title: Poultry rearing and slaughtering practices in rural Egypt: an exploration of risk factors for H5N1 virus human transmission.
abstract: BACKGROUND
  Highly pathogenic avian influenza (H5N1) virus continues to cause infections in Egypt. This study describes the practices associated with raising and slaughtering household poultry to identify risk factors for H5N1 infection and reasons for non-compliance with preventive measures.
  
  
  METHODS
  An investigation was conducted of 56 households with household flocks (19 households with human H5N1 cases, 19 with poultry H5N1 cases, and 18 with no reported poultry or human H5N1 cases). Data were collected via structured observations and in-depth interviews.
  
  
  RESULTS
  Half of the households kept at least some free-range poultry and mixed at least some different species of poultry as it was considered beneficial for the poultry. Feeding and cleaning practices exposed children to contact with poultry; slaughtering contaminated homes; use of personal protective barriers was not a norm; waste management exposed the communities to slaughtering waste and dead chickens; and reporting of sick and dead poultry was not a practice. Only minor changes in poultry-handling took place following H5N1 virus outbreaks.
  
  
  CONCLUSIONS
  H5N1 virus prevention in Egypt represents both an epidemiological and socio-cultural challenge. Traditional poultry-rearing practices that likely increase exposures to H5N1-infected poultry are common throughout Egypt. Despite education campaigns following sporadic H5N1 outbreaks, no differences in these practices could be detected between households with previous H5N1 human or poultry cases and those households with any previous experience with H5N1. Development of H5N1 infection-related education campaign strategies should focus on perceptions underlying traditional practices in order to tailor public awareness messages that are meaningful for communities.
authors.affiliation: Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt.Centers for Disease Control and Prevention, Atlanta, GA, USA.Preventive Sector, Ministry of Health and Population in Egypt, Cairo, Egypt.
authors.forename: Anna-Leena
authors.initials: AL
authors.lastname: Lohiniva
authors.forename: Erica
authors.initials: E
authors.lastname: Dueger
authors.forename: Maha
authors.initials: M
authors.lastname: Talaat
authors.forename: Samir
authors.initials: S
authors.lastname: Refaey
authors.forename: Amal
authors.initials: A
authors.lastname: Zaki
authors.forename: Katherine
authors.initials: K
authors.lastname: Chisholm Horton
authors.forename: Amr
authors.initials: A
authors.lastname: Kandeel
mesh_terms: D000293:Adolescent; D000328:Adult; D000822:Animal Husbandry / Q000379:methods*; D000818:Animals; D002645:Chickens; D002648:Child; D002675:Child, Preschool; D004534:Egypt; D005260:Female; D006801:Humans; D007223:Infant; D053124:Influenza A Virus, H5N1 Subtype / Q000302:isolation & purification*; D005585:Influenza in Birds / Q000635:transmission*; D008297:Male; D012307:Risk Factors; D012424:Rural Population; D055815:Young Adult; D015047:Zoonoses / Q000517:prevention & control* / Q000635:transmission*
keywords: Backyard poultry; human H5N1 risk factors; socio-cultural