Geographic Distribution of Households with Goats and Women’s Adverse Pregnancy Outcomes and Perceptions of Healthcare Providers Toward Risk of Exposure to Goats or Their Raw Products in Pregnant Women


  • Kan Kledmanee Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
  • Tipppawan Liabsuetrakul Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.



adverse pregnancy outcomes, goats, healthcare providers, perceptions, raw goat products, risk screening


Objective: To identify the geographic distribution of households with goats and rates of adverse pregnancy outcomes in women, and assess healthcare providers’ perceptions towards risk of adverse pregnancy outcomes related with exposure to goats or their raw products during pregnancy and their intention to do risk screening.
Material and Methods: A cross-sectional study was conducted in Songkhla province using the number of households with goats and the rates of abortion, stillbirth, and preterm birth reported in the Thailand 2015 Universal Coverage Scheme database. The perceptions towards risk of exposure to goats or their raw products and the intention to do risk screening according to the Health Belief Model of 46 healthcare providers from four districts of this province were using correlation analysis and multiple linear regression.
Results: A high number of households with goats was found in all four districts but the number of households with goats was not significantly correlated with any of the rates of adverse pregnancy outcomes. Most perceptions of healthcare providers were highly correlated with intention to do risk screening, except their perceptions on barriers. Cues to action was significantly (p-value=0.018) associated with intention to do risk screening in multiple regression analysis.
Conclusion: No correlation between the number of households with goats and rates of adverse pregnancy outcomes were found; however, healthcare providers had positive perceptions and intention to do risk screening for exposure to goats or their raw products in pregnant women. Education and warning messages concerning zoonosis as strengthening cues to action are needed.


Download data is not yet available.


1. Food and Agriculture Organization of the United Nations (FAO). Production of goats [homepage on the Internet]. Rome: FAO; 2018 [cited 2018 Jun 30]. Available from:

2. Semae S. The success way of goat raising by Muslim way. J Yala Rajabhat Univ 2007;2:72–81.

3. Kimman T, Hoek M, de Jong MCM. Assessing and controlling health risks from animal husbandry. NJAS - Wagening J
Life Sci 2013;66:7–14.

4. Facciolà A, Palamara MAR, D’Andrea G, Marano F, Magliarditi D, Puglisi G, et al. Brucellosis is a public health problem in southern Italy: burden and epidemiological trend of human and animal disease. J Infect Public Health 2018;11:861–6.

5. Rossetti CA, Arenas-Gamboa AM, Maurizio E. Caprine brucellosis: a historically neglected disease with significant
impact on public health. PLoS Negl Trop Dis 2017;11. doi: 10.1371/journal.pntd.0005692.

6. van der Hoek W, Meekelenkamp JCE, Dijkstra F, Notermans DW, Bom B, Vellema P, et al. Proximity to goat farms and Coxiella burnetii seroprevalence among pregnant women. Emerg Infect Dis 2011;17:2360–3.

7. Committee on Infectious Diseases; Committee on Nutrition; American Academy of Pediatrics. Consumption of raw or
unpasteurized milk and milk products by pregnant women and children. Pediatrics 2014;133:175–9.

8. Jittapalapong S, Sangvaranond A, Pinyopanuwat N, Chimnoi W, Khachaeram W, Koizumi S, et al. Seroprevalence of
Toxoplasma gondii infection in domestic goats in Satun Province, Thailand. Vet Parasitol 2005;127:17–22.

9. Doung-ngern P, Chuxnum T, Pangjai D, Opaschaitat P, Kittiwan N, Rodtian P, et al. Seroprevalence of Coxiella burnetii antibodies among ruminants and occupationally exposed people in Thailand, 2012–2013. Am J Trop Med Hyg 2017;96:786–90.

10. Ninprom T, Nonthasorn P, Thiptara A, Kongkaew W. Prevalence and spatial distribution of brucellosis in goats in the southernmost provinces of Thailand in 2014. Thai - NIAH EJournal 2016;11:16–26.

11. Pandey D. Pregnancy outcome in maternal toxoplasmosis: a case control study. Open Access J Gynecol 2018;3:1–6.

12. Ali S, Akhter S, Neubauer H, Scherag A, Kesselmeier M, Melzer F, et al. Brucellosis in pregnant women from
Pakistan: an observational study. BMC Infect Dis 2016;16:468.

13. Jover-Díaz F, Robert-Gates J, Andreu-Gimenez L, Merino-Sanchez J. Q fever during pregnancy: an emerging cause of prematurity and abortion. Infect Dis Obstet Gynecol 2001;9:47–9.

14. Kledmanee K, Liabsuetrakul T, Sretrirutchai S. Risk of adverse pregnancy outcomes and seroprevalence for brucellosis in pregnant women exposed to goats or raw goat products in southern Thailand: a prospective cohort study. BMC Pregnancy Childbirth 2019;19:118.

15. Kersting AL, Medeiros LC, LeJeune JT. Zoonoses and the physicians’ role in educating farming patients. J Agromedicine2009;14:306–11.

16. Janz NK, Becker MH. The health belief model: a decade later. Health Educ Behav 1984;11:1–47.

17. Yarbrough SS, Braden CJ. Utility of health belief model as a guide for explaining or predicting breast cancer screening behaviours. J Adv Nurs 2001;33:677–88.

18. Bednarczyk RA, Chamberlain A, Mathewson K, Salmon DA, Omer SB. Practice-, provider-, and patient-level interventions to improve preventive care: development of the P3 Model. Prev Med Rep 2018;11:131–8.

19. Wong S, Marcus R, Hawkins M, Shallow S, McCombs KG, Swanson E, et al. Physicians as food-safety educators: a
practices and perceptions survey. Clin Infect Dis 2004;38:S212–8.

20. Department of Livestock. Farmers and livestock in 2015 [homepage on the Internet]. Bangkok: Department of Livestock; 2015 [cited 2015 Jan 23]. Available from:

21. Songkhla Provincial Statistics Office. Provincial Statistical Report 2015 [homepage on the Internet]. Songkhla: Songkhla Provincial Statistics Office; 2015 [cited 2018 Jan 23]. Available from:

22. Nielsen SY, Mølbak K, Henriksen TB, Krogfelt KA, Larsen CS, Villumsen S. Adverse pregnancy outcomes and Coxiella
burnetii antibodies in pregnant women, Denmark. Emerg Infect Dis 2014;20:925–31.

23. Akbarian Z, Ziay G, Schauwers W, Noormal B, Saeed I, Qanee AH, et al. Brucellosis and Coxiella burnetii infection in householders and their animals in secure villages in Herat province, Afghanistan: a cross-sectional study. PLoS Negl Trop Dis 2015;9:1–17.

24. Kramer MS, Zhang X, Platt RW. Analyzing risks of adverse pregnancy outcomes. Am J Epidemiol 2014;179:361–7.

25. Te-Chaniyom T, Geater AF, Kongkaew W, Chethanond U, Chongsuvivatwong V. Goat farm management and Brucella serological test among goat keepers and livestock officers, 2011–2012, Nakhon Si Thammarat province, southern Thailand. One Health 2016;2:126–30.

26. Speare R, Mendez D, Judd J, Reid S, Tzipori S, Massey PD. Willingness to consult a veterinarian on physician’s advice for zoonotic diseases: a formal role for veterinarians in medicine? PLoS One 2015;10. doi: 10.1371/journal.pone.

27. Dunn BS, Tice AD, Dc ELH, Katz AR. Knowledge and perceptions about community-acquired Staphylococcal infections among health care workers in Hawai‘i. Hawaii J Med Public Health 2013;72:6.

28. Weng YH, Bhembe PT, Chiou HY, Yang CY, Chiu YW. Perceived risk of tuberculosis infection among healthcare
workers in Swaziland. BMC Infect Dis 2016;16:1–8.

29. Kirkham C, Berkowitz J. Listeriosis in pregnancy: survey of British Columbia practitioners’ knowledge of risk factors,
counseling practices, and learning needs. Can Fam Physician 2010;56:158–66.

30. Zhang HL, Mnzava KW, Mitchell ST, Melubo ML, Kibona TJ, Cleaveland S, et al. Mixed methods survey of zoonotic disease awareness and practice among animal and human healthcare providers in Moshi, Tanzania. PLoS Negl Trop Dis 2016;10.doi: 10.1371/journal.pntd.0004476.

31. Weng HY, Ankrom K. Practices and perceptions of animal contact and associated health outcomes in pregnant women and new mothers. Front Vet Sci 2016;3:1–7.

32. Hill WA, Petty GC, Erwin PC, Souza MJ. A survey of Tennessee veterinarian and physician attitudes, knowledge, and practices regarding zoonoses prevention among animal owners with HIV infection or AIDS. J Am Vet Med Assoc 2012;240:1432–40.

33. Grant S, Olsen CW. Preventing zoonotic diseases in immunocompromised persons: the role of physicians and veterinarians. Emerg Infect Dis 1999;5:159.

34. John K, Kazwala R, Mfinanga GS. Knowledge of causes, clinical features and diagnosis of common zoonoses among
medical practitioners in Tanzania. BMC Infect Dis 2008;8:162.




How to Cite

Kledmanee K, Liabsuetrakul T. Geographic Distribution of Households with Goats and Women’s Adverse Pregnancy Outcomes and Perceptions of Healthcare Providers Toward Risk of Exposure to Goats or Their Raw Products in Pregnant Women. J Health Sci Med Res [Internet]. 2019 Jun. 19 [cited 2022 Oct. 1];37(3):217-2. Available from:



Original Article