J Infect Dis. 2018 Jul 7. doi: 10.1093/infdis/jiy400. [Epub ahead of print]
Effectiveness of market-level biosecurity at reducing exposure of poultry and humans to avian influenza: a systematic review and meta-analysis.

Zhou X1, Wang Y2, Liu H2, Guo F3, Doi SA4,5, Smith C6, Clements ACA4, Edwards J1,7, Huang B2, Soares Magalh„es RJ1,8.
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In this study, we aimed to identify the effect of market-level risk factors on avian influenza (AI) infection in poultry and humans and generate evidence that will inform AI prevention and control programs at live bird markets (LBMs).

We performed a systematic literature review in both English and Chinese search engines. We estimated the pooled odds ratios of biosecurity indicators relating to AI infections at market level using a quality effects (QE) meta-analysis model.

Biosecurity measures effective at reducing AI market contamination and poultry infection at LBMs include smaller market size, selling single poultry species and separating different species, performing cleaning and disinfection and market closures, ban on overnight storage and sourcing poultry from local areas. Our meta-analysis indicates that higher risk of exposure to AI infection occurs in workers at retail LBMs, female workers and those who contact ducks, conduct cleaning, slaughtering, defeathering or evisceration.

The most effective strategies to reduce AI market contamination identified in this study should target larger LBMs that are located at non-central city areas, sell and slaughter multi-species of live poultry. LBM workers directly involved in cleaning and poultry processing tasks should participate in occupational health and safety programmes.

PMID: 29986030 DOI: 10.1093/infdis/jiy400