Prevention of human exposure to livestock faecal waste in the household: a scoping study of interventions conducted in sub-Saharan Africa.

BACKGROUND: Poorly managed animal faecal waste can result in detrimental environmental and public health implications. Limiting human exposure to animal waste through Animal inclusive Water Sanitation and Hygiene (A-WASH) strategies is imperative to improve public health in livestock keeping households but has received little attention to date. A small number of A-WASH interventions have previously been identified through a systematic review by another research team, and published in 2017. To inform intervention design with the most up-to-date information, a scoping study was conducted to map the existing evidence for A-WASH in sub-Saharan Africa (SSA) emerging since the previous review. METHODS: This review followed PRISMA guidelines to identify interventions in SSA published between January 2016 to October 2022. Databases searched included PubMed, PMC Europe, CabDirect and Web of Science. Studies were eligible for inclusion if they were written in English and documented interventions limiting human contact with animal faecal material in the SSA context. Key data extracted included: the intervention itself, its target population, cost, measure of effectiveness, quantification of effect, assessment of success, acceptability and limitations. These data were synthesized into a narrative, structured around the intervention type. FINDINGS: Eight eligible articles were identified. Interventions to reduce human exposure to animal faecal matter were conducted in combination with 'standard' human-centric WASH practices. Identified interventions included the management of human-animal co-habitation, educational programs and the creation of child-safe spaces. No novel A-WASH interventions were identified in this review, beyond those identified by the review in 2017. Randomised Controlled Trials (RCTs) were used to evaluate six of the eight identified interventions, but as effect was evaluated through various measures, the ability to formally compare efficacy of interventions is lacking. CONCLUSION: This study indicates that the number of A-WASH studies in SSA is increasing and the use of RCTs suggests a strong desire to create high-quality evidence within this field. There is a need for standardisation of effect measures to enable meta-analyses to be conducted to better understand intervention effectiveness. Evaluation of scalability and sustainability of interventions is still lacking in A - WASH research.

Co-infection of pigs with Taenia solium cysticercosis and gastrointestinal parasites in Eastern and Western Uganda.

A study was carried out in Kamuli and Hoima districts in Eastern and Western regions of Uganda to determine the Taenia solium porcine cysticercosis (PCC) and gastrointestinal (GI) parasites co-infection status in pigs. One hundred sixty-one households were selected randomly and visited between November and December 2019. A household questionnaire was administered, and faecal and blood samples were collected from at least one pig older than 3 months per household. A blood sample was obtained from a jugular venipuncture, and a rectal faecal sample was obtained. Taenia spp. circulating antigen levels in the sample sera were tested using a commercial enzyme-linked immunosorbent assay kit, apDia™ cysticercosis Ag ELISA. The modified McMaster technique was used to identify and quantify the GI parasites. The apparent animal-level seroprevalence for PCC was 4.8% (95% CI 2.7-7.1) and differed across the two districts (p = 0.018). At the pig herd level, the prevalence was 9.7% (95% CI 5.5-14.4). The prevalence of the different nematode eggs and coccidian oocysts in the two districts was as follows: strongyles 79.0% (95% CI 74.3-83.6), coccidia 73.3% (95% CI 68.3-78.6), Trichuris spp. 7.4% (95% CI 4.9-10.6), Strongyloides ransomi 2.1 (95% CI 0.7-3.5) and Ascaris spp. 4.9 (95% CI 2.8-7.4). Overall, across the two districts, the arithmetic mean for the oocysts per gram (OPG) for coccidia was 2042.2 ± 5776.1, and eggs per gram (EPG) were the highest in strongyles 616.1 ± 991. Overall, 57.4% of the porcine cysticercosis seropositive pigs were also positive for at least one of the gastrointestinal helminths which included strongyles, Strongyloides ransomi, Trichuris spp. and Ascaris spp. The co-infection status of pigs with both PCC and GI parasites demonstrated by this study can provide an incentive for integrating the control and management of both parasites with oxfendazole. Further studies are required to understand the feasibility of using oxfendazole including cost-benefit analysis and the acceptability by local stakeholders for the control of T. solium cysticercosis and gastrointestinal parasites in pigs.

Assessment of Foodborne Disease Hazards in Beverages Consumed in Nigeria: A Systematic Literature Review.

Risk assessment is a formal process of identifying hazards and assessing the risk associated with them (risk is a combination of the severity of illness and the probability of occurrence). This review highlights foodborne disease hazards reported in beverages consumed in Nigeria for the period between 2000 and 2020. Based on a preregistered protocol and search syntax, studies were retrieved from the PubMed, Google Scholar, and ScienceDirect databases. Rayyan QCRI software was used to screen the articles. Data were then extracted from the included full-text articles, into a standardized excel workbook. A total of 18,762 articles were identified, from which 126 were included in the final analyses. The common beverages studied were sachet water (14.9%), borehole/well water (13.9%), cereal-based beverages (12.1%), raw/fresh milk (8.3%) and nono/nunu, which is a fermented milk-cereal beverage (7.2%). Sufficient data were available to undertake pooled prevalence estimates for some hazards within select beverages and revealed contamination rates for Staphylococcus spp. in raw/fresh milk, 12.3% (95% CI 6.3-20.0); Salmonella spp. in borehole/well water, 19.8% (95% CI 13.1-27.4); Klebsiella spp. in sachet water, 40.0% (95% CI 12.4-71.7); Staphylococcus spp. in nono/nunu, 32.6% (95% CI 14.7-53.8), and Escherichia spp. in nono/nunu, 30.7% (95% CI 21.9-40.2). Heterogeneity was present in the aggregate summary estimates. This review has highlighted the presence of several hazards of high importance to public health in commonly consumed beverages in Nigeria. The data presented here provide an entry point for future quantitative risk assessments both to determine the level of exposure of the community to these hazards and also for the identification of the most effective mitigation strategies to reduce these risks and improve health outcomes in Nigeria.

Prevalence and risk factors for exposure to Toxoplasma gondii in slaughterhouse workers in western Kenya.

BACKGROUND: Toxoplasma gondii is a zoonotic protozoan parasite infecting warm-blooded animals. Infection in people can occur through ingestion of oocysts passed in the faeces of the definitive hosts; ingestion of bradyzoites in the tissue of infected intermediate hosts; or exposure to tachyzoites in raw milk and eggs. Slaughterhouse workers are considered a high-risk group for T. gondii exposure because of their contact with raw meat, although a positive relationship between handling raw meat and T. gondii seropositivity has not been demonstrated in all studies. This study aimed to determine the seroprevalence of antibodies to T. gondii in slaughterhouse workers in Kenya and identify risk factors associated with seropositivity. METHODS: A survey of slaughterhouse workers was conducted in 142 slaughter facilities in the study area. Information regarding demographics, contact with livestock, meat consumption, and practices in the slaughterhouse was collected using structured questionnaires. Commercial ELISAs were used to detect IgM and IgG antibodies against T. gondii and a multi-level logistic regression model was used to identify potential risk factors for seropositivity in slaughterhouse workers. RESULTS: The apparent prevalence of antibodies to T. gondii was 84.0% (95% Confidence Interval (CI) 81.2-86.5%) for IgG and 2.2% (95% CI 1.3-3.5%) for IgM antibodies. All IgM positive individuals were IgG positive. Risk factors for exposure to T. gondii were: increasing age (Odds Ratio (OR) 1.03; 95% CI 1.01-1.05); owning poultry (OR 2.00; 95% CI 1.11-3.62); and consuming animal blood (OR 1.92; 95% CI 1.21-3.03). CONCLUSIONS: The seroprevalence of antibodies to T. gondii was very high in this population and considerably higher than published values in the general population. Risk factors included age, owning poultry and drinking animal blood which were consistent with previous reports but none were specifically associated with working in the slaughterhouse. In this instance slaughterhouse workers may represent a useful sentinel for the general population where the level of exposure is also likely to be high and may signify an unidentified public health risk to vulnerable groups such as pregnant women. A detailed understanding of the epidemiology of infection is required, which should include an assessment of incidence, mortality, and burden since T. gondii infection is likely to have life-long sequelae.

Stepwise approach for the control and eventual elimination of Taenia solium as a public health problem.

BACKGROUND: Taenia solium taeniosis/cysticercosis is a public health and agricultural problem, especially in low-income countries, and has been ranked the top foodborne parasitic hazard globally. In 2012, the World Health Organization published a roadmap that called for a validated strategy for T. solium control and elimination by 2015. This goal has not been met, and validated evidence of effective control or elimination in endemic countries is still incomplete. Measuring and evaluating success of control programmes remains difficult, as locally acceptable targets have not been defined as part of the 2012 roadmap nor from other sources, and the performance of tools to measure effect are limited. DISCUSSION: We believe that an international agreement supported by the tripartite World Health Organization, Food and Agriculture Organization of the United Nations, and World Organisation for Animal Health is needed to facilitate endemic countries in publicising SMART (Specific, Measurable, Achievable/attainable, Relevant, Time-bound) country-level control target goals. These goals should be achievable through locally acceptable adoption of options from within a standardised 'intervention tool-kit', and progress towards these goals should be monitored using standardised and consistent diagnostics. Several intervention tools are available which can contribute to control of T. solium, but the combination of these - the most effective control algorithm - still needs to be identified. In order to mount control efforts and ensure political commitment, stakeholder engagement and funding, we argue that a stepwise approach, as developed for Rabies control, is necessary if control efforts are to be successful and sustainable. CONCLUSIONS: The stepwise approach can provide the framework for the development of realistic control goals of endemic areas, the implementation of intervention algorithms, and the standardised monitoring of the evaluation of the progress towards obtaining the control target goals and eventually elimination.

An integrated study of human and animal infectious disease in the Lake Victoria crescent small-holder crop-livestock production system, Kenya.

BACKGROUND: The neglected zoonotic diseases (NZD) are an understudied group that are a major cause of illness throughout the developing world. In general, little is known about the prevalence and burden of NZDs in affected communities, particularly in relation to other infectious diseases with which they are often co-endemic. We describe the design and descriptive epidemiological outputs from an integrated study of human and animal zoonotic and non-zoonotic disease in a rural farming community in western Kenya. METHODS: This cross-sectional survey involved 2113 people, their cattle (n = 983) and pigs (n = 91). People and animals were tested for infection or exposure to a wide range of zoonotic and non-zoonotic pathogens. Prevalence estimates, with adjustment for the complex study design, were derived. Evidence for spatial clustering in exposure or infection was identified using the spatial scan statistic. RESULTS: There was a high prevalence of human parasitism in the community, particularly with hookworm (Ancylostoma duodenale or Necator americanus) (36.3% (95% CI 32.8-39.9)), Entamoeba histolytica/dispar (30.1% (95% CI 27.5-32.8)), and Plasmodium falciparum (29.4% (95% CI 26.8-32.0)). Human infection with Taenia spp. was also prevalent (19.7% (95% CI 16.7-22.7)), while exposure to other zoonotic pathogens was comparatively rarer (Brucella spp., 0.6% (95% CI 0.2-0.9); Coxiella burnetii, 2.2% (95% CI 1.5-2.9); Rift Valley fever, 0.5% (95% CI 0.2-0.8)). A low prevalence of exposure to Brucella spp. was observed in cattle (0.26% (95% CI 0-0.56). This was higher for Rift Valley fever virus (1.4% (95% CI 0.5-2.22)) and C. burnetii (10.0% (95% CI 7.7-12.2)). The prevalence of Taenia spp. cysticercosis was 53.5% (95% CI 48.7-58.3) in cattle and 17.2% (95% CI 9.1-25.3) in pigs. Mycobacterium bovis infection was found in 2.2% of cattle (95% CI 1.3-3.2), while the prevalence of infection with Mycobacterium spp. was 8.2% (95% CI 6.8-9.6) in people. CONCLUSION: Zoonotic infections in people and animals occur in the context of a wide range of co-endemic pathogens in a rural community in western Kenya. The wide diversity of pathogens under study provides a unique opportunity to explore the distribution and determinants of infection in a multi-pathogen, multi-host system.

Risk factors for leptospirosis seropositivity in slaughterhouse workers in western Kenya.

OBJECTIVES: Leptospirosis has been documented in slaughterhouse workers around the world. Risk factors include smoking and drinking at work, and performing tasks such as cleaning offal. This paper examined risk factors for leptospirosis seropositivity in slaughterhouse workers in western Kenya. METHODS: The study was conducted between May 2011 and October 2012. Questionnaires were used to collect information from workers on demographic data, health and hygiene practices in the slaughterhouse. A commercial ELISA detected antibodies to Leptospira spp. in serum samples and multilevel logistic regression analysis identified factors associated with leptospirosis seropositivity. RESULTS: A total of 737 workers from 142 slaughterhouses were recruited. The seroprevalence of antibodies to Leptospira spp. was 13.4% (95% CI 11.1% to 16.1%). Risk factors included: having wounds (OR 3.1; 95% CI 1.5 to 6.1); smoking (OR 1.8; 95% CI 1.1 to 2.9); eating at work (OR 2.1; 95% CI 1.2 to 3.6); cleaning the offal (OR 5.1; 95% CI 1.8 to 15.0); and having a borehole for personal water use (OR 2.3; 95% CI 1.1 to 4.7). At the slaughterhouse level, risk factors included having a roof (OR 2.6; 95% CI 1.2 to 5.6) and drawing water from a well (OR 2.2; 95% CI 1.2 to 4.0). Protective factors included working in slaughterhouses where antemortem inspection was conducted (OR 0.6; 95% CI 0.4 to 1.0) and where workers wore protective aprons (OR 0.4; 95% CI 0.2 to 0.7). CONCLUSIONS: This is the first report of leptospirosis seropositivity in slaughterhouse workers in Kenya. Potential risk factors were identified and this information can be used to educate workers regarding their disease risks and ways to prevent or reduce transmission.

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.

Evidence for the presence of African swine fever virus in an endemic region of Western Kenya in the absence of any reported outbreak.

BACKGROUND: African swine fever (ASF), caused by African swine fever virus (ASFV), is a severe haemorrhagic disease of pigs, outbreaks of which can have a devastating impact upon commercial and small-holder pig production. Pig production in western Kenya is characterised by low-input, free-range systems practised by poor farmers keeping between two and ten pigs. These farmers are particularly vulnerable to the catastrophic loss of livestock assets experienced in an ASF outbreak. This study wished to expand our understanding of ASFV epidemiology during a period when no outbreaks were reported. RESULTS: Two hundred and seventy six whole blood samples were analysed using two independent conventional and real time PCR assays to detect ASFV. Despite no recorded outbreak of clinical ASF during this time, virus was detected in 90/277 samples analysed by conventional PCR and 142/209 samples analysed by qPCR. Genotyping of a sub-set of these samples indicated that the viruses associated with the positive samples were classified within genotype IX and that these strains were therefore genetically similar to the virus associated with the 2006/2007 ASF outbreaks in Kenya. CONCLUSION: The detection of ASFV viral DNA in a relatively high number of pigs delivered for slaughter during a period with no reported outbreaks provides support for two hypotheses, which are not mutually exclusive: (1) that virus prevalence may be over-estimated by slaughter-slab sampling, relative to that prevailing in the wider pig population; (2) that sub-clinical, chronically infected or recovered pigs may be responsible for persistence of the virus in endemic areas.

Nutrient requirements and low-cost balanced diets, based on seasonally available local feedstuffs, for local pigs on smallholder farms in Western Kenya.

Growth performance of pigs on smallholder farms in the tropics is low. Lack of feedstuffs, seasonal feed shortages, and feeding nutritionally unbalanced diets contribute to slow growth. Low-cost balanced diets are needed to improve pig performance. In this study, we estimated the nutrient requirements of local pigs on smallholder farms in Kenya and developed balanced low-cost diets using seasonally available local feedstuffs. Diets were formulated to provide pigs with 80 % of the nutrient density in corn and soybean meal-based (reference) diets to minimize the cost per unit of energy and other nutrients. Estimated requirements for starting and growing pigs (8 to 35 kg body weight) were as follows: digestible energy (DE) 2960 kcal/kg of dry matter (DM), standardized ileal digestibility (SID) lysine 5.8 g/kg of DM, calcium 2.8 g/kg of DM, standardized total tract digestible (STTD) phosphorous 1.4 g/kg of DM, and crude protein 85 g/kg of DM. Nutrient requirements of local pigs on smallholder farms in Kenya were lower than those of exotic breed pigs raised in commercial settings. Seasonally available local feedstuffs were used to develop low-cost balanced diets. Twenty-two diets are presented based on season, cost, and feedstuff availability. This study has broad applicability as a case study of an approach that could be applied in other tropical regions in which smallholder pig keeping is practiced and where local feedstuffs for pigs are available seasonally.

Prevalence of Taenia solium cysticercosis in pigs entering the food chain in western Kenya.

Three hundred forty-three pigs slaughtered and marketed in western Kenya were subjected to lingual examination and HP10 Ag-ELISA for the serological detection of Taenia solium antigen. When estimates were adjusted for the sensitivity and specificity of the diagnostic assays, prevalence of T. solium cysticercosis estimated by lingual exam and HP10 Ag-ELISA was between 34.4% (95% confidence interval (CI) 19.4-49.4%) and 37.6% (95% CI 29.3-45.9%), respectively. All pigs, however, were reported to have passed routine meat inspection. Since T. solium poses a serious threat to public health, these results, if confirmed, indicate that the introduction of control strategies may be appropriate to ensure the safety of pork production in this region.

Prevalence of porcine cysticercosis in the Lake Kyoga Basin, Uganda.

BACKGROUND: Taenia solium is a zoonotic helminth with the potential to cause life threatening epilepsy in people through the aberrant larval infection of the brain called Neurocysticercosis (NCC). The pig is the intermediate host for T. solium where the larval form, cysticercus cellulosae, normally develops after the pig eats eggs of the parasite. Humans are the definitive host where the adult tapeworm develops and are infected through the consumption of poorly cooked, infected meat. T. solium has been acknowledged by the World Health Organization (WHO), Food and Agriculture Organization (FAO) and UK Department for International Development (DFID) as being a neglected zoonotic disease, and was recently included in the WHO roadmap for control of neglected tropical diseases. This neglect encompasses a lack of epidemiological data and a lack of validated, effective control strategies being adopted. Understanding the epidemiology of this parasite in the intermediate host is the first step towards designing suitable intervention strategies for the improvement of public health. This study was undertaken to provide an accurate and up-to-date estimate for the prevalence of porcine cysticercosis in the Lake Kyoga basin. RESULTS: Sera from 378 pigs were analysed with the HP10 Antigen Enzyme Linked Immunosorbant Assay (ELISA) and the prevalence was found to be 25.7% (95% confidence interval 21.0% to 30.0%). Previous sero- surveillance in this region, using the B158/B60 Ag Elisa had indicated a prevalence of 8.6% in 2005 indicating a dramatic increase in prevalence (J. Parasitol Res, Article ID 375493, 2009) within a 6 year period. CONCLUSION: This increasing prevalence in the disease indicates to us that there is currently no effective control of this parasite and that in this region of Uganda at least; cysticercosis remains a neglected zoonotic disease.

Gender considerations in One Health: a framework for researchers.

One Health research and intervention outcomes are strongly influenced by gender dynamics. Women, men, girls, and boys can be negatively affected by gender-based disadvantage in any of the three One Health domains (animal, human, and environmental health), and where this occurs in more than one domain the result may be a compounding of inequity. Evidence worldwide shows that women and girls are more likely to suffer from such gender-based disadvantage. A thoughtfully implemented One Health intervention that prioritizes gender equity is more likely to be adopted, has fewer unintended negative consequences, and can support progress toward gender equality, however there is limited evidence and discussion to guide using a gender lens in One Health activities. We propose a framework to identify key gender considerations in One Health research for development - with a focus on Low-and Middle-Income Countries. The framework encourages developing two types of research questions at multiple stages of the research process: those with a bioscience entry-point and those with a gender entry-point. Gender considerations at each stage of research, institutional support required, and intervention approaches is described in the framework. We also give an applied example of the framework as it might be used in One Health research. Incorporation of gender questions in One Health research supports progress toward more equitable, sustainable, and effective One Health interventions. We hope that this framework will be implemented and optimized for use across many One Health challenge areas with the goal of mainstreaming gender into One Health research.

Consumer preferences and willingness to pay for safe pork products in rural Kenya.

Designing interventions to support the safe development of rapidly growing livestock value chains in sub-Saharan Africa requires a clear understanding of consumer demands. This study aimed to determine purchase patterns, consumers' preferences, and willingness to pay for safe pork attributes; specifically, the presence of a veterinary inspection stamp and the cleanliness of the butchery. A discrete choice experiment-based survey was used to investigate the purchasing behavior of 401 pork consumers: 253 buying raw pork for household consumption, and 148 buying cooked pork for out-of-home consumption. The study findings indicate that the average quantity of pork purchased by consumers was approximately 0.4 Kg per transaction, with the majority of consumers making several purchases per week. The average price per Kg of pork was KES 310 (Approx. 2.60 USD) at the time of the study. Data from the choice experiment showed that consumers were willing to pay a price premium of KES 245 (Approx. 2.1 USD) and KES 164 (Approx. 1.4 USD) per Kg for evidence of better veterinary meat inspection and higher butchery hygiene respectively; further, these were the two most important attributes they considered while making a pork purchase decision. These findings highlight the potential to leverage consumers' willingness to pay to improve the food safety within pork value chains in this context. Investing to increase consumer awareness on food safety issues should be considered to generate an effective market demand, especially in rural areas with relatively lower literacy levels.

The evolution of Kenya's animal health surveillance system and its potential for efficient detection of zoonoses.

Introduction: Animal health surveillance systems in Kenya have undergone significant changes and faced various challenges throughout the years. Methods: In this article, we present a comprehensive overview of the Kenya animal health surveillance system (1944 to 2024), based on a review of archived documents, a scoping literature review, and an examination of past surveillance assessments and evaluation reports. Results: The review of archived documents revealed key historical events that have shaped the surveillance system. These include the establishment of the Directorate of Veterinary Services in 1895, advancements in livestock farming, the implementation of mandatory disease control interventions in 1944, the growth of veterinary services from a section to a ministry in 1954, the disruption caused by the Mau Mau insurrection from 1952 to 1954, which led to the temporary halt of agriculture in certain regions until 1955, the transition of veterinary clinical services from public to private, and the progressive privatization plan for veterinary services starting in 1976. Additionally, we highlight the development of electronic surveillance from 2003 to 2024. The scoping literature review, assessments and evaluation reports uncovered several strengths and weaknesses of the surveillance system. Among the strengths are a robust legislative framework, the adoption of technology in surveillance practices, the existence of a formal intersectoral coordination platform, the implementation of syndromic, sentinel, and community-based surveillance methods, and the presence of a feedback mechanism. On the other hand, the system's weaknesses include the inadequate implementation of strategies and enforcement of laws, the lack of standard case definitions for priority diseases, underutilization of laboratory services, the absence of formal mechanisms for data sharing across sectors, insufficient resources for surveillance and response, limited integration of surveillance and laboratory systems, inadequate involvement of private actors and communities in disease surveillance, and the absence of a direct supervisory role between the national and county veterinary services. Discussion and recommendations: To establish an effective early warning system, we propose the integration of surveillance systems and the establishment of formal data sharing mechanisms. Furthermore, we recommend enhancing technological advancements and adopting artificial intelligence in surveillance practices, as well as implementing risk-based surveillance to optimize the allocation of surveillance resources.

The spatial ecology of free-ranging domestic pigs (Sus scrofa) in western Kenya.

BACKGROUND: In many parts of the developing world, pigs are kept under low-input systems where they roam freely to scavenge food. These systems allow poor farmers the opportunity to enter into livestock keeping without large capital investments. This, combined with a growing demand for pork, especially in urban areas, has led to an increase in the number of small-holder farmers keeping free range pigs as a commercial enterprise. Despite the benefits which pig production can bring to a household, keeping pigs under a free range system increases the risk of the pig acquiring diseases, either production-limiting or zoonotic in nature. This study used Global Positioning System (GPS) technology to track free range domestic pigs in rural western Kenya, in order to understand their movement patterns and interactions with elements of the peri-domestic environment. RESULTS: We found that these pigs travel an average of 4,340 m in a 12 hr period and had a mean home range of 10,343 m(2) (range 2,937-32,759 m(2)) within which the core utilisation distribution was found to be 964 m(2) (range 246-3,289 m(2)) with pigs spending on average 47% of their time outside their homestead of origin. CONCLUSION: These are the first data available on the home range of domestic pigs kept under a free range system: the data show that pigs in these systems spend much of their time scavenging outside their homesteads, suggesting that these pigs may be exposed to infectious agents over a wide area. Control policies for diseases such as Taenia solium, Trypanosomiasis, Trichinellosis, Toxoplasmosis or African Swine Fever therefore require a community-wide focus and pig farmers require education on the inherent risks of keeping pigs under a free range system. The work presented here will enable future research to incorporate movement data into studies of disease transmission, for example for the understanding of transmission of African Swine Fever between individuals, or in relation to the life-cycle of parasites including Taenia solium.

Structure of the pork value chain in Northern Uganda: implications for Taenia solium control interventions.

Introduction: This study characterizes the pork value chain in Agago, Kitgum, Lamwo, and Pader districts of Northern Uganda and analyzes its implications on the transmission and control of Taenia solium infections. Methodology: Data were collected through focus group discussions (FGDs) with farmers and pig and pork traders, key informant interviews (KIIs) with local government officials and consumers, and district-level multi-stakeholder mini workshops organized in the study area. The value chain actors identified include input and services providers, pig farmers, live pig traders, pork traders, and consumers. Results: Most of the pig production, marketing and consumption was found to occur through informal channels. Pig production in this area is dominated by smallholder extensive systems, with most producers keeping less than 10 pigs. The production segment of the pig value chain is characterized by low use of inputs and services such as veterinary extension, drugs and improved feeds. Pigs scavenge for food under free-range systems and are at risk of parasitic infections such as the zoonotic helminth Taenia solium. This risk is exacerbated by the inherent contextual aspects of the study sites including low latrine coverage, open defecation, and high poverty. In addition, some respondents viewed pigs as "sanitation policemen" where they leave them to roam around and eat dirt including feaces thereby cleaning the environment. T. solium was recognized as an important pig health constraint in this value chain alongside African swine fever (ASF). Unlike ASF that was associated with the pig mortalities, the cysts were associated with rejection of pigs by traders at purchase, condemnation of pig carcasses by meat inspectors and rejection of raw pork by consumers at points of sale. Discussion: Poor organization of the value chain and lack veterinary extension and meat inspection services results in some pigs infected with T. solium entering the food chain, exposing consumers to infection with the parasite. To reduce the pig production losses and public health impact from T. solium infections, there is need for control and prevention interventions targeting specific nodes of the value chain where the risk of transmission is highest.

Food safety interventions in low- and middle-income countries in Asia: A systematic review.

Effective and sustainable interventions are necessary for long-term improvement of food safety. This review provides a summary of food safety interventions evaluated in selected low- and middle-income countries in Asia between 2000 and 2020. A systematic screening of published articles from PubMed and CabDirect databases was carried out with the aid of Rayyan QCRI software. A total of 25 studies were considered in the review. A 'before and after' study design was the most frequently used design (64%), while five studies (20%) used a randomized control trial (RCT) design. Interventions applied focused on training to improve knowledge, attitudes, and practices (KAP) towards safe food (60%) or on specific technologies (40%). Nine of the 25 studies were specific on the value chain considered: cattle (1), poultry (1), pigs (4) and fish value chains (3). Except for one study, all interventions reported some level of success; 17 were rated as having a high level of success, defined differently across studies. However, there is a clear evidence gap for the efficacy and cost-effectiveness of food safety interventions in market settings, both consumer- and vendor-facing. A rigorous and standardized assessment of intervention effectiveness and sustainability is recommended, to not only identify areas of improvement, but also to ensure scaling of interventions with demonstrated evidence of success and sustainability.

Insights into the diagnosis, vaccines, and control of Taenia solium, a zoonotic, neglected parasite.

Taenia solium taeniasis/cysticercosis (TSTC) is a foodborne, zoonotic neglected tropical disease affecting predominately low- and middle-income countries. Humans are definitive hosts for T. solium, whereas pigs act as intermediate hosts. Taeniasis, i.e. intestinal infection with adult T. solium in the human host, occurs through ingestion of undercooked pork infected with the larval stage (porcine cysticercosis, PCC). Human cysticercosis occurs after humans ingest T. solium eggs, acting as accidental intermediate hosts. Migration of cysticerci to the human brain results in neurocysticercosis (NCC), manifesting in a variety of clinical symptoms, most notably epilepsy. NCC is the leading cause of acquired epilepsy cases in endemic areas. PCC results in reduced pork value because of condemnation or the risk of condemnation of the meat. Available serological diagnostic tests for porcine and human cysticercosis are characterized by low sensitivity and are not cost-effective. An effective vaccine for T. solium cysticercosis in pigs has been developed, although it is not yet commercially available in all endemic countries, and still no vaccine is available for use in humans. This primer highlights the recent development in the field of diagnostic tests and vaccine production and explores possible strategies for future control and eradication of T. solium. In the absence of highly specific diagnostic tests and human vaccines, treatment of infected pigs and tapeworm carriers and prevention of disease transmission remain the principal means to interrupt the zoonotic cycle of T. solium in endemic countries.

Non-typhoidal salmonella contamination along the pork value chain in a rural East African setting: a cross-sectional study.

BACKGROUND: Non-typhoidal Salmonella (NTS) is a serious foodborne pathogen that has previously been isolated from pigs presented for slaughter in a rural pork value chain in western Kenya. METHODS: To understand varying NTS contamination along the value chain we assessed prevalence at slaughter, transport and retail. Suspect isolates from culture were confirmed using matrix-assisted laser desorption-ionization time of flight mass spectrometry. RESULTS: Prevalence on pig carcasses, meat transportation containers, retailed raw and cooked pork and accompanying side salads was 18.1%, 23.9%, 28.0%, 1.9% and 8.6%, respectively. CONCLUSION: NTS contamination is propagated along the pork value chain in rural western Kenya, demonstrating the need for improved hygiene measures to prevent human exposure.