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There is growing recognition of the contribution of the social determinants of health to the burden of many infectious diseases. However, the relationship between socioeconomic status and the incidence and outcome of melioidosis is incompletely defined. All residents of Far North Queensland, tropical Australia with culture-proven melioidosis between January 1998 and December 2020 were eligible for the study. Their demographics, comorbidities and socioeconomic status were correlated with their clinical course. Socioeconomic status was determined using the Socio-Economic Indexes for Areas (SEIFA) Index of Relative Socio-economic Disadvantage score, a measure of socioeconomic disadvantage developed by the Australian Bureau of Statistics. Socioeconomic disadvantage was defined as residence in a region with a SEIFA score in the lowest decile in Australia. 321 eligible individuals were diagnosed with melioidosis during the study period, 174 (54.2%) identified as Indigenous Australians; 223/321 (69.5%) were bacteraemic, 85/321 (26.5%) required Intensive Care Unit (ICU) admission and 37/321 (11.5%) died. 156/321 (48.6%) were socioeconomically disadvantaged, compared with 56603/269002 (21.0%) of the local general population (p<0.001). Socioeconomically disadvantaged patients were younger, more likely to be female, Indigenous, diabetic or have renal disease. They were also more likely to die prior to hospital discharge (26/156 (16.7%) versus 11/165 (6.7%), p = 0.002) and to die at a younger age (median (IQR) age: 50 (38-68) versus 65 (59-81) years, p = 0.02). In multivariate analysis that included age, Indigenous status, the presence of bacteraemia, ICU admission and the year of hospitalisation, only socioeconomic disadvantage (odds ratio (OR) (95% confidence interval (CI)): 2.49 (1.16-5.35), p = 0.02) and ICU admission (OR (95% CI): 4.79 (2.33-9.86), p<0.001) were independently associated with death. Melioidosis is disease of socioeconomic disadvantage. A more holistic approach to the delivery of healthcare which addresses the social determinants of health is necessary to reduce the burden of this life-threatening disease.

During January 1998-December 2019, the annual incidence of melioidosis in Far North Queensland, Queensland, Australia, more than doubled. Because climate and prevalence of predisposing medical conditions remained stable during that time, we hypothesize that the increased incidence was caused by urban expansion and increased construction, resulting in greater exposure to Burkholderia pseudomallei.

In the 2000s, the idea of a so-called middle-segment arose in North-West Europe to address the criticism on intensive broiler production systems. Middle-segment systems being indoor housing of slower-growing broiler strains at a stocking density ≤38 kg/m2. Previous literature showed that Dutch middle-segment systems entail a relatively large gain in animal welfare at a relatively low increase in costs, i.e., have a high cost-efficiency. The question is to what extent these findings are applicable to other countries. Therefore, the aim of this study is to gain insight in the global prospects of middle-segment systems by exploring the cost-efficiency of these systems in other parts of the world. A set of representative countries, containing the Netherlands, United States and Brazil were selected. Cost-efficiency was defined as the ratio of the change in the level of animal welfare and the change in production costs. The level of animal welfare was measured by the Welfare Quality (WQ) index score. Data was collected from literature and consulting experts. Results show that in the Netherlands, United States and Brazil a change from conventional towards a middle-segment system improves animal welfare in a cost-efficient manner (the Netherlands 9.1, United States 24.2 and Brazil 12.1). Overall, it can be concluded that in general middle-segment production systems provide a considerable increase in animal welfare at a relatively small increase in production costs and therefore offer good prospects for a cost-efficient improvement of broiler welfare.

Since the 1970s, animal welfare (AW) in Dutch broiler production has been criticized by non-governmental organizations (NGOs) and the general public. Despite the development of production concepts aimed at improving AW, the conventional concept, which satisfied only the minimum legal requirements, remained by far the most dominant one in the Dutch fresh broiler meat market. Then, quite suddenly, in 2014–2015 (i.e., within less than two years), a new broiler concept with increased AW was introduced, which included a slower growing animal, more space, and an improved light regime. This alternative completely replaced the by then conventional concept. The aim of this study was to investigate the origin, causes, and driving forces of this sudden change. Popular and scientific literature, as well as interviews with key players in this transition process, were used to re-construct the chronology of events and draw the main and decisive findings. The latter include: (1) The availability of a cost-efficient alternative to conventional concepts, (2) a basic willingness to change within the entire value chain (including consumers), (3) initiating and triggering actions by NGOs, (4) decisive initiatives by retailers and (5) simultaneous introduction of the new concept and replacement of the conventional concept (i.e., depriving the consumer of a cheaper choice alternative). The result was a real transition of the Dutch fresh meat market without negative purchasing responses of the consumers. It was concluded that, although the Dutch fresh broiler meat market only included 30% of total domestic production, the existence of the abovementioned decisive factors could bring about an important change in favor of AW within a short period of time.

Dengue infection spread in naive populations occurs in an explosive and widespread fashion primarily due to the absence of population herd immunity, the population dynamics and dispersal of Ae. aegypti, and the movement of individuals within the urban space. Knowledge on the relative contribution of such factors to the spatial dimension of dengue virus spread has been limited. In the present study we analyzed the spatio-temporal pattern of a large dengue virus-2 (DENV-2) outbreak that affected the Australian city of Cairns (north Queensland) in 2003, quantified the relationship between dengue transmission and distance to the epidemic's index case (IC), evaluated the effects of indoor residual spraying (IRS) on the odds of dengue infection, and generated recommendations for city-wide dengue surveillance and control. We retrospectively analyzed data from 383 DENV-2 confirmed cases and 1,163 IRS applications performed during the 25-week epidemic period. Spatial (local k-function, angular wavelets) and space-time (Knox test) analyses quantified the intensity and directionality of clustering of dengue cases, whereas a semi-parametric Bayesian space-time regression assessed the impact of IRS and spatial autocorrelation in the odds of weekly dengue infection. About 63% of the cases clustered up to 800 m around the IC's house. Most cases were distributed in the NW-SE axis as a consequence of the spatial arrangement of blocks within the city and, possibly, the prevailing winds. Space-time analysis showed that DENV-2 infection spread rapidly, generating 18 clusters (comprising 65% of all cases), and that these clusters varied in extent as a function of their distance to the IC's residence. IRS applications had a significant protective effect in the further occurrence of dengue cases, but only when they reached coverage of 60% or more of the neighboring premises of a house. By applying sound statistical analysis to a very detailed dataset from one of the largest outbreaks that affected the city of Cairns in recent times, we not only described the spread of dengue virus with high detail but also quantified the spatio-temporal dimension of dengue virus transmission within this complex urban environment. In areas susceptible to non-periodic dengue epidemics, effective disease prevention and control would depend on the prompt response to introduced cases. We foresee that some of the results and recommendations derived from our study may also be applicable to other areas currently affected or potentially subject to dengue epidemics.

Background Illegal use of fipronil as an insecticide in 2017 has caused substantial damage to Dutch laying hen farms. We assessed how the fipronil crisis has affected the financial performance of affected farms as well as unaffected farms. While affected farms faced culling their flocks and lost revenue, unaffected farms benefitted from temporary high egg prices. Methods A three-step normative modelling approach is taken using financial statements and a partial budget. The estimations are for a 50,000 laying hen farm facing the fipronil crisis for 5 months. First, a baseline is created by generating an income statement of this laying hen farm representing a ‘normal year’. Second, incremental costs and revenue as a result of the fipronil crisis are estimated. Third, the baseline income statement is updated with the outcomes of the partial budget. This results in two additional income statements that report the net operating result of this farm being unaffected and affected by the fipronil crisis. Results While in a normal year this average-sized farm has a net operating result of around 18,000 euros, profitability was estimated to be − 369,000 euros and + 169,000 euros for the affected and unaffected farm due to the crisis respectively. For affected farms, impacts were especially high as there was no government compensation or insurance. Conclusions As Dutch farms typically operate as independent family farms, there was also no compensation from other chain actors. The affected farms therefore likely have faced financial distress and have had to increase debt or use their financial reserves for household consumption and restarting the business. Outcomes contribute to discussions around liability claims and cost-benefit assessments of measures to improve the chain food safety and rapid alert systems. Graphical Abstract

The Asian tiger mosquito, Aedes albopictus, is an important vector of dengue, chikungunya and Zika viruses and is a highly invasive and aggressive biter. Established populations of this species were first recognised in Australia in 2005 when they were discovered on islands in the Torres Strait, between mainland Australia and Papua New Guinea. A control program was implemented with the original goal of eliminating Ae. albopictus from the Torres Strait. We describe the evolution of management strategies that provide a template for Ae. albopictus control that can be adopted elsewhere. The control strategy implemented between 2005 and 2008 targeted larval habitats using source reduction, insect-growth regulator and pyrethroid insecticide to control larvae and adults in the containers. However, the infrequency of insecticide reapplication, the continual accumulation and replacement of containers, and imminent re-introduction of mosquitoes through people's movement from elsewhere compromised the program. Consequently, in 2009 the objective of the program changed from elimination to quarantine, with the goal of preventing Ae albopictus from infesting Thursday and Horn islands, which are the transport hubs connecting the Torres Strait to mainland Australia. However, larval control strategies did not prevent the species establishing on these islands in 2010. Thereafter, an additional strategy adopted by the quarantine program in early 2011 was harborage spraying, whereby the vegetated, well shaded resting sites of adult Ae. albopictus were treated with a residual pyrethroid insecticide. Inclusion of this additional measure led to a 97% decline in Ae. albopictus numbers within two years. In addition, the frequency of container treatment was increased to five weeks between treatments, compared to an average of 8 weeks that occurred in the earlier iterations of the program. By 2015 and 2016, Ae. albopictus populations on the two islands were undetectable in 70-90% of surveys conducted. Importantly, a comprehensive surveillance network in selected strategic areas has not identified established populations of this species on the Australian mainland. The program has successfully reduced Ae. albopictus populations on Thursday Island and Horn Island to levels where it is undetectable in up to 90% of surveys, and has largely removed the risk of mainland establishment via that route. The vector management strategies adopted in the later years of the program have been demonstrably successful and provide a practical management framework for dengue, chikungunya or Zika virus outbreaks vectored by Ae. albopictus. As of June 2016, Ae. albopictus had not established on the Australian mainland and this program has likely contributed significantly to this outcome.

Despite extensive efforts to control the highly pathogenic avian influenza (HPAI), it remains endemic in Western Java, Indonesia. To understand the limited effectiveness of HPAI control measures, it is important to map the complex structure of the poultry sector. The governance of the poultry value chain in particular, could play a pivotal role, yet there is limited information on the different chain governance structures and their impacts on HPAI control. This article uses value chain analysis (VCA), focusing on an in-depth assessment of governance structures as well as transaction cost economics and quantitative estimates of the market power of different chain actors, to establish a theoretical framework to examine biosecurity and HPAI control in the Western Java poultry chain. During the research, semi-structured interviews were conducted with key value-chain stakeholders, and the economic performance of identified actors was estimated. Results indicated the co-existence of four different poultry value chains in West Java: the integrator chain, the semi-automated slaughterhouse chain, the controlled slaughter-point chain, and the private slaughter-point chain. The integrator chain was characterized by the highest levels of coordination and a tight, hierarchical governance. In contrast, the other three types of value chains were less coordinated. The market power of the different actors within the four value chains also differed. In more integrated chains, slaughterhouses held considerable market power, while in more informal value chains, market power was in the hands of traders. The economic effects of HPAI and biosecurity measures also varied for the identified actors in the different value chains. Implementation of biosecurity and HPAI control measures was strongly related to the governance structure of the chain, with interactions between different chains and governance structures accentuating the risk of HPAI. Our findings highlight that a proper understanding of the chain governance structure is vital to improve the effectiveness of HPAI control measures, by making the interventions more specific and fit-for-purpose given the incentive structures present in different chains.

Background Chicken meat plays a crucial role in food and nutrition security across many African countries, serving as an affordable and high-quality source of animal protein. Driven by population growth and economic development, the demand for chicken meat in African countries has increased, resulting in significant gaps between supply and demand. To address this imbalance, several countries have turned to importing larger quantities of frozen chicken meat. However, concerns have been raised regarding these imports, as low-cost chicken meat entering African markets is seen as potentially disruptive to local markets. The study employs the typical farm approach, utilizing synthetic farms known as ‘typical farms’, to measure the competitiveness of broiler farms in Ghana (a country which is highly reliant on imports) and Senegal (a country with a complete import ban), relative to farms in European countries (Germany and the Netherland) that are significant exporters of chicken meat. Results The study revealed that typical broiler farms in Ghana and Senegal are less competitive than those in Germany and the Netherlands due to lower farm performance (e.g. higher Feed Conversion Ratios and mortality rates) and higher cost of production. Typical Ghanaian broiler farms face substantial cost disadvantages. Their production costs are 180% to 219% higher than the typical German farm and 144% to 178% higher than the typical Dutch farm. While Senegalese farms perform somewhat better, they still lag behind the typical German and Dutch farms, with production costs 39% to 90% higher than the typical German farm and 21% to 66% higher than the typical Dutch farm, respectively. Furthermore, farm-level modeling indicates that improving farm performance alone may not sufficiently reduce production costs in Ghana and Senegal to levels comparable with those in Germany and the Netherlands. Conclusions The study concludes that improved farm management practices and lower input prices are necessary to improve the competitiveness of broiler farms in Ghana and Senegal. Additionally, small-scale producers, who are least competitive, require targeted support in order to increase their competitiveness.