Kenya Field Epidemiology and Laboratory Training Program, Kenyatta Hospital Grounds, Nairobi, Kenya.
International Livestock Research Institute, Nairobi, Kenya.
Transbound Emerg Dis. 2022 Sep;69(5):e1839-e1853. doi: 10.1111/tbed.14518. Epub 2022 Mar 30.
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.
活禽市场（LBMs）为 95%的食用家禽提供了重要的枢纽。撒哈拉以南非洲小农户的 LBM 监测系统通常无法正常运行，缺乏有关公共卫生风险和新出现病原体的数据。肯尼亚的研究报告称，家禽中的弯曲杆菌患病率为 29-44%。我们分析了肯尼亚的这些 LBM，以了解从家禽向人类传播弯曲杆菌的可能性。我们在一个广泛存在后院家禽系统的地区，对 14 个 LBM 中的 186 名活禽贸易商（LPT）进行了横断面调查。向所有与家禽有定期接触的 LPT 发放了经过预测试的结构化问卷，以收集市场数据和有关弯曲杆菌病的风险信息。在单独的泄殖腔培养物中检测到弯曲杆菌，并通过 PCR 进行鉴定。从风险评估的结果中获得的中位数评分将受访者分为高风险和低风险类别。我们以 95%置信区间（CI）进行逻辑回归，以比较市场特征和弯曲杆菌阳性与风险类别，以确定与 LBM 相关的公共卫生风险。市场中位数有 13 名贸易商，平均年龄为 46.3±13.7 岁。186 名受访者中，男性占 162/186（87.1%）。LPT 市场行为过程各不相同：只有 58.6%的 LPT 将鸟类分开；现场宰杀（38.7%）；在有限的健康检查中遇到患病的鸟（93%）和死鸟（83%）（31.2%）。活禽中弯曲杆菌阳性率为 43/112（38.4%，95%CI：29.4-48.1）。有关弯曲杆菌病的风险信息很低，为 41/114（36%，95%CI：27.2-45.5）。卫生风险与垃圾堆积有关（调整后的患病率优势比[aPOR]：19.67，95%CI：3.01-128.52）。使用洗手设施（aPOR：0.32，95%CI：0.13-0.78）和获取信息（aPOR：0.24，95%CI：0.09-0.61）是保护性的。卫生风险与不良卫生习惯有关。LBM 可以作为弯曲杆菌的中央监测点。公共卫生当局/行为者应考虑采取适当措施，以改善卫生措施和弯曲杆菌控制策略。
