Epidemiology of multidrug-resistant zoonotic E. coli from beef processing and retail points in Delta State, Nigeria: Public health implications

Some sorbitol non-fermenting E. coli (SN-F E. coli) and all E. coli O157 are zoonotic. Contamination of beef with zoonotic E. coli at the processing or retail point is a significant public health problem. Despite the public health importance of these organisms, there is no published data on the prevalence and antimicrobial resistance (AMR) of zoonotic E. coli from Delta State, Nigeria. Consequently, this study determined the prevalence and AMR of SN-F E. coli and E. coli O157 isolates from meat contact surfaces at the processing and retail points in the study area. The isolation, biochemical and serological characterisations and AMR status of the isolates were performed following standard microbiological methods. Overall prevalence of SN-F E. coli and E. coli O157 were 13.8% (56/406) and 1.5% (6/406), respectively. Majority of the 56 SN-F E. coli (64.3%, 36/56) and all the six E. coli O157 (10.7%, 6/56) detected in this study were found at the meat processing points. Most of the SN-F E. coli were isolated at the slaughterhouse floor (31%), meat hooks (17.2%) and meat sellers' knives (17.2%). The SN-F E. coli exhibited greater AMR to ampicillin (67.9%), gentamycin (64.3%) and tetracycline (50%) than other antimicrobial agents tested. No isolate was resistant to aztreonam. All six E. coli O157 isolates were resistant to enrofloxacin. Overall, 23 AMR patterns, comprised 14 from meat processing points and nine from meat retailing points, were observed from the 56 antimicrobial-resistant SN-F E. coli isolates. All the six E. coli O157 and 73.2% (41/56) of the SN-F E. coli isolates were multidrug-resistant. An overall mean multiple antimicrobial resistance index of 0.6 was recorded. Multidrug-resistant zoonotic E. coli were detected at meat processing and retail points in Delta State, Nigeria. The findings warrant the adoption of One Health control approach, "farm to fork" principle of food safety and prudent use of antimicrobial agents in animal agriculture. These may help to limit beef contamination with multidrug-resistant zoonotic E. coli at the processing and retailing points, for public health safety.

Detection of multidrug-resistant Campylobacter species from food-producing animals and humans in Nigeria: Public health implications and one health control measures

Antimicrobial-resistant thermophilic Campylobacter species (TCS) pose tremendous public health problems because they are zoonotic, difficult to treat and usually harboured by food-producing animals (FPAs). This study ascertained the phenotypic antimicrobial resistance (AMR) in 56 phenotypically identified TCS from slaughtered cattle, poultry, and humans in Enugu State, Nigeria. The presence of selected AMR and virulence genes harboured by the animal and human isolates were also detected and compared in 36 PCR-confirmed Campylobacter species. All the 56 TCS were multidrug-resistant as none were susceptible to ampicillin, penicillin-G, amoxicillin-clavulanic acid, cephalothin and metronidazole. The isolates were 92.9 %, 62.5 %, 92.9 %, 42.9 %, 26.8 %, 25 %, 28.6 %, 53.7 %, 30.1 %, 32.1 % and 55.4 % resistant to ceftriaxone, nalidixic acid, cefotaxime, enrofloxacin, ciprofloxacin, streptomycin, gentamycin, erythromycin, azithromycin, chloramphenicol and tetracycline, respectively. The top four most effective classes of antimicrobials were aminoglycosides > macrolides > amphenicol > fluoroquinolones. The AMR genes detected and the percentage of the isolates that harboured them were: aadE-1 (33.3 %), aphA-3-1 (36.1 %), tetO (44.4%), Blaoxa-61 (61.1 %) and the multidrug efflux pump, cmeB (86.1%). Virulence genes detected and the corresponding percentage of TCS that harboured them were: cdtB (61.1 %), flaA (47.2 %), ciaB (38.9 %), and pldA (38.9 %). The cmeB was significantly detected in animal isolates (p = 0.018, OR = 5.1, CI = 0.7-6.6) while BlaOXA-61 predominated in human isolates (p = 0.019, OR = 6.2). Likewise, ciaB virulence gene was mostly detected (p = 0.019, OR = 6.4, CI = 1.3-25) in animal isolates. The findings underscore the roles of FPAs in the zoonotic dissemination of Campylobacter-associated AMR and virulence genes in the study area. This warrants the adoption of One Health control strategies to limit spread of the multidrug-resistant zoonotic Campylobacter species.

Mpox in Nigeria: Perceptions and knowledge of the disease among critical stakeholders-Global public health consequences

BACKGROUND

The mpox (monkeypox) disease is a re-emerging viral zoonosis of international concern that is endemic in parts of Africa. The mpox virus (MPXV), which was hitherto largely limited to some Central and West African countries, was declared a public health emergency of international concern by the WHO on July 23, 2022 following the rapid spread of the virus to non-endemic countries. Globally, as of March 16, 2023, the WHO had reported 86,496 laboratory-confirmed cases of mpox and 111 deaths in 110 countries. Of the 1,420 cases of mpox reported in Africa as of March 16, 2023, Nigeria alone recorded 57.1% (812) of the confirmed cases and eight fatalities recorded in the continent. To help improve on the understanding of the current situation in Nigeria, the present study assessed the perception and knowledge of mpox among Nigerian healthcare workers, academics and tertiary students. The study also sought to highlight the global public health significance of the MPXV, and recommend a One Health approach to limit exporting of the virus beyond the borders of Nigeria.

METHODS

A web-based cross-sectional survey was conducted between 24 July 2022 and 12 August 2022 to evaluate the perception and knowledge of mpox among 1544 Nigerians, consisted of healthcare workers (n = 832), academics (n = 306) and tertiary students (n = 462). Data on the respondents' socio demographics and their information sources on mpox were also collected. Each correct response was allotted one point while an incorrect response was scored zero. The scores for perception and knowledge were dichotomized into positive (>5.5) and negative (≤5.5) and adequate (>5.8) and inadequate (≤5.8), respectively; using the average scores for perception and knowledge. The average score for perception and knowledge were summarised and presented as the mean and standard deviation (SD). Chi-square tests of association and binary logistic regression were carried out to determine factors associated with the outcome variables.

RESULTS

Of the 1452 respondents that had heard of mpox, 878 (60.5%) and 419 (28.9%) had adequate knowledge and positive perception concerning MPXV infection respectively. Average perception score was 5.5. Mean perception and knowledge scores were 4.5(SD: 2.0) and 5.8 (SD: 1.9), respectively. Factors that were significantly associated with knowledge level were age (p = 0.020) educational qualification attained (p = 0.004), occupation (p<0.001), and geopolitical zone of residency (p = 0.001). There was a positive correlation between perception and knowledge scores (r = 0.4, p<0.001). Positive perceptions were likely among respondents who had tertiary education, and residing in North-west Nigeria. Likewise, adequate knowledge scores were likely among respondents under 30 years of age, with tertiary education or reside in North-west Nigeria. Sources of information were significantly associated with perception (p = 0.004) and knowledge (p<0.001) of the respondents.

CONCLUSION

The findings of this study show that there is disparity in the knowledge and perception of mpox in the study population, and as a result, there is a need to intensify awareness about MPXV infection to enhance positive perception among the respondents. This has potential to safeguard public health and contain the disease thus preventing it from spreading to the global community. A One Health approach involving animal and human health workers is imperative for improved knowledge and a good perception towards the disease among respondents, and enhanced active surveillance and early detection of MPXV in reservoir hosts (rodents and non-human primates); to prevent reverse zoonotic transmission of the virus at the human-animal interface.

Indiscriminate slaughter of pregnant goats for meat in Enugu, Nigeria: Causes, prevalence, implications and ways-out

BACKGROUND

The indiscriminate slaughter of pregnant goats (SPGs) undermines meat production and food security especially in developing countries. It also connotes animal cruelty, depletion of goat population and may enhance the spread of zoonotic pathogens inhabiting the female reproductive tract during carcass processing. Consequently, this study determined the causes and prevalence of slaughtering pregnant goats for meat in Enugu, Nigeria. The study also estimated the economic losses associated with SPGs, discussed the negative public health consequences and suggested the ways-out.

METHODS

Structured, validated and pilot-tested questionnaire was used to ascertain the reasons for SPGs for meat among 78 willing and randomly selected respondents. The questionnaire survey was conducted in the form of interview. Pregnancy statuses of the goats slaughtered were ascertained by visual inspection and palpation of the eviscerated and longitudinally incised uteri and the horns for macroscopic evidence of pregnancy. Ages of the dams were estimated by dentition method. Estimation of the gestational age was performed by crown-rump length method. The study lasted for six months, comprised of three months (December to March) during the dry/hot season and another three months (May to August) during the wet/rainy season. Economic loss estimation was based on the current monetary values of a matured (30 kilogram) goat and one kilogram of chevon in Enugu, Nigeria; which was determined through market survey. Pearson's Chi-square test was used to determine whether there were significant (P<0.05) statistical associations between SPGs and age and season.

RESULTS

Major reasons adduced for SPGs were: economic hardship (41%), ignorance of the goat's pregnancy status (21%), increased demand for chevon (13%) and feed scarcity during drought (11%). Of the 1,658 does examined during the six months study, 589 (35.5%) were pregnant. The majority (876/1658, 52.8%) of the female goats slaughtered were in their active reproductive age of ≤ 4 years, while 782 (47.2%) were aged > 4 years. Similarly, majority (1007/1658, 60.7%) of the does/nannies were slaughtered during the dry/hot season. A total of 907 foetuses at first (n = 332, 36.6%), second (n = 486, 53.6%) and third (n = 89, 9.8%) trimesters of gestation were recovered from the 589 PGs. Singleton, twin and triplet pregnancies were observed in 312 (53%), 236 (40%) and 41 (7%) PGs, respectively. About ₦34.44 million ($83,390) would have been earned if the foetuses were born alive and raised to maturity. Additionally, 19,136 kg of chevon, valued at ₦47,841, 000 ($115,838), which would have accrued from the wasted foetuses was also lost.

CONCLUSION

Considering the economic, zoonotic and livestock production implications of this work, frantic efforts to reduce SPGs in Enugu, Nigeria is imperative. This could be achieved through advocacy, goat farmers' enlightenment, ante-mortem pregnancy diagnosis, provision of subsidized feed materials during the dry season and strict enforcement of the Nigerian Meat Edict law, which proscribes unapproved slaughter of gravid animals. These measures may improve food safety and security, improve goat reproduction and production, reduce protein malnutrition, limit dissemination of zoonotic pathogens during carcass processing and hence protect public health in Nigeria.

Pre-slaughter, slaughter and post-slaughter practices of slaughterhouse workers in Southeast, Nigeria: Animal welfare, meat quality, food safety and public health implications

BACKGROUND

Pre-slaughter stress or the welfare condition of food-producing animals (FPAs) and the slaughter practices of slaughterhouse workers (SHWs) are critically important for the safety and quality of meats processed in slaughterhouses (SHs). Consequently, this study determined the pre-slaughter, slaughter, and post-slaughter (PSP) practices of SHWsin four SHs in Southeast, Nigeria; and discussed the impacts on meat quality and safety.

METHODS

The PSP practices were determined by observation method. Additionally, a structured and validated closed-ended questionnaire was used to determine the knowledge of the SHWs on: the effects of poor welfare (preslaughter stress) on the quality and safety of meats produced, carcass/meat processing practices and modes of transmission of meat-borne zoonotic pathogens during carcass/meat processing. Finally, a systematic post-mortem inspection (PMI) was conducted on cattle, pigs and goats slaughtered, and economic losses accruable from condemned carcasses/meats were estimated.

RESULTS

Food-producing animals were transported to the SHs or held in the lairage under inhumane conditions. A pig being conveyed to one of the SHs was seen gasping for air, as it was firmly tied on motorbike at the thoracic and abdominal regions. Fatigued cattle were forcefully dragged on the ground from the lairage to the killing floor. Cattle for slaughter were restrained, held in lateral recumbency and left groaning, due to extreme discomfort, for about one hour before slaughter. Stunning was not performed. Singed pig carcasses were dragged on the ground to the washing point. Although more than 50% of the respondents knew the modes of transmission of meat-borne zoonotic pathogens during meat processing, 71.3% of the SHWs processed carcasses on bare floor, 52.2% used same bowl of water to wash multiple carcasses while 72% did not wear personal protective equipment during meat/carcass processing. Processed meats were transported to meat shops in an unsanitary conditions, using open vans and tricycles. During the PMI, diseased carcasses/meats/organs were detected in 5.7% (83/1452), 2.1% (21/1006) and 0.8% (7/924) of the cattle, pig and goat carcasses inspected, respectively. Gross lesions pathognomonic of bovine tuberculosis, contagious bovine pleuro-pneumonia, fascioliasis and porcine cysticercosis were detected. Consequently, 391,089.2 kg of diseased meat/organs valued at 978 million Naira (235, 030 USD) were condemned. There were significant associations (p < 0.05) between educational level and the use of personal protective equipment (PPE) during slaughterhouse operations and knowledge that FPAs can harbour zoonotic pathogens (p = < 0.001) transmissible during carcass processing. Similarly, significant association was observed between working experience and use of PPE; and between geographical location of the respondents and knowledge that zoonotic pathogens in animals are transmissible during carcass processing or via the food chain.

CONCLUSION

The findings show that slaughter practices of SHWs have detrimental impacts on the quality and safety of meats processed for human consumption in Southeast, Nigeria. These findings underscore the need to: improve the welfare condition of slaughter-animals, mechanise abattoir operations, train and retrain the SHWs on hygienic carcass/meat processing practices. There is a need to adopt strict enforcement of food safety laws to promote meat quality, food safety and consequently promote the health of the public.

Persisting Vaccine Hesitancy in Africa: The Whys, Global Public Health Consequences and Ways-Out-COVID-19 Vaccination Acceptance Rates as Case-in-Point

Vaccine hesitancy (VH) is the seventh among the WHO's top 10 threats to global public health, which has continued to perpetuate the transmission of vaccine preventable diseases (VPDs) in Africa. Consequently, this paper systematically reviewed COVID-19 vaccine acceptance rates (VARs)-including the vaccine uptake and vaccination intention-in Africa from 2020 to 2022, compared the rates within the five African regions and determined the context-specific causes of VH in Africa. Generally, COVID-19 VARs ranged from 21.0% to 97.9% and 8.2% to 92.0% with mean rates of 59.8 ± 3.8% and 58.0 ± 2.4% in 2021 and 2022, respectively. Southern and eastern African regions had the top two VARs of 83.5 ± 6.3% and 68.9 ± 6.6% in 2021, and 64.2 ± 4.6% and 61.2 ± 5.1% in 2022, respectively. Based on population types, healthcare workers had a marginal increase in their mean COVID-19 VARs from 55.5 ± 5.6% in 2021 to 60.8 ± 5.3% in 2022. In other populations, the mean VARs decreased from 62.7 ± 5.2% in 2021 to 54.5 ± 4% in 2022. As of 25 October 2022, Africa lags behind the world with only 24% full COVID-19 vaccinations compared to 84%, 79% and 63% reported, respectively, in the Australian continent, upper-middle-income countries and globally. Apart from the problems of confidence, complacency, convenience, communications and context, the context-specific factors driving COVID-19 VH in Africa are global COVID-19 vaccine inequality, lack of vaccine production/maintenance facilities, insecurity, high illiteracy level, endemic corruption, mistrust in some political leaders, the spreading of unconfirmed anti-vaccination rumors and political instability. With an overall mean COVID-19 acceptance rate of 58%, VH still subsists in Africa. The low VARs in Africa have detrimental global public health implications, as it could facilitate the emergence of immune invading SARS-CoV-2 variants of concern, which may spread globally. Consequently, there is a need to confront these challenges frontally and engage traditional and religious leaders in the fight against VH in Africa, to restore public trust in the safety and efficacy of vaccines generally. As the availability of COVID-19 vaccines improves, the vaccination of pets and zoo-animals from which reverse zoonotic transmission of SARS-CoV-2 have been reported is recommended, to limit the evolution and spread of new variants of concern and avert possible SARS-CoV-2 epizootic or panzootic diseases in susceptible animal species.

COVID-19 Vaccine Hesitancy and Determinants of Acceptance among Healthcare Workers, Academics and Tertiary Students in Nigeria

The COVID-19 pandemic has resulted in millions of human deaths, prompting the rapid development and regulatory approval of several vaccines. Although Nigeria implemented a COVID-19 vaccination program on 15 March 2021, low vaccine acceptance remains a major challenge. To provide insight on factors associated with COVID-19 vaccine hesitancy (VH), we conducted a national survey among healthcare workers, academics, and tertiary students, between 1 September 2021 and 31 December 2021. We fitted a logistic regression model to the data and examined factors associated with VH to support targeted health awareness campaigns to address public concerns and improve vaccination rates on par with global efforts. A total of 1525 respondents took part in the survey, composed of healthcare-workers (24.5%, 373/1525), academics (26.9%, 410/1525), and students (48.7%, 742/1525). Only 29% (446/1525) of the respondents were vaccinated at the time of this study. Of the 446 vaccinated respondents, 35.7% (159/446), 61.4% (274/446) and 2.9% (13/446) had one, two and three or more doses, respectively. Reasons for VH included: difficulty in the vaccination request/registration protocols (21.3%, 633/1079); bad feelings towards the vaccines due to negative social media reports/rumours (21.3%, 633/1079); personal ideology/religious beliefs against vaccination (16.7%, 495/1079); and poor confidence that preventive measures were enough to protect against COVID-19 (11%, 323/1079). Some health concerns that deterred unvaccinated respondents were: innate immunity issues (27.7%, 345/1079); allergic reaction concerns (24.6%, 307/1079); and blood clot problems in women (21.4%, 266/1079). In the multivariable model, location of respondents/geopolitical zones, level of education, testing for COVID-19, occupation/job description and religion were significantly associated with VH. Findings from this study underscore the need for targeted awareness creation to increase COVID-19 vaccination coverage in Nigeria and elsewhere. Besides professionals, similar studies are recommended in the general population to develop appropriate public health interventions to improve COVID-19 vaccine uptake.