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Introduction Informal markets play a crucial role in providing fresh and nutritious foods for people in low and middle-income countries. However, the safety of food sold in these markets remains a major concern, contributing to a high burden of foodborne illnesses. Methods This study was designed to analyze stakeholder perceptions of food safety in selected informal public markets in Kenya. Eight focus group discussions and 15 key informant interviews were conducted. In addition, two workshops were held to validate the findings. Results and discussion We found that consumers and vendors confounded food quality, especially freshness, with safety, and paid more attention to appearance and physical qualities than food safety. Information (such as branding and expiry dates) and heuristic cues (such as the flow of buyers and the presence of flies) were used to assess food safety. Meat was perceived as the food most likely to cause disease. Chemical hazards in fresh produce and aflatoxins in maize were mentioned as priority hazards by both vendors and consumers. Stakeholders more knowledgeable about food safety considered microbial hazards as a top priority. Although diarrheal diseases were reported to be prevalent in the communities, these were often thought to be the result of agri-chemical residues in fresh produce or the consumption of high-fat foods, and not commonly linked to bacteria in food. Gaps identified during the interviews included poor infrastructure, inadequate food safety knowledge, insufficient or prohibitive policies, insufficient political will, and poor food safety-related practices. There were few mentions of lack of motivation or incentives for behavior change, or insufficient consumer demand for food safety. To fill the gaps, several opportunities were discussed, including contextualizing policies and regulations, investing in infrastructure, capacity building, and training, and promoting involvement and collaboration among various stakeholders. Co

Background: Foodborne diseases impose substantial public health burden and jeopardize socio-economic development worldwide. While accurate information on foodborne hazards is needed for informed decision in food safety interventions, such information is scarce in developing countries such as Burkina Faso. We conducted a systematic review and meta-analysis of studies reporting foodborne hazards in foods in Burkina Faso to describe the present knowledge of the situation. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used to conduct this review. Abstracts were searched in PubMed and CAB direct between 1 January 1990 to 30 September 2019. We used random-effects models to estimate pooled prevalence and I2 values to measure heterogeneity between studies. Results: 188 articles were identified, of which 14 are included in this review: 12 were on bacterial hazards (Salmonella, Campylobacter, Staphylococcus, E. coli, Shigella), three on fungal hazards and one on parasitic hazards (Toxoplasma gondii). The overall pooled prevalence of Salmonella spp. was 13% (95% CI: 8–21), the highest in lettuce: 50% (95% CI: 30–70) and the lowest in milk: 1.2% (95% CI: 0–5), demonstrating substantial variation among the studies (I2 = 85, 95% CI: 79–90%, p < 0.01). Campylobacter spp. was reported in chicken carcass, with 50% of the samples being positive. The overall pooled microbial load of Staphylococcus in the studied food samples was 3.2 log (95% CI: 2.8–3.6) CFU per g or ml of food, the highest in poultry samples: 4.5 log (95% CI: 2.8–6.2) CFU per g or ml of food. The overall pooled prevalence of Escherichia coli (E. coli) was 40% (95% CI: 29–51), the highest in beef intestines: 62% (95% CI: 22–91) and the lowest in dairy products: 31% (95% CI: 17–50), showing substantial variation across the studies (I2 = 86, 95% CI: 80–90%, p < 0.01). Conclusion: Our results showed widespread contamination of foods with foodborne hazards across

Background: Foodborne disease (FBD) affects millions of people each year, posing a health burden similar to malaria, tuberculosis or HIV. A recent World Bank study estimated the productivity losses alone attributed to unsafe food within Africa at $20 billion in 2016, and the cost of treating these illnesses at an additional $3.5 billion. Ethiopia faces multiple food safety challenges due to lack of infrastructure and basic pre-requisites for food safety such as clean water and environment, washing facilities, compounded by limited implementation of food safety regulations, and a lack of incentives for producers to improve food safety. A consolidation of our understanding and evidence of the source, nature and scale of FBD in Ethiopia is needed to inform policy and future research. We performed a Systematic Literature Review (SLR) of publications on FBD occurrence in Ethiopia including hazard presence and impact. Method: The SLR followed Cochrane and PRISMA guidelines. We searched PubMed and CAB-Direct for relevant publications between 1990 and 2019 (inclusive). Observational studies and reviews were included. Two reviewers screened titles and abstracts, and retained publications were reviewed in full for quality and data extraction. Result: In total 128 articles met the inclusion criteria. Most articles focused on the identification of biological hazards in food. High levels of microbial contamination in different food value chains were often found in the small, ad hoc, observational studies that dominated the literature. Raw milk (22/128, 17.0%) and raw beef (21/128, 16.4%) were the most studied food products. Foodborne (FB) parasites were often found at higher rates in food than bacterial and viral pathogens, possibly due to differences in ease of identification. High levels of bacterial contamination on the hands of food handlers were widely reported. There were no reports on the incidence of human FBDs or resulting health and economic impacts. Conclusion: Our fi

Antimicrobial use (AMU) is a major driver of antimicrobial resistance (AMR). An understanding of current practices can lead to better targeting of AMU-reducing interventions. An analysis of the distribution and current usage of veterinary drugs in peri-urban smallholder poultry systems in Kenya was undertaken. A survey among poultry farmers and key informant interviews with agrovet operators and other players in the value chain was conducted in Machakos and Kajiado counties. Interview data were analyzed using descriptive and thematic approaches. A total of 100 farmers were interviewed. The majority (58%) were > 50 years old, and all kept chickens, while 66% kept other livestock. Antibiotics constituted 43% of the drugs reportedly used on the farms (n = 706). These were mostly administered by the farmers themselves (86%) through water (98%). Leftover drugs were stored for later use (89%) or disposed of (11%). Incineration was the main method for the disposal of leftover drugs and empty containers. As described by the key informants (n = 17), the drug distribution chain relied on agrovet shops that were supplied by local distributors and pharmaceutical companies, which, in turn, supplied drugs to the farmers. Farmers reportedly purchased drugs without prescriptions and rarely observed the withdrawal periods. Drug quality was a concern, especially for products requiring reconstitution.

The occurrence of aflatoxin M1 (AFM1) in milk has been widely reported in Kenya, with levels freqently exceeding national and international thresholds. Exposure to aflatoxin increases the risk of hepatic cancers and can also have other negative health impacts in children such as growth impairment and immunosuppression. Anti-mycotoxin agents (AMAs) included in contaminated feeds can greatly reduce the amount of AFM1 released in milk. A 45-day trial was designed to assess secretion of AFM1 in milk from individual cows fed commercial Kenyan dairy feed, as well as the efficacy of Novasil (TM) Plus in reducing the levels. A four-by-four Latin square cross-over design was used for the experiment. Four cows were fed on naturally contaminated with AFB1 feed, with levels ranging from 19 to 47 mu g/kg, and either no binder or inclusion of binder at the rate of 0.6 or 1.2%. Milk samples were collected each day and analyzed for AFM1. The results showed that AFM1 levels in the milk varied between the cows, even when fed similar levels of contaminated feed. On average, inclusion of 0.6% binder into the diet resulted in 34% decline in milk AFM1 levels, while 1.2% binder dose resulted in a decline of 45%. Significant reduction in AFM1 secretion was observed in all experimental units (p < 0.005), though only minimal reduction was recorded in one of the units (Cow 4) compared to the other three. This trial shows novel data on aflatoxin exposure and excretion in Kenyan dairy cows in a field setting where AFB1 level is uncontrolled. We demonstrate significant reduction in AFM1 secretion in milk using AMA, though AFM1 levels were still above the recommended EC standard of 50 LATIN SMALL LETTER ENGg/kg. This study suggests that AMAs alone cannot be relied on to reduce AFM1 in milk to safe levels. Training and good feeding practices are recommended in addition to use of AMAs.

BackgroundAntimicrobial resistance (AMR) is a global public health threat. The indiscriminate use of antibiotics in the animal health sector contributes to increasing rates of AMR and studies involving dairy farmers in India have found knowledge levels regarding antibiotics and AMR to be very low. The purpose of this study was to assess different methods to raise awareness and knowledge about AMR and antibiotic use among dairy farmers, paravets (veterinary assistants), and veterinarians. Materials and MethodsThe study was conducted in September-December of 2018 in some parts of Haryana, Assam, Karnataka, and West Bengal. It had two parts: an intervention meeting (September-October 2018) which consisted of focus group discussions (FGD) with farmers, key informant interviews (KII) with veterinary professionals along with distribution of information packages, and then a follow-up survey (November-December 2018). The villages were randomly allocated to either one of the four intervention approaches (1-FGD/KII and information package on AMR; 2-FGD/KI and information on animal health; 3- FGD/KII and information package on animal health plus information on AMR; or 4- only the FGD/KII). A follow-up survey was done to assess the effect of interventions. ResultsIn total, 274 dairy farmers and 51 veterinary professionals (21 veterinarians and 30 paravets) participated in the follow-up survey. Many of the farmers and veterinary professionals who participated in the follow-up survey had been part of the intervention meetings. The average knowledge score of farmers was 7.8. It was found that the knowledge score was higher amongst farmers who had participated in the intervention meetings (p < 0.05), had received intervention approach 2 (p = 0.03) or approach 3 (p = 0.01), and amongst female farmers (p = 0.03) compared to male. The veterinary professionals had good knowledge but lacked interest in training the farmers about antimicrobial resistance. ConclusionOur research demons

Aflatoxins, which commonly contaminate animal feeds and human food, present a major public health challenge in sub-Saharan Africa. After ingestion by cows, aflatoxin B1 is metabolized to aflatoxin M1 (AFM1), some of which is excreted in milk. This study involved smallholder dairy farms in urban and periurban areas of Nairobi and Kisumu, Kenya. The objective was to determine the effectiveness of training and providing farmers with aflatoxin binder (NovaSil(R)) on AFM1 contamination in raw milk. A baseline survey was undertaken and 30 farmers whose milk had AFM1 levels above 20 ppt were randomly selected for inclusion in the study. Of these, 20 farmers were part of the intervention, and were given training on the usage of the NovaSil(R) binder, while 10 served as a control group. All farmers were visited biweekly for three months for interviews and milk samples were collected to measure the AFM1 levels. The AFM1 levels were quantified by enzyme linked immunosorbent assay. The NovaSil(R) binder significantly reduced AFM1 concentrations in the raw milk produced by the farmers in the intervention group over the duration of the study (p < 0.01). The control farms were more likely to have milk with AFM1 levels exceeding the regulatory limit of 50 ppt compared to the intervention farms (p < 0.001) (odds ratio = 6.5). The farmers in the intervention group perceived that there was an improvement in milk yield, and in cow health and appetite. These farmers also felt that the milk they sold, as well as the one they used at home, was safer. In conclusion, the use of binders by dairy farmers can be effective in reducing AFM1 in milk. Further research is needed to understand their effectiveness, especially when used in smallholder settings.

Consumers have a right to safer foods, and traceability is one approach to meeting their expectations. Kenya does not have an operational animal traceability system, and while a few initiatives have been piloted, these have only focused on the beef value chain. In this paper, we begin a discussion on traceability in the pig value chain, with an initial focus on smallholder systems of Western Kenya. First, a background to local pig production is given, and a description of animal identification and traceability options applicable to these systems is explained. Based on this, a "butcher-to-farm" traceability system, with health, production and food safety as objectives, is discussed. Requirements for establishing such a system (including actor incentives) are additionally discussed. The proposed approach can be piloted in the field and findings used to inform the design of a larger pilot and possibly pave way for implementation of a national traceability system, in line with the guidelines provided by the World Organization for Animal Health (OIE). Organized systems in the area (including commercial producer and trader groups) would offer a useful starting point.

Background Antimicrobial resistance (AMR) is a major global public health issue. In India, access to medicines is poorly regulated and therefore antibiotics in dairy cattle are commonly used by farmers without consulting with veterinarians. This study was conducted to understand practices and knowledge related to antibiotic use and AMR among dairy farmers and veterinary professionals in selected urban and peri-urban areas of India. Methods A total of 28 focus group discussions with farmers and 53 interviews with veterinary professionals were carried out. Results Mastitiswas identified as the main animal health challenge. Antibiotic consultation behavior of farmers depended on the availability of veterinarians. Except in Bangalore, farmers were found to often treat animals on their own. They were found unaware of the concept of AMR, but knew the importance of vaccination. Veterinarians included in the study had a good understanding of antibiotics, AMR, and zoonotic diseases. Conclusion The knowledge level and practices observed in the study related to the use/abuse of antibiotics can potentially increase the risk of development of AMR and its transfer in the community. Our findings can help support AMR – mitigation efforts in the country, including the design of better policies on antibiotic use in dairy., Animal and Human health, ILRI

Livestock interventions can improve nutrition, health, and economic well-being of communities. The objectives of this review were to identify and characterize livestock interventions in developing countries and to assess their effectiveness in achieving development outcomes. A scoping review, guided by a search strategy, was conducted. Papers needed to be written in English, published in peer-reviewed journals, and describe interventions in animal health and production. Out of 2739 publications systematically screened at the title, abstract, and full publication levels, 70 met our inclusion criteria and were considered in the study. Eight relatively high-quality papers were identified and added, resulting in 78 reviewed publications. Only 15 studies used randomized controlled trial designs making it possible to confidently link interventions with the resulting outcomes. Eight studies had human nutrition or health as outcomes, 11 focused on disease control, and four were on livestock production. Eight interventions were considered successful, but only four were scalable. We found good evidence that livestock-transfer programs, leveraging livestock products for nutrition, and helping farmers manage priority diseases, can improve human well-being. Our report highlights challenges in garnering evidence for livestock interventions in developing countries and provides suggestions on how to improve the quantity and quality of future evaluations.

Background: Dairy production in Kenya is important and dominated by small-holder farmers who market their produce through small-scale traders in the informal sector. Method: This study aimed to determine the prevalence of aflatoxin (AFM1) in informally marketed milk in peri-urban Nairobi, Kenya, and to assess knowledge of milk traders on aflatoxins using questionnaires. A total of 96 samples were analyzed for AFM1 using enzyme-linked immunosorbent assay. In addition, boiling and fermentation experiments were carried out in the laboratory. Results: All samples had AFM1 above the limit of detection (5 ng/kg) (mean of 290.3 ± 663.4 ng/kg). Two-thirds of the samples had AFM1 levels above 50 ng/kg and 7.5% of the samples exceeded 500 ng/kg. Most of the traders had low (69.8%) or medium (30.2%) knowledge. Educated (p = 0.01) and female traders (p= 0.04) were more knowledgeable. Experimentally, fermenting milk to lala (a traditional fermented drink) and yogurt significantly reduced AFM1 levels (p< 0.01) (71.8% reduction in lala after incubation at room temperature for 15 h, and 73.6% reduction in yogurt after incubation at 45ºC for 4h). Boiling had no effect. Conclusion: The study concluded that the prevalence of raw milk with AFM1 was high, while knowledge was low. Fermentation reduced the AFM1 levels.

Introduction: Milk consumption in Kenya supersedes other countries in East Africa. However, milk contamination with aflatoxin M1 (AFM1) is common, but the magnitude of this exposure and the health risks are poorly understood and need to be monitored routinely. This study aimed at assessing the awareness, knowledge and practices of urban and peri-urban farmers about aflatoxins and determining the levels of aflatoxin contamination in on-farm milk in a selected area within Nairobi County. Materials and methods: A cross-sectional study was undertaken to assess aflatoxin contamination levels of milk in Kasarani sub-county. A total of 84 milk samples were collected from small-holder dairy farms and analyzed for AFM1 using Enzyme-Linked Immunosorbent Assay (ELISA). Results and Discussion: Ninety nine percent of the samples (83/84) analysed were contaminated with AFM1. The mean aflatoxin level was 84 ng/kg with 64% of the samples exceeding the EU legal limit of 50 ng/kg. Whereas 80% of the farmers were aware of aflatoxin, there was no correlation between farmers' knowledge and gender with AFM1 prevalence. Conclusion: This study concludes that AFM1 is a frequent contaminant in milk and there is need to enhance farmers awareness on mitigation.

Non-PR, IFPRI1; CRP4, MTID; A4NH, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Aflatoxin is a poisonous substance produced by a fungus, Aspergillus flavus, that occurs naturally in soils of cultivated and non-cultivated areas. The fungus commonly produces the toxin in maize, groundnut, and other staple grains and vegetables, and is especially prevalent in Africa. When animals consume feed contaminated with aflatoxin, milk and (at very low levels) meat, fish and eggs, can also be contam-inated. This note brings together recent research from the CGIAR and others on technologies for aflatoxin control in Africa and provides recommendations for catalyzing their adoption.

Non-PR, IFPRI1; CRP4, MTID; A4NH, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Aflatoxin is a poisonous substance produced by a fungus, Aspergillus flavus, that occurs naturally in soils of cultivated and non-cultivated areas. The fungus commonly produces the toxin in maize, groundnut, and other staple grains and vegetables, and is especially prevalent in Africa. When animals consume feed contaminated with aflatoxin, milk and (at very low levels) meat, fish and eggs, can also be contam-inated. This note brings together recent research from the CGIAR and others on technologies for aflatoxin control in Africa and provides recommendations for catalyzing their adoption.

Background: Food safety is of increasing global concern, and a OneHealth issue requiring attention of many disciplines. Aflatoxins are toxins produced by fungi and found in foods and feeds, and exposure causes negative health effects in humans and animals. When lactating animals consume aflatoxin B1, the metabolite (AFM1) is transferred to milk.Methods: A cross-sectional study was designed to determine characteristics of smallholder dairy farming in urban and peri-urban areas of Kisumu and quantify AFM1 in milk. Data was collected from 97 randomly selected dairy farms on farming practices, milk production, and awareness about aflatoxins. Collected milk samples were analyzed using enzyme-linked immunosorbent assay for AFM1.Results: Average milk produced was 13 liters per day per household and mainly used for household consumption and sold to neighbours. Farmers mainly fed cows on forage and concentrates (62.9%). Levels of AFM1 ranged from below the detection limit to 151 ppt, with a mean of 29.67 p...