Food Protection Trends - May/June 2022 - 195

continental nations: Belize, on the eastern coast of Central
America, and Guyana and Suriname, along the northern
coast of South America. The population of CARICOM
countries varies from a low of around 5,000 in Montserrat to
an estimated 11.5 million in Haiti, totaling approximately 19
million people (69).
The economies of most of the smaller CARICOM island
countries rely primarily on tourism. The larger mainland
nations, such as Guyana, are less dependent on tourism as their
economies were historically built on agriculture. However, they
are now diversifying by exploiting natural resources, such as oil
reserves (67). Nonetheless, the most important and valuable
resource for CARICOM's economic growth and development
is its human capital stock. To this end, the health and wellbeing
of the residents of CARICOM must be sustained
through health services for the prevention and treatment of
chronic and infectious diseases.
Gastrointestinal illnesses have a significant impact on the
overall population health of a country. Developing countries
are disproportionately affected by diarrheal disease because
of disparities in health and epidemiological infrastructure
compared with industrialized nations (20, 53). Between 2005
and 2012, the number of reported foodborne illnesses in
the Caribbean region increased steadily. Among foodborne
pathogens, Salmonella accounted for the highest number of
illness cases (13). Foodborne disease can be a burden to the
individual through direct and indirect financial costs and to
society with loss of human labor and cost to the public health
care systems. CARICOM cannot afford these costs, as the
countries attempt to achieve sustainable development goals
while mitigating multiple socio-environmental challenges,
such as poverty and climate variability (10). However, the first
step toward implementing public health measures targeting
the food supply is to contextualize the issue and determine
the magnitude of the problem. Therefore, this article aims
to summarize the prevalence of nontyphoidal Salmonella, as
well as the burden of foodborne salmonellosis in CARICOM
member states.
REVIEW METHODOLOGY
Four databases - Google Scholar, PubMed, ScIELO,
and Scopus, were consulted monthly between March 2020
and September 2021 using the search terms " Salmonella "
plus " food safety, " " foodborne illness, " or " gastrointestinal
illness " and each CARICOM country's name. Information
was also sourced from international public health agencies,
such as Pan American Health Organization (PAHO) (54,
55), the World Health Organization (68), and the Food and
Agriculture Organization of the United Nations (21-25);
regional organizations, including CARICOM secretariat (10,
11), Caribbean Public Health Agency (13, 14), and Caribbean
Industrial Research Institute (12), and each country's
governmental health-related Websites (17, 29-33, 35-39).
Because there are limited published data from most countries,
the scope of the review included publications from as early as
1971. All 69 primary articles, except for five, were published
after 2000. The articles were retrieved in full text through the
University of Nebraska-Lincoln library system, and primary
data were extracted from articles that met the inclusion criteria,
namely scientific publications in English, documenting the
occurrence, presence, prevalence, burden, or incidence of
nontyphoidal Salmonella in human food matrices in any of the
CARICOM countries, regardless of publication date.
PREVALENCE OF SALMONELLA IN CARICOM
COUNTRIES
Salmonella in the broiler chicken production chain
CARICOM is striving to reduce its food import bill by
providing support to farmers and increasing intraregional
trade. Therefore, poultry production is expanding in the region
(24). Approximately 80% of meat consumed in CARICOM
is poultry, with the region producing 67% of all its broiler
meat and almost 100% of eggs consumed. The six largest
poultry-producing countries are Barbados, Belize, Guyana,
Jamaica, Suriname, and Trinidad and Tobago (23). Poultry
rearing in CARICOM varies from large intensive and semiintensive
operations to small backyard and extensive free-range
operations (21).
Serological analysis of backyard-reared poultry in Trinidad
and Tobago did not indicate the presence of Salmonella
serovar Enteritidis antibodies, even though other pathogens
were detected (45). Contrarily, a study in Jamaica found
that the pathogen was present in 9 (0.75%) of 1,200 cecal
samples from large poultry farms. In small, organically reared
poultry farms, positive samples were detected in 13 (15%)
of 86 cecal samples. Salmonella had a positivity rate of 5%
(6/120) in cecum, crop, and gizzard samples from small
non-organic rearing operations. The potential source of
Salmonella was identified as the areas surrounding the farms
because the pathogen was detected in rat feces, muscoid
flies, and swine feces in the vicinity. The higher prevalence
of Salmonella estimated on small farms is of concern because
neighboring residents are more likely to purchase poultry
from small poultry farms, potentially increasing exposure
to contaminated products in the community. However,
Salmonella was not detected in samples from local markets,
and it is unclear whether the retail samples came from small
or large farms (18).
The type of poultry processing and retail operation can
influence the presence of Salmonella. An examination of
poultry meat from small retail plucking operations in Trinidad
and Tobago detected the presence of Salmonella in 7 (7.3%)
of 96 carcass, 3 (3.1% ) of 96 drip, 2 (2.1%) of 93 gizzard, and
1 (1%) of 95 liver samples, respectively. Only three different
serotypes were detected among the positive samples, namely
Salmonella Kiambu, S. Kentucky, and S. Mbandaka (59). In
another study in Trinidad, Salmonella frequency was compared
between cottage poultry operators and supermarkets. The
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