may enter the consumer market. The findings of this study
could enable the development of appropriate interventions to minimise public health risks. Initially,
improvements need to be made to facilities and practices to improve worker safety and reduce the risk of food
contamination. Simultaneously, training programmes should target workers and inspectors to improve awareness
of the risks. In addition, education of health care workers should highlight the increased risks of injury and
disease in slaughterhouse workers. Finally, enhanced surveillance, targeting slaughterhouse workers could be
used to detect disease outbreaks. This “One Health” approach to disease surveillance is likely to benefit workers,
producers and consumers
Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment
Background High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular
diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four
cardiometabolic risk factors for all countries and regions from 1980 to 2010.
Methods We used data for exposure to risk factors by country, age group, and sex from pooled analyses of populationbased health surveys. We obtained relative risks for the eff ects of risk factors on cause-specifi c mortality from metaanalyses
of large prospective studies. We calculated the population attributable fractions for- each risk factor alone,
and for the combination of all risk factors, accounting for multicausality and for mediation of the eff ects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specifi c population attributable fractions by the number of disease-specifi c deaths. We obtained cause-specifi c mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the fi nal estimates.
Findings In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronic kidney disease, and diabetes in every region, causing more than 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths, and high cholesterol for more than 10%. After
accounting for multicausality, 63% (10\ub78 million deaths, 95% CI 10\ub71\u201311\ub75) of deaths from these diseases in 2010 were attributable to the combined eff ect of these four metabolic risk factors, compared with 67% (7\ub71 million deaths,
6\ub76\u20137\ub76) in 1980. The mortality burden of high BMI and glucose nearly doubled from 1980 to 2010. At the country
level, age-standardised death rates from these diseases attributable to the combined eff ects of these four risk factors
surpassed 925 deaths per 100 000 for men in Belarus, Kazakhstan, and Mongolia, but were less than 130 deaths per 100 000 for women and less than 200 for men in some high-income countries including Australia, Canada, France,
Japan, the Netherlands, Singapore, South Korea, and Spain.
Interpretation The salient features of the cardiometabolic disease and risk factor epidemic at the beginning of
the 21st century are high blood pressure and an increasing eff ect of obesity and diabetes. The mortality burden
of cardiometabolic risk factors has shifted from high-income to low-income and middle-income countries. Lowering
cardiometabolic risks through dietary, behavioural, and pharmacological interventions should be a part of the globalresponse to non-communicable diseases
Dietary patterns and breast cancer risk among women in northern Tanzania: a case–control study
BACKGROUND: Breast cancer is the second most common cancer among women in the Kilimanjaro Region of Tanzania. It was tested within a case–control study in this region whether a specific dietary pattern impacts on the breast cancer risk. METHODS: A validated semi-quantitative Food Frequency Questionnaire was used to assess the dietary intake of 115 female breast cancer patients and 230 healthy age-matched women living in the same districts. A logistic regression was performed to estimate breast cancer risk. Dietary patterns were obtained using principal component analysis with Varimax rotation. RESULTS: The adjusted logistic regression estimated an increased risk for a “Fatty Diet”, characterized by a higher consumption of milk, vegetable oils and fats, butter, lard and red meat (OR = 1.42, 95 % CI 1.08–1.87; P = 0.01), and for a “Fruity Diet”, characterized by a higher consumption of fish, mango, papaya, avocado and watery fruits (OR = 1.61, 95 % CI 1.14–2.28; P = 0.01). Both diets showed an inverse association with the ratio between polyunsaturated and saturated fatty acids (P/S ratio). CONCLUSION: A diet characterized by a low P/S ratio seems to be more important for the development of breast cancer than total fat intake