Diarrhoea, vomiting and the role of milk consumption : perceived and identified risk in Bamako (Mali)

OBJECTIVES To evaluate the public health impact of milk contamination in Bamako, Mali. METHODS A case-control study assessed the risk-factors for food-borne toxi-infections with diarrhoea and vomiting as main clinical picture. A total of 131 schoolchildren between 5 and 20 years of age were interviewed by trained interviewers in schools in Bamako. A structured questionnaire was used to record health problems, food and particularly milk consumption habits and socio-economic indicators. RESULTS Final multivariate logistic regression analysis identified regular consumption of boiled milk [odds ratio(OR) = 4.38; 95 1.15-16.71], age between 5 and 10 years (OR vs. age group 11-15 years = 3.28; 95 household (OR = 7.65; 95 diarrhoea and vomiting. Other milk products and the socio-economic level of the household were not significantly associated with the outcome. Many people were unaware of the potential risks of milk consumption. CONCLUSIONS Milk products may be a risk factor for food-borne toxi-infections. Attention has to be paid to products considered `safe`, such as boiled or pasteurized milk. The low awareness of potential risks of many people may increase the risk of milk consumption. To achieve a sustainable increase in local milk production in Africa, milk quantity and production and transformation quality should be improved simultaneously.