How human brucellosis incidence in urban Kampala can be reduced most efficiently? A stochastic risk assessment of informally-marketed milk

In Kampala, Uganda, studies have shown a significant incidence of human brucellosis. A stochastic risk assessment involving two field surveys (cattle farms and milk shops) and a medical record survey was conducted to assess the risk of human brucellosis infection through consumption of informally ma...

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Autores principales: Makita, K., Fèvre, Eric M., Waiswa, C., Eisler, M.C., Welburn, S.C.
Formato: Journal Article
Lenguaje:Inglés
Publicado: Public Library of Science 2010
Acceso en línea:https://hdl.handle.net/10568/2998
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author Makita, K.
Fèvre, Eric M.
Waiswa, C.
Eisler, M.C.
Welburn, S.C.
author_browse Eisler, M.C.
Fèvre, Eric M.
Makita, K.
Waiswa, C.
Welburn, S.C.
author_facet Makita, K.
Fèvre, Eric M.
Waiswa, C.
Eisler, M.C.
Welburn, S.C.
author_sort Makita, K.
collection Repository of Agricultural Research Outputs (CGSpace)
description In Kampala, Uganda, studies have shown a significant incidence of human brucellosis. A stochastic risk assessment involving two field surveys (cattle farms and milk shops) and a medical record survey was conducted to assess the risk of human brucellosis infection through consumption of informally marketed raw milk potentially infected with Brucella abortus in Kampala and to identify the best control options. Methodology/Principal Findings In the cattle farm survey, sera of 425 cows in 177 herds in the Kampala economic zone were sampled and tested for brucellosis using a competitive enzyme-linked immunosorbent assay (CELISA). Farmers were interviewed for dairy information. In the milk shop surveys, 135 milk sellers in the urban areas were interviewed and 117 milk samples were collected and tested using an indirect enzyme-linked immunosorbent assay (IELISA). A medical record survey was conducted in Mulago National Referral Hospital for serological test results. A risk model was developed synthesizing data from these three surveys. Possible control options were prepared based on the model and the reduction of risk was simulated for each scenario. Overall, 12.6% (6.8–18.9: 90%CI) of informally marketed milk in urban Kampala was contaminated with B.abortus at purchase and the annual incidence rate was estimated to be 5.8 (90% CI: 5.3–6.2) per 10,000 people. The best control option would be the construction of a milk boiling centre either in Mbarara, the largest source of milk, or in peri-urban Kampala and to ensure that milk traders always sell milk to the boiling centre; 90% success in enforcing these two options would reduce risk by 47.4% (21.6–70.1: 90%CI) and 82.0% (71.0–89.0: 90%CI), respectively. Conclusion/Significance This study quantifies the risk of human brucellosis infection through informally marketed milk and estimates the incidence rate in Kampala for the first time; risk-based mitigation strategies are outlined to assist in developing policy.
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spelling CGSpace29982023-12-08T19:36:04Z How human brucellosis incidence in urban Kampala can be reduced most efficiently? A stochastic risk assessment of informally-marketed milk Makita, K. Fèvre, Eric M. Waiswa, C. Eisler, M.C. Welburn, S.C. In Kampala, Uganda, studies have shown a significant incidence of human brucellosis. A stochastic risk assessment involving two field surveys (cattle farms and milk shops) and a medical record survey was conducted to assess the risk of human brucellosis infection through consumption of informally marketed raw milk potentially infected with Brucella abortus in Kampala and to identify the best control options. Methodology/Principal Findings In the cattle farm survey, sera of 425 cows in 177 herds in the Kampala economic zone were sampled and tested for brucellosis using a competitive enzyme-linked immunosorbent assay (CELISA). Farmers were interviewed for dairy information. In the milk shop surveys, 135 milk sellers in the urban areas were interviewed and 117 milk samples were collected and tested using an indirect enzyme-linked immunosorbent assay (IELISA). A medical record survey was conducted in Mulago National Referral Hospital for serological test results. A risk model was developed synthesizing data from these three surveys. Possible control options were prepared based on the model and the reduction of risk was simulated for each scenario. Overall, 12.6% (6.8–18.9: 90%CI) of informally marketed milk in urban Kampala was contaminated with B.abortus at purchase and the annual incidence rate was estimated to be 5.8 (90% CI: 5.3–6.2) per 10,000 people. The best control option would be the construction of a milk boiling centre either in Mbarara, the largest source of milk, or in peri-urban Kampala and to ensure that milk traders always sell milk to the boiling centre; 90% success in enforcing these two options would reduce risk by 47.4% (21.6–70.1: 90%CI) and 82.0% (71.0–89.0: 90%CI), respectively. Conclusion/Significance This study quantifies the risk of human brucellosis infection through informally marketed milk and estimates the incidence rate in Kampala for the first time; risk-based mitigation strategies are outlined to assist in developing policy. 2010-12-01 2010-12-13T15:45:19Z 2010-12-13T15:45:19Z Journal Article https://hdl.handle.net/10568/2998 en Open Access Public Library of Science Makita K, Fèvre EM, Waiswa C, Eisler MC and Welburn SC. 2010. How human brucellosis incidence in urban Kampala can be reduced most efficiently? A stochastic risk assessment of informally-marketed milk. PLOS ONE 5(12): e14188.
spellingShingle Makita, K.
Fèvre, Eric M.
Waiswa, C.
Eisler, M.C.
Welburn, S.C.
How human brucellosis incidence in urban Kampala can be reduced most efficiently? A stochastic risk assessment of informally-marketed milk
title How human brucellosis incidence in urban Kampala can be reduced most efficiently? A stochastic risk assessment of informally-marketed milk
title_full How human brucellosis incidence in urban Kampala can be reduced most efficiently? A stochastic risk assessment of informally-marketed milk
title_fullStr How human brucellosis incidence in urban Kampala can be reduced most efficiently? A stochastic risk assessment of informally-marketed milk
title_full_unstemmed How human brucellosis incidence in urban Kampala can be reduced most efficiently? A stochastic risk assessment of informally-marketed milk
title_short How human brucellosis incidence in urban Kampala can be reduced most efficiently? A stochastic risk assessment of informally-marketed milk
title_sort how human brucellosis incidence in urban kampala can be reduced most efficiently a stochastic risk assessment of informally marketed milk
url https://hdl.handle.net/10568/2998
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