Foodborne Disease Outbreak among students of Oshakati Senior Secondary School, Oshana region, Namibia - January, 2019

  • Water or foodborne
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Background:
On 29 January 2019, a cluster of students from Oshakati Secondary School, Namibia reported to the casualty depart- ment of Oshakati Hospital with a history of acute diarrhoea and abdominal cramps. We investigated to verify the outbreak, identify potential sources and implement control measures.
Methods:
We conducted an unmatched 1:1 case-control study. We reviewed medical records and interviewed food handlers. Environmental assessment was conducted. We interviewed 89 cases and 89 controls using structured questionnaires to identify risk factors. A case was any students staying at Oshakati Secondary School hostel with a history of diarrhoea and abdominal cramps, with or without blood in stool, or vomiting from 28 to 29 January 2019. A control was any asymptomatic student from the same school from 28 to 29 January 2019. Stool and water samples were collected for laboratory testing. Descriptive and inferential statistical analysis were performed. We generated frequencies, proportions and odd ratios with 95% Confidence Intervals (CI). Statistical significance was determined at p-value of <0.05.
Results:
We confirmed 89 cases, giving an attack rate of 7% (89/1033) with no deaths. Of these, females were 78 (88%). The mean age of cases was 17.24 (+/- 1.4 SD). Eating eggs and soft porridge was protective of becoming ill; (AOR 0.29, [955 CI 0.13 – 0.61], p-value 0.001) and (AOR 0.34, [95% CI 0.16 – 0.71], p-value 0.004) respectively. Soup was significantly associated with illness, (AOR 4.6, [95% CI 1.5 – 13.71], p-value 0.005). Giardia lamblia trophozoitesand Blantadium coli (B. coli) were isolated from stool and water samples respectively.
Conclusion
This foodborne outbreak at Oshakati Secondary School was caused by Giardia lamblia trophozoites and B. coli. Eating soup was significantly associated with illness. We recommended the Environmental division to routinely inspect the school kitchen and conduct analysis on municipal water. We educated food handlers on food safety and hand wash.

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