Estimates of disease burden caused by foodborne pathogens in contaminated dairy products in Rwanda.

BACKGROUND: The Girinka program in Rwanda has contributed to an increase in milk production, as well as to reduced malnutrition and increased incomes. But dairy products can be hazardous to health, potentially transmitting diseases such as bovine brucellosis, tuberculosis, and cause diarrhea. We analyzed the burden of foodborne disease due to consumption of raw milk and other dairy products in Rwanda to support the development of policy options for the improvement of the quality and safety of milk. METHODS: Disease burden data for five pathogens (Campylobacter spp., nontyphoidal Salmonella enterica, Cryptosporidium spp., Brucella spp., and Mycobacterium bovis) were extracted from the 2010 WHO Foodborne Disease Burden Epidemiology Reference Group (FERG) database and merged with data of the proportion of foodborne disease attributable to consuming dairy products from FERG and a separately published Structured Expert Elicitation study to generate estimates of the uncertainty distributions of the disease burden by Monte Carlo simulation. RESULTS: According to WHO, the foodborne disease burden (all foods) of these five pathogens in Rwanda in 2010 was like or lower than in the Africa E subregion as defined by FERG. There were 57,500 illnesses occurring in Rwanda owing to consumption of dairy products, 55 deaths and 3,870 Disability Adjusted Life Years (DALYs) causing a cost-of-illness of $3.2 million. 44% of the burden (in DALYs) was attributed to drinking raw milk and sizeable proportions were also attributed to traditionally (16-23%) or industrially (6-22%) fermented milk. More recent data are not available, but the burden (in DALYs) of tuberculosis and diarrheal disease by all causes in Rwanda has declined between 2010 and 2019 by 33% and 46%, respectively. CONCLUSION: This is the first study examining the WHO estimates of the burden of foodborne disease on a national level in Rwanda. Transitioning from consuming raw to processed milk (fermented, heat treated or otherwise) may prevent a considerable disease burden and cost-of-illness, but the full benefits will only be achieved if there is a simultaneous improvement of pathogen inactivation during processing, and prevention of recontamination of processed products.

Food saftey: an examination of the potential impact on the economies of countries of the Caribbean Community [abstract]

Food safety pertains to the prevention, reduction or elimination of the risk of ill-health as a result of the consumption of foods whether fresh or processed, obtained through the domestic market or by international trade. Food saftey issues therefore impact on agricultural production and trade, as well as on the manufacture of processed foods and on the preparation and service of meals, whether these be in a hotel/restaurant environment or by itinerant street vendors. Agricultural production, trade and tourism are together significant contributors to the output of the open economies of the countries of the Caribbean Community. The discussion examines the findings of a recent assessment of the food safety status of Caribbean Community (CARICOM) Member States, which focussed on food safety in respect of plant, animal and human health systems in the various countries. The economic structure of selected countries is highlighted together with an indication of the trends in trade. The findings of the food safety assessment are then reviewed in the context of their possible impact on the economic output of the countries. The analysis showed that agricultural production and trade play a critical role in the economic output of many CARICOM States, Through their contribution to export earnings as well as employment. Tourism is also important in this regard. Inadequate attention to food safety issues can result in loss of market share either through a shift in purchasing patterns as experienced by other countries, or through detention by the regulatory agency of the importing country. Weak food safety policies could also jeopardize the tourism sector. Improvements in the food safety system and its infrastructure would serve to enhance the earning potential of the agricultural and tourism sectors and this should lead to greater economic output from those sectors. (AU)

Food availability and security

Notes that in discussing the question of food availability and security, the underlying issue is the attainment of levels of food consumption that will ensure adequate nutrition even for the lowest populkation deciles, with regard to income distribution. Cites Mellor who observed that in the 1980s food insecurity was considered to be the inability of poor countries, families or individuals to purchase sufficient quantities of food from existing supplies. At issue is the influence of food prices on the purchasing power of most low income persons together with the major role of agricultural production as a source of employment for the poor(AU)

Food availability and security

Notes that in discussing the question of food availability and security, the underlying issue is the attainment of levels of food consumption that will ensure adequate nutrition even for the lowest populkation deciles, with regard to income distribution. Cites Mellor who observed that in the 1980s food insecurity was considered to be the inability of poor countries, families or individuals to purchase sufficient quantities of food from existing supplies. At issue is the influence of food prices on the purchasing power of most low income persons together with the major role of agricultural production as a source of employment for the poor