Meat safety knowledge, attitude and practices of slaughterhouse workers in Kajiado, Kenya.

BACKGROUND: A major contributor to the poor meat safety status in Kenya is low level of slaughter hygiene knowledge and practices among slaughterhouse workers. INTRODUCTION: The study determined knowledge, attitude and practices (KAPs) of workers from 7 small and medium slaughterhouses in Kajiado County on slaughter hygiene and meat safety. METHODOLOGY: Semi-structured questionnaires were administered to 78 workers, managers and meat inspectors. RESULTS: Majority (92.3%) of workers lacked slaughter hygiene and meat safety training. Workers had high knowledge with an overall mean score of 19.2 ± 2 out of 24, high personal hygiene scores (9.9 ± 0.8 out of 11), moderate carcass contamination scores (4.2 ± 0.8 out of 6), meat-borne illness score (3.1 ± 1 out of 4) and temperature intervention scores (2.1 ± 0.6 out of 3). Moderate and high scores were recorded in attitude and practices and differed significantly across slaughterhouses (p < 0.05) with a mean of 33 ± 5 out of 40 and 59.3 ± 3.5 out of 65, respectively. There was no significant difference in KAP scores between trained and untrained workers. Carcass decontamination practices by workers differed from that of the meat inspector. Surface and handheld equipment sanitization practices were observed as poor. Medical testing practice was poor and significantly different across slaughterhouses (p < 0.001) with infection rates of zoonoses and occupational hazards as high as 33% in some slaughterhouses. CONCLUSION: The study concluded that although high knowledge and neutral attitude were scored by slightly more than half of the workers, poor practices were reported and observed in carcass decontamination, equipment and facility sanitization and worker medical examination. Slaughter facilities in Kajiado County have an opportunity to offer their workers role-specific training, the provision of personal protective equipment, hygiene and sanitation facilities and strict oversight of worker medical testing.

Mobile phone application in the management of maternal and young child malnutrition: a review

Background: Malnutrition is one of the leading causes of maternal and young child mortality in underdeveloped countries, particularly during pregnancy and delivery. The effects of malnutrition in pregnant women include low birth weight, preterm birth, intrauterine growth restriction, nutrient deficiencies and reduced breast milk production. Mobile phone applications are widely used with features such as portability, ease of communication, storage at relatively low cost that makes such technology attractive to nutritionists. Objective: To assess if mobile phone applications can be beneficial in maternal and young child malnutrition intervention. Methods: Zotero reference management software was used to ensure the rigor and reproducibility of the review process. Based on defined key words, a search was conducted on Google Scholar, ScienceDirect, PubMed and Springer databases to retrieve all publications on mobile phone applications in maternal and young child malnutrition interventions. The study used ten articles from unique studies that met the study criteria and are reported in terms of authors, year, sample size, study design and outcome measure. Results: The articles revealed that mobile phone applications were highly useful in maternal and young child malnutrition intervention, prompting nutrition information seeking and facilitating communication with healthcare providers. Conclusion: Mobile phone applications are widely acknowledged, and beneficial in maternal and neonatal malnutrition management, they have the potential to improve maternal and young child nutritional status through self-monitoring. Given the low uptake of current mobile phone application, it should be given a significant consideration as a potential strategy for managing maternal and young child malnutrition.

Determinants of stunting in children aged between 6-23 months in Musanze region, Rwanda.

Under-nutrition causes approximately half of all deaths in young children every year globally which is exacerbated by the multiple malnutrition burden. Infant and young child feeding practices pose immediate effects on the nutrition status of under 2 years aged children and greatly influence the survival of a child. This study aimed at determining the implication of the infant and young child feeding practices in evaluating stunting in young children among other stunting risk factors. Analytical cross-section study was carried out in Musanze, a district of Rwanda and involved 241 mothers having children aged between 6 and 23 months. Data was collected using a validated semi-structured questionnaire with observations and check list guides. Chi-square test and logistic regressions were used to determine the associations and risk factors of various variables. The results show that minimum meal frequency (MMF) was attained at 83% rate, minimum dietary diversity (MDD) at 57%, minimum acceptable diet (MAD) at 53% with consumption of iron rich foods at 29%. Stunting prevalence was 28%. The MAD had a significant (p = 0.021) association with height-for-age Z-score of a child and was found to be the stunting's predictor. The child's sex, consumption of animal sourced foods, child underweight status and income type were revealed as other stunting risk factors. A holistic approach that promotes infant and young child feeding practices and complementary feeding in particular can contribute to the alleviation of the stunting burden in Rwanda. Further, other associated factors that influence child nutrition status should be taken into consideration by the policy decision makers and development partners when developing food and nutrition sensitive programs and interventions.

Nutrition Status of Refugee and Host-Country Children: Negotiating for Equal Distribution of Relief Food During Emergencies in Uganda.

About 25.4 million people worldwide are living as refugees of whom 1.36 million are in Uganda. The refugees in this study were from South Sudan. The objective of this study was to determine the nutrition status of the refugee children and elucidate the factors that contribute to poor nutrition status among the host. The study used comparative analytical cross-sectional design on 340 children aged 6-59 months. The overall prevalence of global acute malnutrition was 3.9%, underweight 14.1%, and stunting 24.7%. Five factors contributed to poor nutrition status; household size (ORa 1.34, 1.92), illness in wasted, stunted and underweight (ORa 1.47, 1.49, 1.97) children, being a host in relation to wasting and stunting (ORa 1.81, 1.36) and deworming (ORa 3.2, 2.13). Although the host had good nutrient intake, the refugee children had better nutrition status. Therefore, the Uganda government should formulate a policy that allows the host to benefit equally from food relief during emergencies.

Sero-prevalence and risk factors of Brucella presence in farm bulk milk from open and zero grazing cattle production systems in Rwanda.

BACKGROUND: Animal and human brucelloses have been reported in Rwanda, human brucellosis being linked to drinking inadequately heat-treated milk. However, information on Brucella detection and prevalence in milk produced in Rwanda is limited. OBJECTIVES: To determine the sero-prevalence and risk factors of Brucella in farm bulk milk from zero and open grazing cattle production systems in Rwanda. METHODS: A total of 330 farm bulk milk samples were collected from 198 zero grazing farms and 132 open grazing farms in a cross-sectional study in Rwanda. Sero-prevalence of Brucella in milk was analysed using indirect enzyme-linked immunosorbent assay. A questionnaire was administered to farmers to determine the risk factors of milk contamination with Brucella. RESULTS: Anti-Brucella antibodies were prevalent in 19.7% (95% confidence interval (CI), 15.5-24.4) of the 330 collected farm bulk milk. Sero-prevalence was significantly higher (p < 0.05) in open grazing farms (37.9% [50/132]) than in zero grazing farms (7.6% [15/198]). Practising open grazing system (odds ratio, OR = 69.5; 95% CI = 1.6-3033.6), history of abortion (OR = 19.5; 95% CI = 8.1-46.8) and placenta retention (OR = 4.2; 95% CI = 1.7-10.3) were the significant risk factors for the presence of anti-Brucella antibodies in milk. CONCLUSION: Notably, more than a third of farm bulk milk from open grazing farms in Rwanda contains Brucella antibodies. Considering the zoonotic nature of Brucella, there is a need to reinforce brucellosis control programs in the country.

Colorectal cancer-associated Streptococcus infantarius subsp. infantarius differ from a major dairy lineage providing evidence for pathogenic, pathobiont and food-grade lineages.

Streptococcus infantarius subsp. infantarius (Sii), a member of the Streptococcus bovis/Streptococcus equinus complex (SBSEC), predominates as dairy-adapted and non-adapted variants in fermented dairy products (FDP) in East and West Africa. Epidemiologic data suggest an association with colorectal cancer for most SBSEC members, including Sii from Kenyan patients. Phylogenetic relationships of East African human (EAH) isolates to those of dairy and pathogenic origin were analysed to better estimate potential health implications via FDP consumption. The MLST-derived population structure was also evaluated to provide host, disease, geography and dairy adaptation associations for 157 SBSEC isolates, including 83 novel Sii/SBSEC isolates of which 40 originated from Kenyan colonoscopy patients. Clonal complex (CC) 90 was delineated as potential pathogenic CC for Sii. Single EAH, West African dairy (WAD), food and animal Sii isolates clustered within CC-90, suggesting a potential link to pathogenic traits for CC-90. The majority of EAH and WAD Sii were clustered in a shared clade distinct from CC-90 and East African dairy (EAD) isolates. This indicates shared ancestry for the EAH and WAD clade and limitations to translate disease associations of EAH and CC-90 to EAD Sii, which could support the separation of pathogenic, pathobiont/commensal and food lineages.

African fermented dairy products - Overview of predominant technologically important microorganisms focusing on African Streptococcus infantarius variants and potential future applications for enhanced food safety and security.

Milk is a major source of nutrients, but can also be a vehicle for zoonotic foodborne diseases, especially when raw milk is consumed. In Africa, poor processing and storage conditions contribute to contamination, outgrowth and transmission of pathogens, which lead to spoilage, reduced food safety and security. Fermentation helps mitigate the impact of poor handling and storage conditions by enhancing shelf life and food safety. Traditionally-fermented sour milk products are culturally accepted and widely distributed in Africa, and rely on product-specific microbiota responsible for aroma, flavor and texture. Knowledge of microbiota and predominant, technologically important microorganisms is critical in developing products with enhanced quality and safety, as well as sustainable interventions for these products, including Africa-specific starter culture development. This narrative review summarizes current knowledge of technologically-important microorganisms of African fermented dairy products (FDP) and raw milk, taking into consideration novel findings and taxonomy when re-analyzing data of 29 publications covering 25 products from 17 African countries. Technologically-important lactic acid bacteria such as Lactococcus lactis and Streptococcus infantarius subsp. infantarius (Sii), Lactobacillus spp. and yeasts predominated in raw milk and FDP across Africa. Re-analysis of data also suggests a much wider distribution of Sii and thus a potentially longer history of use than previously expected. Therefore, evaluating the role and safety of African Sii lineages is important when developing interventions and starter cultures for FDP in Africa to enhance food safety and food security. In-depth functional genomics, epidemiologic investigations and latest identification approaches coupled with stakeholder involvement will be required to evaluate the possibility of African Sii lineages as novel food-grade Streptococcus lineage.

East and West African milk products are reservoirs for human and livestock-associated Staphylococcus aureus.

Staphylococcus aureus frequently isolated from milk products in sub-Saharan Africa (SSA) is a major pathogen responsible for food intoxication, human and animal diseases. SSA hospital-derived strains are well studied but data on the population structure of foodborne S. aureus required to identify possible staphylococcal food poisoning sources is lacking. Therefore, the aim was to assess the population genetic structure, virulence and antibiotic resistance genes associated with milk-derived S. aureus isolates from Côte d'Ivoire, Kenya and Somalia through spa-typing, MLST, and DNA microarray analysis. Seventy milk S. aureus isolates from the three countries were assigned to 27 spa (7 new) and 23 (12 new) MLST sequence types. Milk-associated S. aureus of the three countries is genetically diverse comprising human and livestock-associated clonal complexes (CCs) predominated by the CC5 (n = 10) and CC30 (n = 9) isolates. Panton-Valentine leukocidin, toxic shock syndrome toxin and enterotoxin encoding genes were predominantly observed among human-associated CCs. Penicillin, fosfomycin and tetracycline, but not methicillin resistance genes were frequently detected. Our findings indicate that milk-associated S. aureus in SSA originates from human and animal sources alike highlighting the need for an overarching One Health approach to reduce S. aureus disease burdens through improving production processes, animal care and hygienic measures.

Phylogenetic, epidemiological and functional analyses of the Streptococcus bovis/Streptococcus equinus complex through an overarching MLST scheme.

BACKGROUND: The Streptococcus bovis/Streptococcus equinus complex (SBSEC) comprises seven (sub)species classified as human and animal commensals, emerging opportunistic pathogens and food fermentative organisms. Changing taxonomy, shared habitats, natural competence and evidence for horizontal gene transfer pose difficulties for determining their phylogeny, epidemiology and virulence mechanisms. Thus, novel phylogenetic and functional classifications are required. An SBSEC overarching multi locus sequence type (MLST) scheme targeting 10 housekeeping genes was developed, validated and combined with host-related properties of adhesion to extracellular matrix proteins (ECM), activation of the immune responses via NF-KB and survival in simulated gastric juice (SGJ). RESULTS: Commensal and pathogenic SBSEC strains (n = 74) of human, animal and food origin from Europe, Asia, America and Africa were used in the MLST scheme yielding 66 sequence types and 10 clonal complexes differentiated into distinct habitat-associated and mixed lineages. Adhesion to ECMs collagen I and mucin type II was a common characteristic (23 % of strains) followed by adhesion to fibronectin and fibrinogen (19.7 %). High adhesion abilities were found for East African dairy and human blood isolate branches whereas commensal fecal SBSEC displayed low adhesion. NF-KB activation was observed for a limited number of dairy and blood isolates suggesting the potential of some pathogenic strains for reduced immune activation. Strains from dairy MLST clades displayed the highest relative survival to SGJ independently of dairy adaptation markers lacS/lacZ. CONCLUSION: Combining phylogenetic and functional analyses via SBSEC MLST enabled the clear delineation of strain clades to unravel the complexity of this bacterial group. High adhesion values shared between certain dairy and blood strains as well as the behavior of NF-KB activation are concerning for specific lineages. They highlighted the health risk among shared lineages and establish the basis to elucidate (zoonotic-) transmission, host specificity, virulence mechanisms and enhanced risk assessment as pathobionts in an overarching One Health approach.

Prevalence and comparison of Streptococcus infantarius subsp. infantarius and Streptococcus gallolyticus subsp. macedonicus in raw and fermented dairy products from East and West Africa.

Streptococcus infantarius subsp. infantarius (Sii) and Streptococcus gallolyticus subsp. macedonicus are members of the Streptococcus bovis/Streptococcus equinus complex (SBSEC) associated with human infections. SBSEC-related endocarditis was furthermore associated with rural residency in Southern Europe. SBSEC members are increasingly isolated as predominant species from fermented dairy products in Europe, Asia and Africa. African variants of Sii displayed dairy adaptations to lactose metabolism paralleling those of Streptococcus thermophilus including genome decay. In this study, the aim was to assess the prevalence of Sii and possibly other SBSEC members in dairy products of East and West Africa in order to identify their habitat, estimate their importance in dairy fermentation processes and determine geographic areas affected by this potential health risk. Presumptive SBSEC members were isolated on semi-selective M17 and SM agar media. Subsequent genotypic identification of isolates was based on rep-PCR fingerprinting and SBSEC-specific16S rRNA gene PCR assay. Detailed identification was achieved through application of novel primers enhancing the binding stringency in partial groES/groEL gene amplification and subsequent DNA sequencing. The presence of S. thermophilus-like lacS and lacZ genes in the SBSEC isolates was determined to elucidate the prevalence of this dairy adaptation. Isolates (n = 754) were obtained from 72 raw and 95 fermented milk samples from Côte d'Ivoire and Kenya on semi-selective agar media. Colonies of Sii were not detected from raw milk despite high microbial titers of approximately 10(6)CFU/mL on M17 agar medium. However, after spontaneous milk fermentation Sii was genotypically identified in 94.1% of Kenyan samples and 60.8% of Kenyan isolates. Sii prevalence in Côte d'Ivoire displayed seasonal variations in samples from 32.3% (June) to 40.0% (Dec/Jan) and isolates from 20.5% (June) to 27.7% (Dec/Jan) present at titers of 10(6)-10(8)CFU/mL. lacS and lacZ genes were detected in all Kenyan and 25.8% (June) to 65.4% (Dec/Jan) of Ivorian Sii isolates. Regional differences in prevalence of Sii and dairy adaptations were observed, but no clear effect of dairy animal, fermentation procedure and climate was revealed. Conclusively, the high prevalence of Sii in Kenya, Côte d'Ivoire in addition to Somalia, Sudan and Mali strongly indicates a pivotal role of Sii in traditional African dairy fermentations potentially paralleling that of typical western dairy species S. thermophilus. Putative health risks associated with the consumption of high amounts of live Sii and potential different degrees of evolutionary adaptation or ecological colonization require further epidemiologic and genomic investigations, particularly in Africa.