A quantitative risk assessment of humans exposure to brucellosis through the consumption of raw cow milk in Arusha, Tanzania.

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Ndaki, Magoke, Enock
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The University of Zambia
Brucellosis is a zoonotic disease that exists worldwide and is endemic in most sub-Saharan African countries. World Health Organisation has named Brucellosis among the neglected diseases. The disease causes substantial morbidity among humans and their livestock. Although it has a low mortality rate, the disease causes a heavy burden on public health and animal health. The study aimed to assess the risk of exposure to various Brucella species through cow milk consumption in the Arusha region, Tanzania. This was a two-tier study; the first study was a cross-sectional descriptive survey involving the collection of primary data related to milk consumption. The second part was a risk modelling study based on the Codex Alimentarius commission framework and utilised data from the consumption survey and secondary data from the literature search. Both questionnaire surveys and data from previous studies were used to collect information for the input variables in the risk model. The obtained data were entered into IBM SPSS version 20, and descriptive statistics on average serving portions and consumption patterns were analysed. Stochastic Monte Carlo simulation in @risk software (version 8.1) platform was used for risk assessment. Results revealed that 96.5% of the population consumes milk in three (3) serving portions in three serving time i.e., morning, afternoon and night, while 73% of the people in the area consume 500ml-1000ml of milk per day. People in the rural setting (about 71%) reported consuming raw milk, while 10% of people in the town setting reported consuming raw milk. The results from the model described the probability of getting infected with Brucella through the consumption of raw milk was estimated at 0.64 (95%CI 0.333-0.861). The model also predicted the number of people likely to get infected with Brucella in the Arusha region in a one-year consumption period to be 1,084,358 (95%CI: 565,000-1458,000) out of 1,694,310 people following consumption of raw milk. The risk of exposure was estimated to be high when dairy cows were infected with Brucella at the farm and when the milk portions were consumed raw. To reduce the risk of human exposure, there is a need to create awareness about Brucellosis in these communities concerning how the disease is transmitted to humans, its associated effects, and the preventive and control measures. Further studies are required to assess the risk of exposure to Brucella species through other pathways such as soft cheese consumption and contact with tissues of infected cattle. The information in this study will help provide guidance in decision-making among stakeholders and the policymakers on control of Brucellosis.
Brucellosis in humans and cattle , Brucellosis in cattle. , Brucellosis in cattle--Diagnosis. , Brucellosis in cattle--Control.