Qualitative Risk Assessment of Campylobacter jejuni in Street Vended Poultry in Informal Settlements of Nairobi County

Aim: To determine the food safety risks of consumption of street-vended poultry products, to evaluate the determinants of microbial safety and the risk rank of these products. Study Design: A cross-sectional survey was done in the Korogocho and Kariobangi North slums among the consumers and vendors to assess their food safety knowledge and practices. Swab samples of the cooking equipment, utensils, and personnel, raw and cooked portions of poultry were collected for microbial quality evaluation. The most prevalent microorganism was assessed for its qualitative risk rank using the Risk Ranger software. Place and Duration of Study: The study was carried out in the capital city of Kenya, Nairobi, from June 2018 to July 2018. Methodology: A total of 15 vendors were exhaustively sampled and included in the study with the food safety and hygiene practices evaluated using a food safety checklist. The snowballing sampling technique was used to locate all the vendors. Samples of raw and cooked street vended poultry products were subjected to microbial analysis. All samples were collected in sterile polythene bags followed by transportation to the laboratory of the Department of Food Science and Technology of the University of Nairobi and microbial analysis. Results: Campylobacter jejuni contamination, in both raw and cooked poultry products, was 8.95±0.94 log10 CFU g-1 and 4.66±2.67 log10 CFU g-1 respectively; the probability of contamination of raw street-vended poultry was found to be 48.96%. The mean weekly intake of the poultry was reported 140.0 g per person. The probability of campylobacter infection in an individual consumer was found as 7.12x10-3 with the predicted illnesses among the population found as 1.11x106 cases. The qualitative risk estimate from the study was reported as 67, above the limit of 48 for medium risk. Conclusion: The study concluded that Campylobacter jejuni posed high food safety risks as a resultant from the consumption of street-vended poultry.

Healthcare-use for Major Infectious Disease Syndromes in an Informal Settlement in Nairobi, Kenya.

A healthcare-use survey was conducted in the Kibera informal settlement in Nairobi, Kenya, in July 2005 to inform subsequent surveillance in the site for infectious diseases. Sets of standardized questionnaires were administered to 1,542 caretakers and heads of households with one or more child(ren) aged less than five years. The average household-size was 5.1 (range 1-15) persons. Most (90%) resided in a single room with monthly rents of US$ 4.50-7.00. Within the previous two weeks, 49% of children (n=1,378) aged less than five years (under-five children) and 18% of persons (n=1,139) aged ≥5 years experienced febrile, diarrhoeal or respiratory illnesses. The large majority (>75%) of illnesses were associated with healthcareseeking. While licensed clinics were the most-frequently visited settings, kiosks, unlicensed care providers, and traditional healers were also frequently visited. Expense was cited most often (50%) as the reason for not seeking healthcare. Of those who sought healthcare, 34-44% of the first and/or the only visits were made with non-licensed care providers, potentially delaying opportunities for early optimal intervention. The proportions of patients accessing healthcare facilities were higher with diarrhoeal disease and fever (but not for respiratory diseases in under-five children) than those reported from a contemporaneous study conducted in a rural area in Kenya. The findings support community-based rather than facility-based surveillance in this setting to achieve objectives for comprehensive assessment of the burden of disease.

Strategies to Reduce Exclusion among Populations Living in Urban Slum Settlements in Bangladesh.

The health and rights of populations living in informal or slum settlements are key development issues of the twenty-first century. As of 2007, the majority of the world’s population lives in urban areas. More than one billion of these people, or one in three city-dwellers, live in inadequate housing with no or a few basic resources. In Bangladesh, urban slum settlements tend to be located in low-lying, flood-prone, poorlydrained areas, having limited formal garbage disposal and minimal access to safe water and sanitation. These areas are severely crowded, with 4-5 people living in houses of just over 100 sq feet. These conditions of high density of population and poor sanitation exacerbate the spread of diseases. People living in these areas experience social, economic and political exclusion, which bars them from society’s basic resources. This paper overviews policies and actions that impact the level of exclusion of people living in urban slum settlements in Bangladesh, with a focus on improving the health and rights of the urban poor. Despite some strategies adopted to ensure better access to water and health, overall, the country does not have a comprehensive policy for urban slum residents, and the situation remains bleak.