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Microbiological Quality of Raw Camel Milk across the Kenyan Market Chain

The objective of this study was to determine the microbiological quality of camel milk at critical points along the market chain. 36 camel milk samples were assessed by plating counts of total bacteria (TBC), Streptococcus/Enterococcus (PSEC), yeast
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   Received: 28 November, 2010. Accepted: 11 May, 2011.   Original Research Paper  Food ©2011 Global Science Books Microbiological Quality of Raw Camel Milk across the Kenyan Market Chain Dasel Wambua Mulwa Kaindi 1*   •   Esther Schelling 2   •   John Wangoh 1   •   Jasper Kathenya Imungi 1   •   Zakaria Farah 3   •   Leo Meile 3   1  University of Nairobi, Faculty of Agriculture, Department of Food Science, Nutrition and Technology, P. O. Box 25093, Kangemi, Nairobi, Kenya 2  Swiss Tropical and Public Health Institute, Socin Str. 57, CH-4002 Basel, Switzerland 3  Laboratory of Food Biotechnology, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology ETH, ETH-Zentrum, CH-8092 Zurich, Switzerland Corresponding author  : *   mulwa.dasel@yahoo.com/ mulwa.dasel@uonbi.ac.ke ABSTRACT The objective of this study was to determine the microbiological quality of camel milk at critical points along the market chain. 36 camel milk samples were assessed by plating counts of total bacteria (TBC), Streptococcus/Enterococcus  (PSEC), yeast and mold (YMC),  Enterobacteriaceae  (EBC), and Staphylococcus  (PSC). At milking level all milk samples had TBCs not exceeding 10 5 cfu ml -1 . EBC exceeding 10 3 cfu ml -1  indicating grade II quality was found in 25% of primary collectors’ milk. 75% of bulked milk at the final market had TBC exceeding 10 6  cfu ml -1  and EBC of 5.0 × 10 4  cfu ml -1 ; grade III and IV quality of raw milk an indicator of poor quality and threat to human health according to Kenya quality standards. All microbiological counts increased along the market chain with milk pH changing from 6.49 at milking level to 6.39 at final market. The air and water at the milking level were grossly contaminated while milk containers at milking and primary collection centers needed more appropriate sanitization procedures.  _____________________________________________________________________________________________________________ Keywords:  camel milk quality, camel milk safety, pastoralism Abbreviations:   ASAL , arid and semi-arid lands; cfu ml -1 , colony forming units per milliliter;  EBC ,  Enterobacteriaceae  count; PSC ,  presumptive, Staphylococcus  count; PSEC , presumptive Streptococcus/Enterococcus  count; TBC , total bacteria count; YMC , yeast and mold count INTRODUCTION Camel husbandry in Kenya is mainly conducted in the arid and semi-arid land (ASAL) regions with daily milk yields of between 3 to 10 kg of milk per camel in a lactation  period of 12 to 18 months (Farah et al. 2007). However, there are several constraints in camel milk production and marketing; clean water for washing containers is scarce or unavailable, common use of recycled oil plastic jerry cans with small opening and long durations during transportation in high ambient temperatures, among other factors (Younan and Abdurahman 2004). Thereby microbial spoilage of camel milk inevitably reduces market value and freshness of marketed milk reducing the income to producers and vendors. According to De-Buyser et al  . (2001), Leclerc et al  . (2002) and Harrington et al  . (2002) public health concern associated with microbial food safety has arisen with certain  Enterobacteriaceae  (e.g.  Escherichia coli , Salmo-nella  spp.,  Shigella spp.), Staphylococcus aureus , pyogenic streptococci, Campylobacter jejuni ,  Listeria monocytogenes , some  Brucella  spp., Yersinia   enterocolitica  and pathogenic molds. Milk has been identified as a vehicle of these organisms in many occasions (Harrington et al  . 2002). For instance, mastitis in camels has been studied in the regions  bordering Kenya: Ethiopia (Abera et al  . 2010), Somalia (Abdurahman 2006) and Sudan (Obied et al  . 1996). In addition, coagulase-negative/ coagulase-positive Staphylo-coccus aureus , Streptococcus agalactee , Shigatoxigenic  E. coli ,  Bacillus spp., and pathogenic molds have been isolated from camel milk in Kenya, Ethiopia and Sudan (Abera et al. 2010; Ahmed et al.  2010; Njage 2010). Poor hygiene is a major cause of spoilage of milk products (Brokken 1992; Farah 2004) with zoonotic and human fecal microorganisms  posing an important public health threat to consumers with traditional preference for raw camel milk (Younan and Abdurahman 2004). Currently, the main focus in Kenya is on improving the camel milk microbiological quality and safety. Proposed interventions have included the use of lactoperoxidase system activated with commercial LP-sys-tem kits on pooled camel milk at collection centers (Njage and Wangoh 2008), introduction of cooling facilities, pas-teurization of milk, and provision of clean water and train-ing on hygiene handling of milk (Younan and Abdurahman 2004; Farah et al. 2007; Musinga et al  . 2008; Kaindi 2009; Kamau et al.  2010; Njage 2010). Therefore it was necessary to investigate the microbio-logical contamination of camel milk along the informal market chain by assessing safety and quality indicator orga-nisms to obtain baseline situation of marketed camel milk. The contamination of air at milking area, water for sani-tizing milk containers, and containers at milking level/pri-mary collection point were also evaluated. MATERIALS AND METHODS The study was carried out in Nanyuki and Isiolo Counties in Kenya. Nanyuki is located at latitude 0° 1 0 North and Longitude 37° 4 0 East while Isiolo is at latitude 0° 21 0 North and lon-gitude 37° 35 0 East. In each region, three camel herds were selected in order to capture two herd management practices (semi-modern ranching and pastoral/ traditional systems) which had well defined market chains. Sample collection The sampling procedure of Bonfoh et al  . (2003) was used with the milking level, primary collection point in the local center (Nany-uki/Isiolo) and final market in Nairobi identified as the critical  points along the market chain. Samples at milking level were col- ®   Food 5 (Special Issue 1)  , 79-83 ©2011 Global Science Books   lected between 6.00-7.00 am. Milk from 18 lactating camels was obtained singly into 50-ml sterile Falcon tubes after milkers’ hands and camel udder had been disinfected with 70% ethanol using a hand sprayer and dried with a disposable towel. Six samples were collected from bulked camel milk at milking level while same number of samples was collected at primary collection point and final market from milk containers followed up along the market chains. Upon milk sample collection pH of all milk samples was measured using a digital pH-meter (High-precision 780 pH Meter, Metrohm AG, Switzerland). Up on sample collection, milk and  prevailing environment temperature were measured and recorded in a field questionnaire. The milking yard was assessed for envi-ronmental TBC and YMC by exposing two Petri dishes containing either Standard Plate Count Agar (Difco, USA) or Yeast Mold agar (Difco, USA). Contamination of milk containers at the milking level and primary collection point was determined using the rin-sing technique with 100 ml of sterile water. A sample of water (100 ml) used for cleaning containers at the milking level and pri-mary collection point were collected into sterile tubes. California Mastitis Test (CMT- test) was carried out on milk obtained from each individual animal before bulking. Labeled samples were then transported for analysis within 12 h to a laboratory in Nairobi in a cool box containing adequate dry ice. Microbiological analysis Serial dilutions of samples were prepared using sterile dilution solution of 0.85% of sodium chloride (NaCl) and 0.1% of peptone from casein. Appropriate triple series dilutions were prepared and 0.1 ml surface-plated in duplicate onto appropriate selective or semi-selective growth medium for enumeration of specific groups of microorganisms ( Table 1 ). Statistical data analysis All data obtained in the field questionnaire and from bacteriolo-gical analysis was entered in Microsoft Access database. Statistical data analysis was carried out using Intercooled Stata Version 9.0 (Stata Corp., College Station, TX, USA, 1984–2000). Data on the microbial counts was first transformed to logarithm of colony for-ming units per milliliter of sample (log cfu ml -1 ) and the results were presented as the geometric means and other descriptive sta-tistics. Linear contrast was carried out to compare the counts at different sampling points along the market chain while one-way analysis of variance was used to compare data from the two herding systems. RESULTS pH, temperature of camel milk, environmental temperature and time elapsed between identified critical points along the market chain There was a slight decrease in the pH of camel milk at critical points along the market chain ( Table 2 ). The pH of  bulked milk at the herd level was 6.49 and decreased to 6.39 at the final market in Nairobi. The milk temperature at milking during the cold and warm weather was between 27-29°C ( Table 2 ) with environmental temperature of 17-21°C. The temperature of the milk on arrival at the primary col-lectors was about 29-30°C with environmental temperature of 24-30°C. At the final market the temperature of milk was  between 10-11°C as a result of refrigeration at the primary collection point before milk transportation to final market in  Nairobi. The time elapsed between milking and primary collection point was 2.75-6.5 h while the milk took 18.75-24.75 h between the primary collection point and final mar-ket in Nairobi. Contamination of milking area air, washing water, containers at the milking level and at primary collection point Microbial quality of milk containers at the milking level and primary collection point was not significantly different (  P   > 0.05) ( Fig. 1 ). The containers at the milking level had the following counts (cfu ml -1 ), TBC 10 1 -10 5 , PSEC 10 3 , EBC 10 4 , YMC 10 2 -10 3  and PSC 10 2 -10 3  while containers at primary collection point had TBC 10 2 -10 5 , PSEC 10 2 -10 4 , EBC 10 1 -10 5 , YM 10 2 -10 5  and PSC 10 1 -10 4 . Water at the herd level was heavily contaminated with more than 1.8 × 10 2 coliforms per milliliter of water and TBC ranging from 10 3 -10 5 cfu ml -1 . The air at the milking yard had TBC 10 2 -10 3 and YMC 10 2  cfu    per plate. The microbiological quality of camel milk The prevalence of mastitis among lactating individual camels was 29% (5/17) at the milking level. The geometric means of the microbial counts and the range of counts  between the main points along the market chain are shown in Table 3 . Pair-wise comparisons of all the organisms with exception of PSEC in milk obtained from individual ani-mals before and after pooling at the milking level were not Table 1  Growth media, preparation and incubation conditions of micro organisms of interest. Growth media Media preparation Incubation conditions Supplements Cultivated organisms of interest Reference strains KF Streptococci Agar (Difco) Boiling for 1 min in a water bath 43°C for 24-48 h, aerobic 1% 2,3,5-triphenyl tetrazolium chloride solution (Merck) Enterococci/ presumptive streptococci (PSEC)  Enterococci faecalis  JH-2-2 Baird Parker Agar (Biolife) Autoclave at 121°C for 15 min 37°C for 24 h5% Egg yolk tellurite emulsion (Biolife) Presumptive staphylococci (PSC) Staphylococcus aureus RN4220/PVC5 Yeast Mould Agar (Difco) Autoclave at 121°C for 15 min 30°C for 2-3 days Chloramphenicol at 20 mg/L (Fluka) Yeast and molds (YMC)  Rhodotorula mucilaginoasa  FSQE63Violet Red Bile Glucose Agar (Merck) Boiling for 1 min in a water bath 37°C for 24 h-  Enterobacteriaceae  (EBC)  Escherichia coli  Xl1- Blue Plate Count Agar (Difco) Autoclave at 121°C for 15 min 30°C for 24 h- Aerobic mesophilic bacteria (TBC) - MacConkey broth MPN method - - Coliforms in washing water - Table 2  pH, temperature of camel milk at different points along the market chain, time elapsed between critical points and the prevailing environmental temperature. Sample description n* pH* Milk temperature* (°C) Environmental temperature* ( o C) Cumulative time (hours) elapsed Individual animal milk 11 6.49 ± 0.1 26 ± 2.3 23.5 ± 6.6 < 0.5 Bulked morning milk at herd level 5 6.49 ± 0.1 28 ± 0.8 24.5 ± 6.0 1 Bulked milk at 1 st  collection point 5 6.46 ± 0.1 29 ± 1.7 25 ± 4.6 4 - 8 Bulked milk at final market (Nairobi) 5 6.39 ± 0.1 10.5 ± 0.5 20 21-25 n* = number of samples; pH* = mean pH ± confidence interval (CI); Milk temperature* = Mean ± CI; Environmental temperature* = Mean ± CI 80  Microbiological profile of camel milk along the informal market chains in Kenya. Kaindi et al.   statistically different. Bacterial counts correlated signifi-cantly (  P   > 0.05) to time taken and point along the market chain except for YMC. Bacterial counts in milk from semi-modern ranching and traditional camel husbandry were not statistically different. DISCUSSION pH, temperature of camel milk, temperature of the environment and time elapsed between points along the market chain Raw bulked milk microbial quality depends on among other factors temperature at which milk is stored and time elapsed  between milking and collection (Soler et al  . 1995; Aumaitre 1999; Ahmed et al  . 2010). Camel milk was observed to take more than 6 hrs without cooling before it arrived at primary collection point and 21-25 h between the latter and final market in Nairobi. Owing to the high ambient temperatures of up to 30°C and lack of cooling system, milk reaches the  primary collectors at elevated temperatures of up to 30°C. Milk reached the final market in Nairobi at 10-11°C but, occasionally it may be higher due to delays during transpor-tation by bus (pers. obs.). Long delays in camel milk deli-very observed in this study, could be explained by delays during transportation as a result of poor infrastructure or long distances between production areas and final market (Farah et al. 2007). The pH of camel milk was 6.3-6.5 similar to findings from Farah (2004) and Ahmed et al  . (2010). The stability of camel milk pH due to its buffering phenomenon as des-cribed by Attia et al  . (2001) was also observed in this study since the pH at final market was acceptable at 6.39 even though total titratable acidity indicated that the milk was already souring (personal observation). It is difficult to ob-serve visual changes due to souring since camel milk does not form a firm coagulum (Yagil et al  . 1983; Wangoh 1997; Attia et al  . 2001; Younan and Abdurahman 2004; Kamau et al  . 2010). Table 3  Total bacterial counts (TBC), counts for presumptive Streptococci/ enterococci  (PSEC), yeast and mold (YMC),  Enterobacteriaceae  (EBC)and  presumptive Staphylococci  (PSC) in raw camel milk along the market chain in Kenya.  Milk from udder (aseptic conditions) (*n=18) Pooled milk at milking (n=6) Primary collectors (n=6) Final market (Nairobi) (n=6) Presumptive microorganisms Geometric mean (cfu ml -1 ) Range of counts (cfu ml -1 ) Geometric mean (cfuml -1 ) Range of counts(cfu ml -1 ) Geometric mean (cfu ml -1 )Range of counts (cfu ml -1 ) Geometric mean (cfu ml -1 ) Range of counts(cfu ml -1 )  TBC 3.6 × 10 2  2.1 × 10 1 -4.7 × 10 4  3.2 × 10 3  9.2 × 10 2 -1.7 × 10 4  5.9 × 10 4  1.1 × 10 3 -5.6 × 10 5  3.2 × 10 6  4.7 × 10 5 -1.0 × 10 7  PSEC 1.7 × 10 2  2.1 × 10 1 -1.4 × 10 3  7.1 × 10 1  3.7 × 10 1 -3.4 × 10 2  3.9 × 10 2  3.1 × 10 1 -2.7 × 10 4  4.4 × 10 3  2.0 × 10 2 -5.4 × 10 4  YMC 2.8 × 10 1  1.1 × 10 1 -1.0 × 10 2  6.2 × 10 1  2.1 × 10 1 -2.7 × 10 2  1.2 × 10 2  1.1 × 10 1 -5.0 × 10 4  1.4 × 10 3  9.8 × 10 2 -3.2 × 10 3  EBC 1.8 × 10 1  1.1 × 10 1 -8.1 × 10 2  5.2 × 10 1  1.1 × 10 1 -8.1 × 10 2  9.5 × 10 1  1.0 × 10 1 -3.0 × 10 5  1.6 × 10 5  1.4 × 10 4 -3.5 × 10 6  PSC 2.4 × 10 2  1.8 × 10 1 -2.4 × 10 4  1.3 × 10 3  3.5 × 10 2 -8.3 × 10 3  6.3 × 10 3  6.0 × 10 2 -8.2 × 10 4  2.0 × 10 5  9.1 × 10 4 -2.8 × 10 5   * n = number of samples Fig. 1  Enterobacteriaceae  (EBC), Total bacterial counts (TBC), yeast and mold (YMC), counts for presumptive  Streptococcus/ enterococcus (PSEC), and presumptive  Staphylococcus aureus (PSC) in (air, aseptically obtained milk, water, containers) at milking level and containers at 1 st  collection point of informally marketed camel milk in Kenya.   81   Food 5 (Special Issue 1)  , 79-83 ©2011 Global Science Books   Camel milk contamination factors The contamination factors along the production and infor-mal market chain reduce the shelf life, quality and safety of camel milk. The air at the milking area had high TBC and YMC showing possibility of milk contamination during milking and/ or storage if milk containers were left open. The milking area was also dusty and hence possibility of contamination from microorganisms from soil, from mil-kers’ hands or camel coat during milking (Younan and Abdurahman 2004; Musinga et al  . 2008). Sanitation and water hygiene are extremely important if contamination of milk is to be avoided (Gran et al  . 2002). In this study, water at the milking level was sourced from rivers or lagoons with coliforms counts more than 180 cfu ml -1  and high TBC making it an important source of milk contamination if the water is not adequately heated before washing of containers. Water for cleaning milk containers should be clean potable water (Lore et al  . 2006; Musinga et al  . 2008). Farah (2004) noted that water in the ASALs is grossly contaminated and its availability in the camel milk  production areas is scarce or unavailable, thus making it difficult to improve milk hygiene at the milking level. The main source of water at the primary collection point was  potable water from a borehole. Majority of milk containers were cleaned at the primary collection point rather than at the milking level. However, after using treated municipal water and container smoking, containers was at the primary collection point was not significantly different from con-tainers at the herd level. This shows that appropriate con-tainer sanitizing procedures are not adhered to. Containers for milking, transportation, and storage of milk should be adequately cleaned/ disinfected to avoid microbial contamination (Lore et al  . 2006). In this study, the commonly used containers for handling, storage, and transportation of camel milk were plastic jerry cans of vary-ing sizes. Since, many containers used are of small capa-city and have a small opening which creates difficulty during cleaning (Bonfoh et al  . 2003; Wangoh 2004; Bonfoh et al  . 2006; Ahmed et al  . 2010). Even though, the use of detergents and good quality water during cleaning of equip-ments improves the microbiological quality of milk (Bon-foh et al  . 2006; Musinga et al  . 2008). Cleaning of con-tainers and disinfection with either chemicals or hot water was not a common practice. The prevalence of mastitis of individual animal milk  before bulking at milking level was 29% similar to that re- ported by Younan and Abdurahman (2004) and Abera et al  . (2010) in Ethiopia. Presence of food-borne pathogens in  bulked milk can also be linked to feacal contamination during milking, or from lactating camels with mastitis (Younan et al  . 2001; Younan and Abdurahman 2004; Oliver et al  . 2005; Ahmed et al  . 2010; Obied et al  . 2010; Megersa  et al  . 2011; Tesfaye et al  . 2011). It is therefore clear that, many interactive factors con-tributed to poor hygienic quality of the camel milk sold at the markets. Younan and Abdurahman (2004) reported several risk factors; little consideration to hygiene, pooling of morning and evening milk at milking level and bulking milk from different camel herds and intense manipulation of small quantities of milk using several containers of small capacity at the primary collectors, transportation and hand-ling without any cooling were also observed during this study. Milk microbiological quality The Kenya Bureau of standards (KEBS) (2007) on raw whole camel milk specifications was used in this study. TBC in camel milk milked directly into a sterile conical flask was 10 2 -10 4  cfu ml -1  similar to results reported by Younan and Abdurahman (2004) and Farah et al  . (2007). However, their findings of bulked milk at milking level was10 3 -10 5  cfu ml -1 , primary collection point at 10 6 -10 7  cfu ml -1  and final market at 10 6 -10 8  cfu ml -1 , were higher than the findings of this study. The current findings were also in agreement with those of camel milk in Qassim region which had mean counts of 10 5  cfu ml -1  and maximum of 10 7  cfu ml -1  (El-Ziney and Al-Turki 2007), mean counts of 10 5  cfu ml -1  in Saudi Arabia camel milk (Al Mohizea 1994) and 10 6  cfu ml -1 in Ethiopia (Semereab and Molla 2001). 75% of the bulked milk at primary collection point was within the microbiological acceptable limit of 10 6  cfu ml -1  indicating milk of grade I and II quality while 75% bulked milk at the final market exceeded the microbiological ac-ceptable limits of 10 6  cfu ml -1 (grade III and IV) of raw milk (KEBS 2007) which indicates poor quality milk and a threat to human health. There was significant increase or buildup of TBC in milk between the primary collection point and the final market. Presumptive Streptococcal/Enterococcal   counts were significantly different between the primary collection point and final market in Nairobi which had mean 10 3  cfu ml -1  and a maximum count of 10 4  cfu ml -1 , probably as a result of microbial build up due to long storage period of market milk and further contamination at the primary collection  point. At primary collection point , yeast and mold count in this study had maximum counts of 10 4  cfu ml -1  which was slightly lower than mean and maximum values of 10 2  and 10 6  cfu ml -1 , respectively for the Qassim region (El-Ziney and Al-Turki 2007), and Moroccan camel’s milk with mean count of 10 6  cfu ml -1  (Benkerroum et al  . 2003). According to Frazier and Westhoff (1998) and Pitt and Hocking (1997), the high YMC in milk are uncommon since the the natural  pH of milk cause bacteria to predominate. However, the FAO (1992) reported that, yeast and molds are able to grow in a wide pH of 2-9 and in many cases they alter the pH of milk to about 4-6.5 favourable to their growth. The EBCs increased from 9.5×10 1  to 1.6×10 5 cfu ml -1   between primary collection centers and final market indi-cating significant contamination and microbial build up at this point. Twenty five percent of bulked camel milk at pri-mary collection point had EBC exceeding 10 3  cfu ml -1  indi-cating grade II quality of milk while 75% of bulked final market milk had EBC exceeding microbiological acceptable limit of 5×10 4  cfuml -1  indicating milk of grade III quality (KEBS 2007). The results are in agreement with the fin-dings of camel milk in Qassim region with a mean value of 10 3  cfu ml -1  and a maximum of 10 7  cfu ml -1  (El-Ziney and Al-Turki 2007). Similarly, high coliform counts were ob-served in camel milk in Ethiopia (Semereab and Molla 2001) and in Moroccan camel milk (Benkerroum et al  . 2003) which was 10 7  cfu ml -1  on average. However, exis-tence of coliforms may not necessarily indicate a direct fecal contamination of milk, but is an indicator of poor sani-tary practices during milking and further handling processes (Frazier and Westhoff 1988). The PSC counts of bulked camel milk at the farm and  primary collection point had mean counts of 10 3  cfu ml -1  while at final market it was 10 5  cfu ml -1 . The mean counts of PSC in bulked milk are in agreement with findings of Moroccan camel milk 10 5  cfu ml -1 and were slightly lower than camel milk in the Qassim region in Saudi Arabia with mean count of 10 7  cfu ml -1  (El-Ziney and Al-Turki 2007). In this study, camel milk quality control checks are un-available, with most buyers and sellers relying on organo-leptic testing, hence, milk microbiological quality deteri-orates unnoticeably. Milk rejects have discouraged many camel farmers from supplying the Nanyuki camel milk dairy which has quality control measures in place. Majority of pastoralists believe that camel milk has unique beneficial  properties which are lost by heating close to boiling temperature and thereby preferred consumption of raw or unpasteurized camel milk for its medicinal or therapeutic  purposes. We therefore underline that consumption of un- processed camel milk at the current status poses potential  public health risk as was reported in other studies (Kauf-mann and Binder 2002; Younan and Abdurahman 2004; Farah et al  . 2007; Njage 2010). 82  Microbiological profile of camel milk along the informal market chains in Kenya. Kaindi et al.   CONCLUSION AND RECOMMENDATIONS The microbial quality of camel milk was the same for semi-modern ranching and traditional camel husbandry. Milk at the milking level had TBCs not exceeding microbiological limit of 10 5  cfu ml -1 and was ranked a grade I quality milk. At primary collectors 25% had EBC exceeding 10 3 cfu ml -1  indicating grade II quality of milk while 75% was grade I quality. However, 75% of bulked milk at the final market exceeded the TBC acceptable limits of 10 6  cfu ml -1  and EBC of 5.0×10 4  cfu ml -1  (grade III and IV quality of raw milk) according to KEBS (2007) an indicator of poor qua-lity and a threat to human health. Therefore, in order to safeguard consumer health and to strengthen the source of income through the sale of milk by  producers and vendors, there should be initiatives to lower microbiological contamination of camel milk at milking level, primary collectors at the local centers and final mar-ket. Training on hygiene handling of milk for herders, the  primary collectors and vendors is also necessary. Other interventions should focus on provision of clean water at milking level, veterinary services, reduce the time taken  before selling milk, provision of milk cooling facilities at milking level and other levels and provision of efficient/ organized milk transportation and storage systems. ACKNOWLEDGEMENTS Our acknowledgement goes to Kenya Camel Association (KCA) for the collaborative effort during the field work. In addition, we thank Patrick Kamau, Christoph Jans and Monika Weller for their contribution in this study. Funding of this study was by the North South Centre Research for Development of the Swiss Federal Ins-titute of Technology ETH Zurich. 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