Occurrence of food-borne diseases among patients presenting at a health facility in the O.R. Tambo District, Eastern Cape Province, South Africa

Abstract

Outbreaks of food-borne disease (FBDs) are frequent in South Africa. However, although notifiable, they are poorly investigated and not often reported. Consequently, there is limited understanding of the burden of FBDs within the rural areas of South Africa. The aim of this study was to investigate the occurrence of FBDs among patients patronising a government facility in the Eastern Cape province for the period 2016 – 2020. A cross-sectional study design using retrospective quantitative data was adopted for this study. All data of patients who were treated for FBD-related illnesses over the study period were included in the study. Data was analysed using descriptive statistics and multivariate analysis. The Statistical Package STATA (Stata/MP 18) was used to analyse the data. Significance was assessed at P <0.05. Most cases of FBDs were caused by consuming meat from cattle that had been injected with medicine (42%, n=176), followed by eating meat from dead cattle (26.25%, n= 110), cattle bitten by snakes (12.89%, n=54), chicken served at school (6.44%, n=27), and meat from dead sheep (4.30%, n= 18). A spike in the number of cases of FBDs was observed between January and June in 2016, 2018 and 2020. Throughout the study period except for 2017 and 2019, the lowest number of cases of FBDs was observed between July and December. Comorbidities like diabetes, TB, and HIV positive, plus pregnancy were associated with severe FBDs leading to increased probability of being admitted. The study highlighted the necessity for educating rural people about the dangers of food of animal origin and the role of comorbidities on the burden of FBDs on health care provision. Results reported here can guide policies that could help reduce the burden of FBDs on the health care system in rural South Africa. A one health approach that includes members of the veterinary team, medical personnel, local leaders and environmental health officers is needed to design and develop intervention strategies and education programmes. Keywords: Food of animal origin, FBDs, food

Die uitbreking van voedsel-oordraagbare siektes kom algemeen in Suid-Afrika voor. Hoewel dit egter aanmeldbaar is, word die siektes nie genoegsaam ondersoek nie en ook dikwels nie gerapporteer nie. Gevolglik is daar ’n beperkte begrip van die las van voedsel oordraagbare siektes in die landelike gebiede van Suid-Afrika. Die doel van hierdie studie was om die voorkoms van voedsel-oordraagbare siektes onder pasiënte in ’n regeringsfasiliteit in die Oos-Kaap-provinsie vir die tydperk 2016 tot 2020 te ondersoek. ’n Deursneestudie-ontwerp met die gebruik van terugwerkende kwantitatiewe data is aangeneem vir hierdie studie. Alle data van pasiënte wat vir voedsel oordraagbaarverwante siektes oor die studietydperk behandel is, is ingesluit in die studie. Die meeste gevalle van voedsel oordraagbare siektes is veroorsaak deur die inname van vleis van vee wat deur medisyne ingespuit is (42%, n=176), gevolg deur die inname van die vleis van dooie vee (26.25%, n=110), vee wat deur slange gebyt is (12.89%, n=54), hoenders wat by skole bedien is (6.44%, n=27) en vleis van skape wat gevrek het (4.30%, n=18). Daar is tussen Januarie en Junie in 2016, 2018 en 2020 ’n styging waargeneem in die getal gevalle van voedsel-oordraagbare siektes. Dwarsdeur die studietydperk, behalwe vir 2017 en 2019, is die laagste getal gevalle van voedsel-oordraagbare siektes waargeneem tussen Julie en Desember. Siektetoestande soos diabetes, TB en HIV/Vigs is geassosieer met erge voedsel-oordraagbare siektes wat gelei het tot ’n styging in die waarskynlikheid om opgeneem te word. Die studie het die noodsaaklikheid beklemtoon om mense van die platteland op te voed oor die gevare van voedsel van diere-oorsprong en die rol van siektetoestande wat betref die druk van voedsel-oordraagbare siektes op gesondheidsorgvoorsiening. Die resultate wat hier gegee word kan beleide rig wat kan help om die druk van voedsel oordraagbare siektes op die gesondheidsorgstelsel in landelike Suid-Afrika te verminder. ’n Een gesondheidbenadering wat lede van die veeartsenyspan, mediese personeel, plaaslike leiers en omgewingsgesondheidsamptenare insluit, is nodig om ingrypingstrategieë en opvoedingsprogramme te ontwerp en te ontwikkel.

Ukuqhambuka kwezifo ezithwalwa kukutya (FBDs) kuxhaphakile eMzantsi Afrika. Nangona kunjalo, noxa ziqapheleka, aziphandwa ngokwaneleyo kwaye akusoloko kunikwa ngxelo ngazo. Ngenxa yoko, kukho ukusilela kokuwuqonda umthwalo weeFBD kwiindawo ezisemaphandleni eMzantsi Afrika. Injongo yolu phando yaba kukuphonononga ukuvela kweeFBD phakathi kwezigulana eziquqa kwiziko likarhulumente kwiphondo leMpuma Koloni kwisithuba sonyaka ka2016 – 2020. Kolu phando kwakhethwa uyilo lophando olugxile kwindawo ethile kusetyenziswa iinkcukacha zophando/idatha zentyilobungakanani yeziganeko ezadlulayo. Zonke inkcukacha zezigulana ezanyangelwa izigulo ezinxulumene neFBD ngexesha lophando ziye zabandakanywa kolu phando. Iinkcukacha zophando zihlalutywe ngokusebenzisa iinkcukachamanani ezichazayo kunye nohlalutyo lwezinto ezininzi ezixubileyo (multivariate). Uninzi lweziganeko zeFBD zabangelwa kukutya inyama yeenkomo ezazitofwe ngeyeza (42%, n = 176), zilandelwe ziziganeko zokutya inyama yeenkomo ezifileyo (26.25%, n= 110), inyama yenkomo elunywe yinyoka (12.89%, n=54), inyama yenkuku ephakwa esikolweni (6.44%, n=27), nenyama yegusha ezifileyo (4.30%, n= 18). Ukunyuka kwamanani kwaqapheleka phakathi kwenyanga kaJanyuwari noJuni ngonyaka ka2016, 2018 no2020. Kulo lonke eli xesha lophando ngaphandle konyaka ka2017 no2019, kwaqatshelwa elona nani liphantsi leziganeko zeFBD phakathi kukaJulayi noDisemba. Izigulo ezihambelanayo (comorbidities) ezinjengeswekile, iTB neHIV kunye nokukhulelwa zaba zizo ezanxulunyaniswa neFBD enobungozi nto leyo eyakhokelela ekwandeni kwamathuba okulaliswa. Olu phando lubalule imfuneko yokufundiswa kwabantu basemaphandleni ngobungozi bokutya okumvelaphi yako zizilwanyana kunye nenxaxheba yezigulo ezihambelanayokumthwalo weeFBD ekuhanjisweni kweenkozo zempilo. Iziphumo ezichazwe apha zingasisikhokelo kwimigaqonkqubo enokuncedisa ekunciphiseni umthwalo kwinkqubo yokukhathalelo lwezempilo kuMzantsi Afrika onendawo ezisemaphandleni. Indlela enye yezempilo ebandakanya amalungu eqela lonyango lwezilwanyana, abasebenzi kwezempilo, iinkokheli zokuhlala, amagosa ezempilo kwezokusingqongileyo iyafuneka ukuze iyile kwaye iphuhlise izicwangcisoqhinga zongenelelo neenkqubo zemfundo.

Ho qhoma ha mafu a bakwang ke dijo (di-FBD) ho etsahala kgafetsa Afrika Borwa. Leha ho le jwalo, le hoja a tsejwa, ha a batlisiswe hantle mme ha a tlalehwe hangata. Ka lebaka leo, ho na le kutlwisiso e fokolang ya boima ba di-FBD ka hara dibaka tsa mahaeng tsa Afrika Borwa. Sepheo sa phuputso ena ke ho batlisisa ho ba teng ha di-FBD hara bakudi ba yang kgafetsa setsing sa mmuso porofenseng ya Kapa Botjhabela bakeng sa nako ya 2016 - 2020. Moralo wa phuputso o fapaneng o sebedisang datha ya morao-rao wa sebediswa bakeng sa phuputso ena. Datha yohle ya bakudi ba ileng ba alafshwa bakeng sa mafu a amanang le FBD nakong ya phuputso e kenyeleditswe phuputsong. Datha e ile ya hlahlojwa ho sebediswa dipalo-palong tse hlalosang le manollo ya dintho tse fapaneng. Bongata ba di-FBD bo bakwa ke ho ja nama ya kgomo e tshetsweng moriana (42%, n=176), ho latelwe ke ho ja nama ya dikgomo tse shweleng (26.25%, n=110), dikgomo tse lonngweng ke dinoha (12.89%). n=54), nama ya kgoho e jewang sekolong (6.44%, n=27), le nama ya dinku tse shweleng (4.30%, n=18). Keketseho ya palo ya diketsahalo tsa FBD e ile ya bonwa dipakeng tsa Pherekgong le Phupjane ka 2016, 2018 le 2020. Nakong yohle ya phuputso ntle le 2017 le 2019, palo e tlase haholo ya diketsahalo tsa FBD e ya bonwa dipakeng tsa Phupu le Tshitwe. Mafu a kang lefu la tswekere, lefuba le HIV, hammoho le boimana a ne a amahanngwa le di-FBD tse matla tse lebisang ho eketseheng ha monyetla wa ho kena sepetlele. Phuputso e ile ya totobatsa tlhokahalo ya ho ruta batho ba mahaeng ka dikotsi tsa dijo tsa tlhaho ya diphoofolo le karolo ya mafu hodima boima ba di-FBD ka phano ya tlhokomelo ya bophelo. Diphetho tse tlalehilweng mona di ka tataisa maano a ka thusang ho fokotsa boima ba di-FBD tsamaisong ya tlhokomelo ya bophelo mahaeng a Afrika Borwa. Katamelo e le nngwe ya bophelo bo botle e kenyelletsang ditho tsa sehlopha sa bongaka ba diphoofolo, basebeletsi ba tsa bongaka, baetapele ba dibaka le diofisiri tsa bophelo bo botle ba tikoloho e ya hlokahala ho rala le ho hlahisa maano a ho kenella le mananeo a thuto.