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

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

Sapp, Amanda C. (University of Florida; Abrams Public Health Center, Tucson)
Nane, G.F. (TU Delft Applied Probability)
Amaya, Mirna P. (University of Florida)
Niyonzima, Eugène (University of Rwanda)
Hategekimana, Jean Paul (University of Rwanda)
VanSickle, John J. (University of Florida)
Gordon, Ronald M. (University of Florida)
Havelaar, Arie H. (University of Florida)

2023

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.

Brucella
Campylobacter
Cryptosporidium
Dairy
Disability-adjusted life years
Disease burden
Incidence
Mortality
Mycobacterium bovis
Risk assessment
Rwanda
Salmonella

http://resolver.tudelft.nl/uuid:8cefc53f-4228-4380-a703-a1ca89aa44df

https://doi.org/10.1186/s12889-023-15204-x

BMC Public Health, 23 (1), 657

Institutional Repository

journal article

© 2023 Amanda C. Sapp, G.F. Nane, Mirna P. Amaya, Eugène Niyonzima, Jean Paul Hategekimana, John J. VanSickle, Ronald M. Gordon, Arie H. Havelaar