An epidemiological investigation of food-borne disease surveillance in the Ncera Villages, Eastern Cape, South Africa

Abstract

An increase in food-borne disease burden in the world’s population has raised concerns over the reliability of surveillance systems. Research has shown the importance of food-borne surveillance systems used in the detection and management of food-borne illness. Government fiscals are increasingly burdened by the rapid spread of food-borne illness, although the exact economic impact is unclear in many countries. In recent years, food security has been the main agenda overshadowing food safety. A reactional approach to outbreaks is the trend instead of proactive systems. Food-borne disease is associated with low and high socio-economic status populations. More than 30 pathogens were identified as the major causes of food- borne outbreaks globally, and some food-borne pathogens have long term health consequences.

Aim: The aim of the study was to investigate food-borne diseases surveillance in Ncera, Mpongo and Needscamp villages and local clinics, in the Eastern Cape, South Africa.

Methodology: A retrospective, observational, quantitative study was conducted in two phases. The first phase included the screening of tick registers at Ncera, Mpongo and Needscamp clinics. The screening was to determine the number of food-borne cases that were reported at these clinics. In the second phase, a stratified random sampling method was used to interview 90 households from the above-mentioned villages to determine the number of villagers who suffered from food-borne diseases, symptoms experienced and food safety practices. Results from both phases were compared to determine whether the number of reported cases at the clinics reflected the same number of cases in the villages from 2012 to 2014. The total size of the study population was 5007 people. Respondents were invited to participate having signed informed consent. Data was summarised and described using descriptive statistics such as frequencies, means and standard deviations. Data was analysed using SPSS version 23; cross tabulations and Chi-square tests at a probability of p< 0.05 were done. Graphs and tables were used to graphically represent the data.

Results: It was found that the majority of household heads were female (n = 51; 58.6%) and 33 (37.9%) of them were married. Most of the residents (n = 84; 96.5%) use the public health clinics for their medical condition treatment. Fifty-six (64.4%) household heads were HIV negative. The majority of households had a monthly income of R1 500 – R 3 500 (n = 45; 51.7). Less than a tenth (n = 6; 6.9%) of household heads were very concerned about the safety of food prepared at home. The relationship between food safety concern levels about food prepared at home and away from home was statistically significant (p = 0.000), reporting a significant difference in the way people perceive the preparation of food at home and away from home. More than a tenth of the villagers (n = 79; 19.7%) reported through the questionnaire, that they fell ill or thought that they fell ill from something they ate in the past 3 months. More than half (n = 56; 51.3%) of the participants who fell ill with food- borne diseases in these villages did not seek medical treatment for their illness whilst 6 (54.6%) did not see the need to seek medical treatment and reported that they got ill during weekends. Of those who sought medical treatment, 16 (39%) received prescribed medication while 3 (7%) reported that they were not provided with medication by healthcare providers when they suffered from food-borne illness. More than a quarter (n = 109; 27.3%) of household members fell ill from food-borne diseases in Ncera, Mpongo and Needscamp villages during the period 2012 to 2014. Whereas there were four food-borne cases reported to the clinics in the same period.

Conclusion: This research gathered information regarding food-borne disease prevalence in Ncera, Mpongo and Needscamp villages. It was observed that there is a gap in the surveillance of food-borne illness in these villages. In some of the tick registers used by healthcare providers at clinics to collect data, vital surveillance information such as gender, age and diagnosis was missing. This study deepens the understanding of food-borne illness and food safety in a village setting.