Abstract
Introduction: A total of 1060 laboratory-confirmed cases and 216 deaths were reported in South Africa from January 2017 to July 2018. A ready-to-eat, processed meat product called polony was identified as the source of the outbreak. This study explored the other factors to determine their association with the effectiveness of Listeriosis outbreak investigation.
Objective: This study aimed to examine the environmental health investigation methods on Listeriosis outbreaks in South Africa throughout 2017 - 2018.
Methods: A quantitative study sample size was 333 Environmental Health Practitioners (EHPs) participants. The study was conducted amongst the local government EHPs in Gauteng, Western Cape and Kwazulu-Natal as the provinces which recorded the highest number of cases andethical clearence was obtained. Data was collected using a questionnaire with a standard set of close-ended and open-ended questions and was analyzed using Statistical Package for the Social Sciences (SPSS) software version 26. For each of the objectives, logistic regression analysis was carried out using one dependent variable and multiple independent variables.
Results: Of the 333 EHPs who participated in the study, the majority 179 (60%) were female, with only 154 (40%) males participating. In the regression analysis, those not trained on outbreak investigation were less likely not to participate in outbreak investigation with odds ratio (OR) 0.15, 95% CI (0.05 – 0.46).
In the regression analysis, those who used the referred cases procedure were less likely not to participate in Listeriosis outbreak training (OR=0.27, 95%CI:0.08–0.86). Those who recommended improved technology and tools as an intervention to improve outbreak investigations had (OR= 4.77, 95% CI: 1.07–21.33).. Participants who used other methods of investigation were less likely not to participate in listeriosis outbreak (OR=0.30, 95% CI: 0.10 – 0.93).
Conclusion: While lack of training, referred cases and not having improved technology and tools were statistically significant for the effectiveness of outbreak investigation, factors such as inadequate human resources, lack of tools of trade and poor legislative and policy framework also impacted the effectiveness of environmental health investigation.
Keywords: Listeria monocytogenes, Whole Genome Sequencing, socio-demographic factors, Listeriosis, Environmental Health Practitioners, outbreak investigation.