Practicalities of implementing burden of disease research in Africa: lessons from a population survey component of our multi-partner FOCAL research project.

BACKGROUND: Collaborative research is being increasingly implemented in Africa to study health-related issues, for example, the lack of evidence on disease burden, in particular for the presumptive high load of foodborne diseases. The FOCAL (Foodborne disease epidemiology, surveillance, and control in African LMIC) Project is a multi-partner study that includes a population survey to estimate the foodborne disease burden in four African low- and middle-income countries (LMICs). Our multi-partner study team had members from seven countries, all of whom contributed to the project from the grant application stage, and who play(ed) specific roles in designing and implementing the population survey. MAIN TEXT: In this paper, we applied Larkan et al.'s framework for successful research partnerships in global health to self-evaluate our project's collaboration, management, and implementation process. Our partnership formation considered the interplay and balance between operations and relations. Using Larkan et al.'s seven core concepts (i.e., focus, values, equity, benefit, communication, leadership, and resolution), we reviewed the process stated above in an African context. CONCLUSION: Through our current partnership and research implementing a population survey to study disease burden in four African LMICs, we observed that successful partnerships need to consider these core concepts explicitly, apply the essential leadership attributes, perform assessment of external contexts before designing the research, and expect differences in work culture. While some of these experiences are common to research projects in general, the other best practices and challenges we discussed can help inform future foodborne disease burden work in Africa.

Genetic diversity and potential routes of transmission of Mycobacterium bovis in Mozambique.

Bovine tuberculosis is a zoonotic disease with largely unknown impact in Africa, with risk factors such as HIV and direct contact with animals or consumption of Mycobacterium bovis infected animal products. In order to understand and quantify this risk and design intervention strategies, good epidemiological studies are needed. Such studies can include molecular typing of M. bovis isolates. The aim of this study was to apply these tools to provide novel information concerning the distribution of bovine tuberculosis in cattle in Mozambique and thereby provide relevant information to guide policy development and strategies to contain the disease in livestock, and reduce the risk associated with transmission to humans. A collection of 178 M. bovis isolates was obtained from cattle in Mozambique. Using spoligotyping and regions of difference analysis, we classified the isolates into clonal complexes, thus reporting the first characterisation of M. bovis strains in this region. Data from MIRU-VNTR typing was used to compare isolates from a number of African countries, revealing a deeply geographically structured diversity of M. bovis. Eastern Africa appears to show high diversity, suggesting deep evolution in that region. The diversity of M. bovis in Africa does not seem to be a function of recent importation of animals, but is probably maintained within each particular region by constant reinfection from reservoir animals. Understanding the transmission routes of M. bovis in Mozambique and elsewhere is essential in order to focus public health and veterinary resources to contain bovine tuberculosis.

Aflatoxin B1 Contamination in Chicken Livers and Gizzards from Industrial and Small Abattoirs, Measured by ELISA Technique in Maputo, Mozambique.

Aflatoxins are the most toxic and carcinogenic mycotoxins produced by Aspergillus species. Aflatoxin B1 (AFB1) contamination in industrial and local chicken livers and gizzards in Maputo was investigated. One hundred boiler livers and 80 boiler gizzards were collected from industrial and local cutting poultry production sectors. The samples were analyzed by the ELISA method (MaxSignal®, Bioo Scientific Corporation). AFB1 was found in 39% of liver samples and 13.8% of gizzards, with mean levels of 1.73 µg/kg and 1.07 µg/kg, respectively. The frequency of contamination and AFB1 levels in samples from local sector producers was not significantly higher than those from industrial sector producers (p > 0.05). No correlation was found (p = 0.493; r² = 0.013) between AFB1 levels in livers and hepatic weights. The AFB1 levels were lower than the allowed limits, suggesting that these products do not pose high risk to consumers. Notwithstanding, there is a need to implement aflatoxin residue monitoring and controls in all chicken meat products; this economic and efficient technique appears to be valuable for improved food safety in Mozambique.