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OBJECTIVE: Research is often lacking in low-income countries to substantiate the regulation of antibiotics in poultry production. Nonregulation of antibiotics in food animal industries has implications for human health. This study was conducted to provide an understanding of farmers' knowledge, attitudes, and practices regarding the use of antibiotics in poultry production in Grenada. METHOD: A cross-sectional study was conducted in August-September, 2016, surveying 30 poultry farmers each having 500 or more chickens grown for commercial purposes. RESULTS: More than 1000 birds were kept on 18 (60.0%) farms. Antibiotics were used on the majority of farms (25, 83.3%). More than half of the respondents, 19 (63.3%), stated they were only somewhat aware of issues related to the use of antibiotics and the majority, 21 (70.0%), were also unable to define antimicrobial resistance. There was inconsistency in the farmers' knowledge about how and when to use antibiotics. There was also a high level of noncompliance with manufacturers' recommendations for use of antibiotics. The respondents were not aware of local programs to monitor antibiotic use or manage antibiotic resistance in the poultry industry. CONCLUSION: Generally, the farmers' knowledge and practices were inconsistent with recommendations by the World Health Organization for antibiotic stewardship. While low-income countries, such as Grenada, are challenged with the lack of resources to undertake research and implement responsive actions, this research highlights the need for some immediate measures of remedy, such as education of farmers and monitoring procurement and use of antibiotics, to reduce risk to public health.
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Jamaica is the third largest island in the Caribbean. The epidemiology of acute gastroenteritis (AGE) is important to Jamaica, particularly in the areas of health, tourism, and because of the potential impact on the local workforce and the economy. Data collected by the National Surveillance Unit on the prevalence of AGE transmitted by food are not accurate. To determine the true magnitude, risk factors, and the extent of underreporting of AGE in Jamaica, we conducted a cross-sectional, population-based retrospective survey during the periods of 21 February-7 March and 14-27 June 2009, corresponding to high- and low-AGE season respectively. Of the total 1,920 persons selected randomly by a multistage cluster-sampling process, 1,264 responded (response rate 65.8%). Trained interviewers administered a standardized, validated questionnaire during face-to-face interviews. The overall prevalence of self-reported AGE was 4.0% (95% CI 2.9-5.1) at a rate of 0.5 episodes/per person-year. The highest monthly prevalence of AGE (14.6%) was found among the 1-4 year(s) age-group and the lowest (2.1%) among the 25-44 years age-group. Of the 18 cases (36%) who sought medical care, 11% were hospitalized, 33% were treated with antibiotics, and 66.7% received oral rehydration fluids. Only 2 cases who sought medical care reportedly submitted stool specimens. The mean duration of diarrhoea was 3.1 days, which resulted in a mean loss of 4 productive days, with over half of the cases requiring someone to care for them. The burden of syndromic AGE for 2009 was extrapolated to be 122,711 cases, showing an underreporting factor of 58.9. For every laboratory-confirmed AGE case, it was estimated that 383 more cases were occurring in the population. This research confirms that the prevalence of AGE is underreported in Jamaica and not being adequately detected by the current surveillance system. The components of the integrated surveillance system for AGE in Jamaica, particularly the laboratory aspect, need to be strengthened.
Assuntos
Efeitos Psicossociais da Doença , Gastroenterite/economia , Gastroenterite/epidemiologia , Doença Aguda , Adolescente , Adulto , Distribuição por Idade , Idoso , Causalidade , Criança , Pré-Escolar , Análise por Conglomerados , Comorbidade , Estudos Transversais , Diarreia/economia , Diarreia/epidemiologia , Feminino , Doenças Transmitidas por Alimentos/economia , Doenças Transmitidas por Alimentos/epidemiologia , Humanos , Lactente , Entrevistas como Assunto/métodos , Jamaica/epidemiologia , Masculino , Pessoa de Meia-Idade , Vigilância da População/métodos , Prevalência , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Distribuição por Sexo , Adulto JovemRESUMO
BACKGROUND: Tourism is an important earner of foreign exchange in Jamaica; hence, the protection of the visitors' health is very important. A study of travelers to Jamaica in 1996 to 1997 found that travelers' diarrhea (TD) affected almost 25% of visitors. The Ministry of Health (Jamaica) initiated a program for the prevention and control of TD aimed at reducing attack rates from 25.0% to 12.0% over a 5-year period through environmental health and food safety standards of hotels. This article examines the food safety systems in Jamaican hotels located in a popular resort area to find out how comparable they are with the Hazard Analysis Critical Control Point (HACCP) strategy. METHODS: A cross-sectional study was done of hotels in St. Mary and St. Ann. Quantitative data were obtained from food and beverage/sanitation staff and qualitative data through in-depth interviews with hotel managers. Observation of the food safety operations was also done. RESULTS: The majority (75%) of larger hotels used a combination of HACCP and Ministry of Health food safety strategies (p = 0.02) and offered all-inclusive services (r =-0.705, p = 0.001). Larger hotels were more likely to have a better quality team approach, HACCP plan, and monitoring of critical control points (CCPs) and more likely to receive higher scores (p < 0.05). More than two thirds of hotel staff were knowledgeable of HACCP. Significantly smaller hotels (87.5%) received less than 70% in overall score (r = 0.75, p = 0.01). Identification of CCPs and monitoring of CCPs explained 96.6% of the change in the overall HACCP scores (p = 0.001). Hotel managers felt that some hotels' systems were comparable with HACCP and that larger properties were ready for mandatory implementation. Conclusions. While some components of the HACCP system were observed in larger hotels, there were serious shortcomings in its comparison. Mandatory implementation of HACCP would require that sector-specific policies be developed for smaller hotels and implemented on a phased basis.