Domestic poultry-raising practices in a Peruvian shantytown: implications for control of Campylobacter jejuni-associated diarrhea
Introduction
Diarrhea remains a leading cause of morbidity and mortality for young children in the developing world (Bern et al., 1992, Dupont, 1995, Prado and O'Ryan, 1994, World Bank, 1993). Campylobacter jejuni is one of the most common pathogens associated with infectious childhood diarrhea worldwide (Albert et al., 1999, Biswas et al., 1996, Caprioli et al., 1996, CDC, 2001, Gedlu and Aseffa, 1996, Grados et al., 1988, Koulla-Shiro et al., 1995, Simango and Nyahanana, 1997, Uysal et al., 1997). The presence of free-range domestic poultry increases children's exposure to C. jejuni (Grados et al., 1988, Marquis et al., 1990). Raising poultry this way is common in periurban Peru and in many other low-income countries.
Corralling domestic poultry has been suggested as a measure that might reduce C. jejuni exposure and thus diarrhea (Marquis et al., 1990). Corralling as a potential domestic hygiene intervention has not been studied, but there is a substantial literature on other domestic hygiene practices related to diarrhea prevention, including water storage, latrine use, hand- and dish-washing at critical times, breast-feeding, use of bottles and weaning foods and disposal of children's feces (Ahmed et al., 1993, Gorter et al., 1998, Huttly et al., 1994, McLennan, 2000, Pinfold and Horan, 1996, Yeager et al., 1999). Behavior change interventions geared towards improving domestic hygiene can significantly reduce the incidence of childhood diarrhea (Ahmed et al., 1993, Huttly et al., 1997, Kaltenthaler and Drasar, 1996, Pinfold and Horan, 1996). However, evaluations show that high or increased biomedical knowledge—for instance about the etiologic link between pathogen and illness—does not necessarily lead to a change in targeted behaviors. On the contrary, domestic hygiene behaviors are formed, influenced and maintained by a complex web of interrelated factors such as history, cultural and individual preference (e.g., for the taste of unboiled water), effort or cost involved in performing the desired behavior, family dynamics, and community cohesiveness (Kunstadter, 1991, McLennan, 2000, Pelto, 1991, Pinfold, 1999).
To explore the cultural, social, and economic feasibility of corralling, we studied motives for raising poultry, the social and economic context of domestic poultry production, and local knowledge about the relationship between domestic poultry and disease in a Peruvian shantytown. We then conducted a 2-month household trial to determine if corralling would be socially, economically and culturally feasible for community residents. This study was the second of a three-part project related to preventing C. jejuni-associated diarrhea. The first phase, begun in 1998, consisted of an 11-month epidemiological surveillance investigating the relationship between Campylobacter strains found in chickens and humans (Oberhelman, 2003). Phase III, an 18-month case-control study testing the efficacy of corrals in reducing C. jejuni-related infections, ended in December 2001. The project was reviewed and approved by the Committee on Use of Human Subjects at Tulane University Health Sciences Center in New Orleans and by the Ethics Committee of the Asociación Benéfica PRISMA in Lima.
Section snippets
Study site
Our study site, Las Pampas de San Juan de Miraflores, is a pueblo joven or shantytown built on the slopes of the steep and rocky desert hills southeast of Lima. The soil is dusty and there is no rain or natural vegetation. The hills are baked by a hot summer sun and chilled by a cold winter wind that blows off the Pacific Ocean to the west. Las Pampas’ roughly 40 000 residents arrived gradually as squatters during the mid- to late 1980s. Over time, most have gained legal title to their 140 m2
Perceived benefits and liabilities of corrals
Forty-three (68%) of the families participating in phase I surveillance had some type of corral. However, most families constructed their corrals in a provisional manner and most kept their birds corralled only part of the time. Informants also reported keeping baby chickens and ducks inside the house or allowing them to enter at will. The most common motive for constructing a corral (Table 1) was to keep birds from being stolen. Other commonly mentioned reasons included to keep the birds from
Design and construction
We tested several designs in an effort to minimize cost, use local materials and make a corral affordable for Las Pampas residents. We settled on a wood frame design, walls of commercial fish netting and a fiberglass roof. The cost of this corral averaged $26.00, about S/. 90. The veterinarian and agronomist stated that birds of different age, sex, or species would become aggressive if kept in a single corral. To avoid this problem—and to avoid reinforcing local concerns about corralling being
Discussion
Community concerns about the effect of corralling on the health and productivity of birds relate to many issues. Most poultry growers in Las Pampas kept birds before moving to the city. In rural areas with more open space, it is customary to raise poultry loose or ‘free-range.’ Immigrants to shantytowns like Las Pampas often try to maintain their old customs in their new more cramped urban quarters. Many growers develop a strong affective relationship with their animals. Consistent with this
Acknowledgements
Our sincerest thanks to the residents and the health promoters of Las Pampas de San Juan de Miraflores for their participation and their many contributions and suggestions. Project veterinarian Dr Mónica Alba Chincha of the Universidad Nacional Mayor de San Marcos and agronomist Ing. Pedro Ciriaco of the Universidad Nacional Agraria-La Molina provided invaluable technical assistance. A.B. PRISMA and NAMRID Lima contributed tremendously to logistics, transportation and data collection and
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