An evaluation of biosecurity compliance levels and assessment of associated risk factors for highly pathogenic avian influenza H5N1 infection of live-bird-markets, Nigeria and Egypt.

Live bird market (LBM) is integral component in the perpetuation of HPAI H5N1, while biosecurity is crucial and key to the prevention and control of infectious diseases. Biosecurity compliance level and risk factor assessments in 155LBMs was evaluated in Nigeria and Egypt through the administration of a 68-item biosecurity checklist, scored based on the modifications of previous qualitative data, and analysed for degree of compliance. LBMs were scored as "complied with a biosecurity item" if they had good-very good scores (4). All scores were coded and analysed using descriptive statistics and risk or protective factors were determined using univariable and multivariable logistic regression at p≤0.05. Trading of wild birds and other animal in the LBMs (Odd Ratio (OR)=34.90; p=0.01) and claims of hand disinfection after slaughter (OR=31.16; p=0.03) were significant risk factors while mandatory routine disinfection of markets (OR=0.13; p≤0.00), fencing and gates for live bird market (OR=0.02; p≤0.01) and hand washing after slaughter (OR=0.41; p≤0.05) were protective factors for and against the infection of Nigerian and Egyptian LBMs with the HPAI H5N1 virus. Almost all the LBMs complied poorly with most of the variables in the checklist (p≤0.05), but pathways to improved biosecurity in the LBMs existed. We concluded that the LBM operators play a critical role in the disruption of transmission of H5N1 virus infection through improved biosecurity and participatory epidemiology and multidisciplinary approach is needed.