Diarrhoea, vomiting and the role of milk consumption: perceived and identified risk in Bamako (Mali).
OBJECTIVE
To evaluate the public health impact of milk contamination in Bamako, Mali.


METHODS
A case-control study assessed the risk-factors for food-borne toxi-infections with diarrhoea and vomiting as main clinical picture. A total of 131 schoolchildren between 5 and 20 years of age were interviewed by trained interviewers in schools in Bamako. A structured questionnaire was used to record health problems, food and particularly milk consumption habits and socio-economic indicators.


RESULTS
Final multivariate logistic regression analysis identified regular consumption of boiled milk [odds ratio(OR) = 4.38; 95% CI = 1.15-16.71], age between 5 and 10 years (OR vs. age group 11-15 years = 3.28; 95% CI = 1.09-9.85) and the existence of dry latrines in the household (OR = 7.65; 95% CI = 1.92-30.55) as risk factors for diarrhoea and vomiting. Other milk products and the socio-economic level of the household were not significantly associated with the outcome. Many people were unaware of the potential risks of milk consumption.


CONCLUSIONS
Milk products may be a risk factor for food-borne toxi-infections. Attention has to be paid to products considered 'safe', such as boiled or pasteurized milk. The low awareness of potential risks of many people may increase the risk of milk consumption. To achieve a sustainable increase in local milk production in Africa, milk quantity and production and transformation quality should be improved simultaneously.
Swiss Tropical Institute, Basel, Switzerland. manuel.hetzel@unibas.ch
Manuel
M
Hetzel
Bassirou
B
Bonfoh
Zakaria
Z
Farah
Malick
M
Traoré
Cheick F
CF
Simbé
Idriss O
IO
Alfaroukh
Esther
E
Schelling
Marcel
M
Tanner
Jakob
J
Zinsstag
D000293:Adolescent; D000328:Adult; D000818:Animals; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003611:Dairy Products; D003906:Developing Countries; D003967:Diarrhea / Q000209:etiology*; D005260:Female; D005516:Food Microbiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008302:Mali; D008892:Milk / Q000009:adverse effects / Q000382:microbiology*; D011634:Public Health; D012307:Risk Factors; D012499:Sanitation / Q000706:statistics & numerical data; D014839:Vomiting / Q000209:etiology*; D014881:Water Supply / Q000706:statistics & numerical data