Improving Health and Wealth by Introduction of an Affordable Bacterial Starter Culture for Probiotic Yoghurt Production in Uganda

Round 1

Reviewer 1 Report

The manuscript entitled “Improving Health and Wealth by Introduction of an 2 Affordable Bacterial Starter Culture for Probiotic Yoghurt Production in Uganda” gives a complete sight of the impact on health and economy of the introduction of probiotic yogurt production skills among small dairy companies, women groups and local entrepreneurs. Very good results where achieved and an example of development promoting intervention is given. The manuscript is well written and I have very few remarks reported below.  I recommend acceptance after minor revisions.

MINOR REMARKS

Table 2, not clear what data in the first row represent

DISCUSSION

Figure 4 and related description should be moved to the introduction since they explain the model of intervention.

Please do not reiterate results in some parts, e.g. Lines 293-296

Descriptions of the characteristics of the different intervention areas should be summarized and made more explicative by highlighting the relationship between efficacy of intervention and socio-economic conditions of each. No need to present in separate sections.

METHODS

Figure 5 is cut at the bottom

Line 484; please, check the content and characters

Author Response

The manuscript entitled “Improving Health and Wealth by Introduction of an Affordable Bacterial Starter Culture for Probiotic Yoghurt Production in Uganda” gives a complete sight of the impact on health and economy of the introduction of probiotic yogurt production skills among small dairy companies, women groups and local entrepreneurs. Very good results were achieved and an example of development promoting intervention is given. The manuscript is well written and I have very few remarks reported below.  I recommend acceptance after minor revisions.

Question / comment 1: Table 2, not clear what data in the first row represent

Answer 1: Thank you for this remark. We have added the ‘Average production volume’ in the description column to clarify what the first row represents.

Question / comment 2: Figure 4 and related description should be moved to the introduction since they explain the model of intervention.

Answer 2: Figure 4 and related descrption has been moved tot he introduction

Question / comment 3: Please do not reiterate results in some parts, e.g. Lines 293-296

Answer 3: The results mentioned in lines 293 – 296 where earlier presented in the result section in the form of a table (table 2), without further elaborations or interpretations. Lines 293 – 296 concern the discussion section, where the results are being compared to findings of other authors in the literature. In our opinion this does not amount to a reiteration. However, we noted that in the discussion section we forgot to refer to the results section as the source of the data being discussed, and we have corrected this by adding a reference to table 2 in line 296.

Question / comment 4: Descriptions of the characteristics of the different intervention areas should be summarized and made more explicative by highlighting the relationship between efficacy of intervention and socio-economic conditions of each. No need to present in separate sections.

Answer 4:

We have removed all the headers and sub-sections of 3.3. In each of these sub-sections we have made the relationship between efficacy of intervention and socio-economic conditions more explicit by addition of reference to Table 1 (L379; L365).

Question / comment 5: Figure 5 is cut at the bottom

Answer 5: In our version of the article Figure 5 was not cut at the bottom (possibly a result of the pdf conversion?)

Question / comment 6: Line 484; please, check the content and characters

Answer 6: Not clear what is actually referred to.  Possibly the word ‘result chain’ has caused confusion, but we think that ‘result chain’ is a common and valid concept, and the spelling and grammar of this sentence are otherwise correct.

Reviewer 2 Report

themanuscript describes and provides evidence that "combination of a training program and access to an affordable and stable  probiotic starter culture to increase health and wealth of local communities by the use of existing  infrastructures and preferences can be taken as a positive reference for deployment of self-sustainable  activities that contribute to value addition at multiple sites along the food chain in sub Saharan Africa".  There is interest in readingand discussing similar initiatives. I would recommend the authors to submit additional papers on thetopic, from  a microbiological perspective. for instance, S. thermophilus, the partner in yogurt, may have a role in preventing S. pneumoniae infection, and Streptococci in general by means of  DNA immunization. All other effects on health are linked to theprobiotic strain. Since the costs of 1 liter of milk is just 1000 UGX, and a unit of probiotic yogurt is 4000 UGX, it may be possible to self-produceby backslopping at home. Is this happening? sugar added yogurt may not be the best option froma helath perspective, what about the consumere preference for a white, not flavoured yogurt? Thank you for this nice article.

Author Response

The manuscript describes and provides evidence that "combination of a training program and access to an affordable and stable probiotic starter culture to increase health and wealth of local communities by the use of existing  infrastructures and preferences can be taken as a positive reference for deployment of self-sustainable  activities that contribute to value addition at multiple sites along the food chain in sub Saharan Africa".  There is interest in reading and discussing similar initiatives. 

Question / comment 1: I would recommend the authors to submit additional papers on the topic, from a microbiological perspective. For instance, S. thermophilus, the partner in yogurt, may have a role in preventing S. pneumoniae infection, and Streptococci in general by means of DNA immunization. All other effects on health are linked to the probiotic strain.

Answer 1: We would like to refer to one of our previous papers (REF 72: Kort, Westerik et al. "A novel consortium of Lactobacillus rhamnosus and Streptococcus thermophilus for increased access to functional fermented foods." Microbial cell factories 14.1 (2015): 195.) for a more microbial perspective on the intervention. We would thank the reviewer for the suggestion of looking deeper into the possible health effects of S. thermophilus in future publications.

Question / comment 2: Since the costs of 1 liter of milk is just 1000 UGX, and a unit of probiotic yogurt is 4000 UGX, it may be possible to self-produced by back slopping at home. Is this happening?

Answer 2: Backslopping of probiotic yoghurt at home is not common. Yoghurt production requires a thermometer (as the minimal equipment) and knowledge on the exact production protocol, which is not usually available at household level. Secondly, the majority of households do not possess a fridge, hence home production would be in small quantities, which would be a relatively labor intensive process. Finally, yoghurt is not commonly consumed from home, but consumed as a convenient snack by those who are at work, at school or travelling and demand a ready-made and conveniently packed product.

Question / comment 3: Sugar added yogurt may not be the best option from a health perspective, what about the consumer preference for a white, not flavored yogurt?

Answer 3: The authors do regret the level of sugar consumption among the majority of the Ugandan population, but it is outside the scope of this  intervention to reduce the sugar consumption of the general population. The owners of the yoghurt production units have full ownership of their business, and in order to sell their product, they are forced to comply with consumer demands, which amounts to sweetened and flavored yoghurt.