RUNNING HEAD: Epidemiological Research study Report
7-2 Final Project Submission: Epidemiological Research Study Report
Ofega Mogbeyiteren
Southern New Hampshire University Kate Tulio 06/13/22
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Population
Salmonella came to be a pathogen of public health concern in the Caribbean in the
mid-1980s when it caused an outbreak of diarrhea locally and among tourist population and
an increase in the number of cases of salmonella. This increase was due to the communicable
disease surveillance system in place at the time not being able to support timely detection of
the outbreaks or investigate the risk factors associated with the infection (the surveillance
system was based on notifiable disease reports from physicians and other health care
providers in the community). From March 1998 - May 1999, a matched case-control study
was undertaken in Trinidad and Tobago to explore risk factors for S. Enteritidis infection
(Stehr-Green J.K., 2004).
There were some identifiable social and behavioral determinants in the study, one of
which is environmental determinant. It was determined during an environmental health
assessment carried out on 10 egg producing farms in Trinidad to identify factors that could
have contributed to the contamination of eggshells and contents with Salmonella, that the
environmental conditions of 6 of the farms were unsanitary with odor build-up such as
ammonia, feces and sometimes blood on the shells of eggs, resulting in higher Salmonella
isolation rate from pooled eggshells and eggs and "none of the 10 farms had routine microbial
monitoring of their flocks or eggs" (Stehr-Green J.K., 2004). This shows that the farmers did
not keep the farms producing the eggs in a sanitary condition thereby leading to
contamination of the eggs before being supplied to sellers who on the other hand, handled
unclean eggshells, which are then sold to the population who ate these eggs raw, undercooked
or not properly cooked all due to lack of knowledge or education as to the effect these actions
could contribute to getting infected. The second social and behavioral determinant would be
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lack of knowledge on the importance of hygiene and safety measures in disease prevention.
Judging from the condition of the six farms inspected, it was evident that these farmers do not
observe safety measures and no routine monitoring because they are not educated on the
importance of proper safety measures and also possibly because they could not afford what is
required to carry out the monitoring routines required, thereby continuing to supply these
contaminated eggs to the public who consume these eggs without caution, because they had
no knowledge of proper food handling measures. This is why the Trinidad and Tobago
Ministries of Health and of Agriculture initiated a farm-to-table approach to Salmonella
prevention and control strategies that combined public health education of consumers, food
service establishments, and food workers (on the risks associated with eating raw and
undercooked eggs and using unrefrigerated eggs) and strategies for reduction of Salmonella
infections among egg-laying flocks and breeder flocks" (Stehr-Green J.K., 2004). The third