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Int. J. Environ. Res. Public Health 2019, 16(3), 506;

Enteric Pathogen Diversity in Infant Foods in Low-Income Neighborhoods of Kisumu, Kenya

Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA 52246, USA
Center of Research, Great Lakes University of Kisumu, Kisumu 40100, Kenya
Department of Disease Control, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
Author to whom correspondence should be addressed.
Received: 28 December 2018 / Revised: 5 February 2019 / Accepted: 7 February 2019 / Published: 12 February 2019
(This article belongs to the Special Issue New Directions in Water, Sanitation and Hygiene Research)
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Pediatric diarrheal disease remains the second most common cause of preventable illness and death among children under the age of five, especially in low and middle-income countries (LMICs). However, there is limited information regarding the role of food in pathogen transmission in LMICs. For this study, we examined the frequency of enteric pathogen occurrence and co-occurrence in 127 infant weaning foods in Kisumu, Kenya, using a multi-pathogen PCR diagnostic tool, and assessed household food hygiene risk factors for contamination. Bacterial, viral, and protozoan enteric pathogen DNA and RNA were detected in 62% of the infant weaning food samples collected, with 37% of foods containing more than one pathogen type. Multivariable generalized linear mixed model analysis indicated type of infant food best explained the presence and diversity of enteric pathogens in infant food, while most household food hygiene risk factors considered in this study were not significantly associated with pathogen contamination. Specifically, cow’s milk was significantly more likely to contain a pathogen (adjusted risk ratio = 14.4; 95% confidence interval (CI) 1.78–116.1) and more likely to have higher number of enteric pathogen species (adjusted risk ratio = 2.35; 95% CI 1.67–3.29) than porridge. Our study demonstrates that infants in this low-income urban setting are frequently exposed to diarrhoeagenic pathogens in food and suggests that interventions are needed to prevent foodborne transmission of pathogens to infants. View Full-Text
Keywords: food; sanitation; infants; milk; pathogen presence; pathogen diversity; TaqMan Array Card food; sanitation; infants; milk; pathogen presence; pathogen diversity; TaqMan Array Card

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Tsai, K.; Simiyu, S.; Mumma, J.; Aseyo, R.E.; Cumming, O.; Dreibelbis, R.; Baker, K.K. Enteric Pathogen Diversity in Infant Foods in Low-Income Neighborhoods of Kisumu, Kenya. Int. J. Environ. Res. Public Health 2019, 16, 506.

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