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Risk factors for food contamination among children discharged from community management of acute malnutrition programmes in South Sudan

A cross‐sectional study and hazard analysis critical control point approach

Bibliographic Data

ID15535870
AuthorsJoseph Wells (0009-0001-1660-8681, London School of Hygiene & Tropical Medicine, corresponding author), David Gama Abugo (London School of Hygiene & Tropical Medicine), John Angong (Action Against Hunger (ACF) Juba South Sudan), Nancy Grace Lamwaka (Action Against Hunger (ACF) Juba South Sudan), Karin Gallandat (0000-0001-6412-1483, London School of Hygiene & Tropical Medicine), Jackson Lwate Hassan (Action Against Hunger (ACF) Juba South Sudan), Lino Deng (Action Against Hunger (ACF) Juba South Sudan), Dimple Save (Action Against Hunger (ACF) Juba South Sudan), Laura Braun (0000-0001-9319-0859, London School of Hygiene & Tropical Medicine), Mesfin Gose (Action Against Hunger (ACF) New York New York USA), Jacob Amanya (Ministry of Health Juba South Sudan), Khamisa Ayoub (Ministry of Health Juba South Sudan), Sarah King (0000-0002-0637-7672, Action Against Hunger (ACF) New York New York USA), Heather Stobaugh (0000-0003-3827-283X, Tufts University), Oliver Cummings (0000-0002-5074-8709, London School of Hygiene & Tropical Medicine), Oliver Cumming (Department of Disease Control London School of Hygiene and Tropical Medicine London UK), Lauren D’Mello-Guyett (0000-0002-8174-1737, London School of Hygiene & Tropical Medicine), Lauren D'Mello‐Guyett (Department of Disease Control London School of Hygiene and Tropical Medicine London UK)
Year2023
Volume20
Issue2
Pagese13612-e13612
Publication date2023-12-25
Open AccessYes
TypeARTICLE
VenueMaternal and Child Nutrition (JOURNAL)
Journal identifiersISSN: 1740-8695 • E-ISSN: 1740-8709
PublisherWiley (PUBLISHER • GB)
DOI10.1111/mcn.13612
PMID38143422
OpenAlexW4390197175
LanguageEN
Citations received2
References cited51

Children under-5 years of age are particularly vulnerable to severe acute malnutrition (SAM), and the risk factors associated with relapse to SAM are poorly understood. Possible causes are asymptomatic or symptomatic infection with enteric pathogens, with contaminated food as a critical transmission route. This cross-sectional study comprised a household survey with samples of child food (n = 382) and structured observations of food preparation (n = 197) among children aged 6-59 months that were discharged from treatment in community management of acute malnutrition (CMAM) programmes in South Sudan. We quantified Escherichia coli and total coliforms (TCs), measured in colony forming units per g of food (CFU/g), as indicators of microbial contamination of child food. A modified hazard analysis critical control point (HACCP) approach was utilised to determine critical control points (CCPs) followed by multivariate logistic regression analysis to understand the risk factors associated with contamination. Over 40% (n = 164) of samples were contaminated with E. coli (43% >0 E. coli CFU/g, 95% CI 38%-48%), and 90% (n = 343) had >10 TCs (CFU/g) (>10 TC CFU/g, 95% CI 87%-93%). Risk factors associated (p < 0.05) with child food contamination included if the child fed themselves (9.05 RR, 95% CI [3.18, 31.16]) and exposure to animals (2.63 RR, 95% CI [1.33, 5.34]). This study highlights the risk factors and potential control strategies that can support interventions that reduce food contamination exposure in young children and help further protect those that are highly vulnerable to recurrent exposure to enteric pathogens

Biology · Contamination · Cross-sectional study · Environmental health · Logistic regression · Malnutrition · Psychological intervention · Severe Acute Malnutrition · Child Nutrition and Water Access · Food Security and Health in Diverse Populations · Medicine · Viral gastroenteritis research and epidemiology · Internal Medicine

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    Open Access•Joseph Wells, David Gama Abugo et al.•Maternal and Child Nutrition•2023

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  • Risk factors for food contamination among children discharged from community management of acute malnutrition programmes in South Sudan

    Open Access•Joseph Wells, David Gama Abugo et al.•Maternal and Child Nutrition•2023

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Citations per year0.67
Citation span2023 - 2026 (4)
Highly citedNo

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