Campylobacter positivity and public health risks in live bird markets in Busia, Kenya: A value chain analysis.

Live bird markets (LBMs) provide integral hubs for 95% of poultry produced for food. Surveillance systems in LBMs serving smallholder farmers in sub-saharan Africa are often non-functional, and data about public health risks and emerging pathogens are lacking. Studies in Kenya have reported 29-44% Campylobacter prevalence in poultry. We analysed such LBMs in Kenya for likely transmission of Campylobacter from poultry to humans. We conducted a cross-sectional survey among 186 live poultry traders (LPTs) in 14 LBMs in a region with widespread backyard poultry systems. A pretested structured questionnaire was administered to all LPTs having regular contacts with poultry to gather market data and risk information on campylobacteriosis. Campylobacter was detected in individual cloacal cultures and identified through PCR. The median score obtained from the outcome of risk assessment dichotomized respondents into high and low risk categories. We performed logistic regression at 95% confidence interval (CI) to compare market characteristics and Campylobacter positivity to risk categories to identify LBM-associated public health risks. Markets had a median of 13 traders, and mean age of 46.3 ± 13.7 years. Majority 162/186 (87.1%) were males. Market behavioural processes by LPTs varied: Only 58.6% LPTs held bird species separate; onsite slaughter (38.7%); encountered sick-bird (93%) and dead-bird (83%) amidst limited health inspection (31.2%). Campylobacter positivity in live birds was 43/112 (38.4%, 95% CI: 29.4-48.1). Risk information on campylobacteriosis was low 41/114 (36%, 95% CI: 27.2-45.5). Sanitary risks were related to accumulation of litter (adjusted prevalence odds ratio [aPOR]: 19.67, 95% CI: 3.01-128.52). Accessing hand-wash facilities (aPOR: .32, 95% CI: .13-.78) and access to information (aPOR: .24, 95% CI: .09-.61) were protective. Sanitary risks were related to poor hygiene. LBMs could be central surveillance sites for Campylobacter. Public health authorities/actors should consider appropriate targeting to improve sanitary measures and Campylobacter control strategies.

Assessment of knowledge, attitudes and practices towards anthrax in Narok County, Southern Kenya.

INTRODUCTION: anthrax is endemic in some parts of Kenya causing mortalities in livestock and morbidity in humans. On January 20th, 2018, news media reported suspected anthrax in a remote southern Kenyan village after villagers became ill following consumption of meat from a dead cow that was confirmed, by microscopy, to have died of anthrax. We assessed community knowledge, attitude and practices (KAP) to identify intervention gaps for anthrax prevention. METHODS: we conducted a KAP survey in randomly selected households (HHs) in villages from selected wards. Using multi-stage sampling approach, we administered structured questionnaire to persons aged ≥15 years to collect KAP information from February 11th-21st, 2018. From a set of questions for KAP, we scored participants' response as "1" for a correct response and "0" for an incorrect response. Univariate analysis and Chi-square tests were performed to explore determinants of KAP. Concurrently, we gathered qualitative data using interview guides for thematic areas on anthrax KAP from key informant interviews and focus group discussions. Qualitative data were transcribed in Ms Word and analyzed along themes by content analysis. RESULTS: among 334 respondents: 187/334 (56%) were male; mean age, 40.7±13.6 years; 331/334 (99.1%) had heard of anthrax and 304/331 (91.8%) knew anthrax to be zoonotic. Transmission was considered to be through eating dead-carcasses by 273/331 (82.5%) and through contact with infected tissue by 213/331 (64.4%). About 59% (194/329) regularly vaccinated their livestock against anthrax, 53.0% (174/328) had slaughtered or skinned a dead-animal and 59.5% (195/328) practiced home slaughter while 52.9% (172/325) treated sick-animals by themselves. Sex (p≤0.001), age (p=0.007) and livestock-rearing years (p≤0.001) were significantly associated with knowledge and practice. CONCLUSION: there were differences in knowledge and practices towards anthrax by age-group and sex. Enhanced public health education and targeted interventions by relevant government agencies is recommended.