Seroprevalence and associated risk factors of leptospirosis in slaughter pigs; a neglected public health risk, western Kenya

BACKGROUND

Leptospirosis is a neglected zoonosis of public health importance transmitted through contact with contaminated soil, water or urine of infected animals. In pigs the disease is characterized by abortion, still births and weak piglets. A cross-sectional study was conducted in May to July 2018 to estimate the sero-prevalence of leptospirosis and factors associated with seropositivity in slaughter pigs. A questionnaire was used to collect information on animal demographics. Serum was tested for anti-leptospiral antibodies using microscopic agglutination test (MAT) with a panel of 8 serovars. Sera were considered positive for sero-reactivity at a MAT titre ≥1:40 against at least one serovar. Chi-square tests were used to measure the strength of association between the MAT test result and exploratory variables.

RESULTS

A total of 252 pig serum samples from seven slaughterhouses were tested for Leptospira antibodies by MAT. Of the 252 pigs sampled, 88.8% (244/252) were indigenous breeds; 55.6% (140/252) were female and 88.7% (220/252) were reared in extensive production systems. Eighty-three (32.9%; 83/252) sera samples tested positive on MAT against at least one serovar. Of the 8 serovars, the highest prevalence was recorded for serovar Lora 21.4% followed by Kenya 5.2%, Sokoine 3.6% and Grippotyphosa at 3.2%. Risk factors for leptospirosis seropositivity in pigs were: originating from farms with other types of livestock (OR 2.3; 95% CI 1.0-4.5) and mature pigs (OR 1.9; 95% CI 1.1-3.3).

CONCLUSION

This study demonstrates that there is a high prevalence of leptospirosis positive pigs at slaughter in a small-holder livestock keeping region of the Lake Victoria basin. The potential for cross species transmission of pathogenic serovars is highlighted as well as the potential for occupational exposure to slaughterhouse personnel. Improvements in husbandry practices (confinement and rodent control) and public health education among slaughterhouse workers and other high-risk groups is recommended.

Seropositivity of Brucella spp. and Leptospira spp. antibodies among abattoir workers and meat vendors in the city of Mwanza, Tanzania: A call for one health approach control strategies

INTRODUCTION

Brucellosis and leptospirosis are among neglected tropical zoonotic diseases particularly in the resource limited countries. Despite being endemic in these countries, there is paucity of information on its magnitude. This study investigated seropositivity of Brucella spp. and Leptospira spp., and associated factors among abattoir workers and meat vendors in the city of Mwanza, Tanzania.

METHODOLOGY

A community based cross-sectional study was conducted in Mwanza city from May to July 2017. Socio-demographic and other relevant information were collected. Detection of Brucella spp. and Leptospira spp. antibodies were done using slide agglutination test and microscopic agglutination test, respectively. Data were analyzed using STATA version 13 Software.

FINDINGS

A total of 250 participants (146 abattoir workers and 104 meat vendors) were enrolled with median age of 31 (IQR: 25-38) years. The overall, seropositivity of Brucella spp. antibodies was 48.4% (95% Cl: 42-54). Seropositivity of B. abortus was significantly higher than that of B. melitensis (46.0%, 95%Cl: 39-52 vs. 23.6%, 95% Cl: 18-28, P<0.001) while seropositivity of both species was 21.2% (95%Cl: 16-26). The seropositivity of Leptospira spp. was 10.0% (95% CI: 6-13) with predominance of Leptospira kirschneri serovar Sokoine which was detected in 7.2% of the participants. Being abattoir worker (OR: 2.19, 95% CI 1.06-4.54, p = 0.035) and long work duration (OR: 1.06, 95%CI: 1.01-1.11, p = 0.014) predicted presence of both B.abortus and B. melitensis antibodies. Only being married (p = 0.041) was significantly associated with seropositivity of Leptospira spp. Primary education was the only factor independently predicted presence of Brucella spp. antibodies among abattoir workers on sub-analysis of occupational exposure. None of factors were found to be associated with presence of Brucella spp. antibodies among meat vendors on sub-analysis.

CONCLUSION

Seropositivity of B.abortus antibodies among abattoir workers and meat vendors is high and seem to be a function of being abattoir worker, having worked for long duration in the abattoir and having primary education. In addition, a significant proportion of abattoir workers and meat vendors in the city was seropositive for Leptospira kirschneri serovar Sokoine. There is a need to consider 'one health approach' in devising appropriate strategies to control these diseases in the developing countries.

Leptospira infections in freshwater fish in Morogoro Tanzania: a hidden public health threat

Leptospirosis caused by spirochete bacterium of genus Leptospira affects humans and animals worldwide. Rodents are major reservoirs of leptospires whereas wetland and aquatic migratory birds also carry and transmit leptospires. Leptospirosis studies in fish are lacking in African countries despite favourable environment and abundant reservoirs, which can spread leptospires into aquatic habitats and infect fish. The objectives of this study were to determine presence of Leptospira in fish; the prevalent Leptospira serovars and whether are related to serovars reported in animals; and to ascertain potential public health risk. Live tilapia, catfish and eel fish (n = 48) were caught in Mindu Dam in Morogoro Municipality in eastern Tanzania. Blood sample was collected using syringes and needles to obtain serum for serological detection of leptospirosis using gold standard microagglutination test utilizing local and reference Leptospira serovars Sokoine, Kenya, Pomona and Hebdomadis. Twenty-six fish (54.2%) were positive for serovar Kenya (29.2%) and Sokoine (25%). Leptospira prevalence was high in both catfish (58.3%) and tilapia fish (47.8%). Thus, different fish types are infected with Leptospira found in animals. Fish could be source of Leptospira infection to humans since tilapia and catfish are the common fish type widely consumed in Tanzania. Further study covering lakes, rivers and dams is required to better understand the prevalence of Leptospira in fish and actual public health threats.

Seroprevalence of Leptospira infection in bats roosting in human settlements in Morogoro municipality in Tanzania

Leptospirosis is a neglected emerging infectious disease with high burden in Africa. Major reservoirs of leptospirosis are rodents and other small mammals. Studies of leptospirosis in bats and the extent to which they contribute to its transmission to humans and domestic animals in Tanzania are lacking. The objective of this study was to determine the prevalence of leptospirosis and local Leptospira serovars in bat colonies found around human settlements in Morogoro, Tanzania. In this study, mist nets were used to capture bats at Sokoine University of Agriculture main campus, whereas bats roosting on trees at Nunge A, Nunge B and M were primary school were captured manually. Leptospirosis was determined using the gold standard microscopic agglutination test for determination of Leptospira antibodies. Six live Leptospira serovars including local Leptospira serovar Sokoine, Kenya and Lora reported in rodents and domestic animals in Tanzania, and reference serovars Hebdomadis, Canicola and Pomona were used in the study. Leptospirosis prevalence was high in bats (19.4%) and higher within colonies (27.3%). Leptospira serovar Sokoine was more prevalent (19.4%) compared to serovars Kenya (2.8%) and Lora (2.8%). Serovars Pomona, Canicola and Hebdomadis were not detected in bats. In conclusion, bats are potential reservoir and transmitter of Leptospira serovar Sokoine, hence should be prevented to access houses and roosting in human settlements to avoid public health risks. Routine diagnosis of human leptospirosis is needed in Tanzania as evidence show a high prevalence of Leptospira in reservoir hosts interacting with humans.

Prevalence of leptospirosis and toxoplasmosis: a study of rodents and shrews in cultivated and fallow land, Morogoro rural district, Tanzania

Leptospirosis and toxoplasmosis are among understudied zoonotic diseases that are also not diagnosed routinely in Tanzania. Humans get leptospirosis and toxoplasmosis through contact with an environment contaminated with Leptospira bacteria and Toxoplasma protozoa from reservoir hosts, which are rodents and cats, respectively. The objective of this study was to determine the prevalence of Leptospira and Toxoplasma infections in rodents and shrews in Mikese area of Morogoro Rural District in eastern Tanzania. A total of 89 rodents and one shrew from cultivated and fallow land were tested for leptospirosis using six Leptospira serovars: Sokoine, Kenya, Canicola, Lora, Hebdomadis and Pomona. Toxoplasmosis was determined in 46 rodents brain smears. The prevalence of leptospirosis was 25.8%, and Leptospira serovar Sokoine was the most prevalent serovar (16.9%). Toxoplasma was detected in one rodent (2.17%) individual while three rodent individuals had Toxoplasma-like parasites hence were considered suspect positive. Findings suggest potential existence of human leptospirosis which needs to be further investigated. Public awareness of leptospirosis and toxoplasmosis should be promoted and their diagnosis considered in patients in health care facilities.

Leptospira Serovars for Diagnosis of Leptospirosis in Humans and Animals in Africa: Common Leptospira Isolates and Reservoir Hosts

The burden of leptospirosis in humans and animals in Africa is higher than that reported from other parts of the world. However, the disease is not routinely diagnosed in the continent. One of major factors limiting diagnosis is the poor availability of live isolates of locally circulating Leptospira serovars for inclusion in the antigen panel of the gold standard microscopic agglutination test (MAT) for detecting antibodies against leptospirosis. To gain insight in Leptospira serovars and their natural hosts occurring in Tanzania, concomitantly enabling the improvement of the MAT by inclusion of fresh local isolates, a total of 52 Leptospira isolates were obtained from fresh urine and kidney homogenates, collected between 1996 and 2006 from small mammals, cattle and pigs. Isolates were identified by serogrouping, cross agglutination absorption test (CAAT), and molecular typing. Common Leptospira serovars with their respective animal hosts were: Sokoine (cattle and rodents); Kenya (rodents and shrews); Mwogolo (rodents); Lora (rodents); Qunjian (rodent); serogroup Grippotyphosa (cattle); and an unknown serogroup from pigs. Inclusion of local serovars particularly serovar Sokoine in MAT revealed a 10-fold increase in leptospirosis prevalence in Tanzania from 1.9% to 16.9% in rodents and 0.26% to 10.75% in humans. This indicates that local serovars are useful for diagnosis of human and animal leptospirosis in Tanzania and other African countries.

Prevalence of bacterial febrile illnesses in children in Kilosa district, Tanzania

INTRODUCTION

Bacterial etiologies of non-malaria febrile illnesses have significantly become important due to high mortality and morbidity, particularly in children. Despite their importance, there are few reports on the epidemiology of these diseases in Tanzania, and the true burden of such illnesses remains unknown. This study aimed to identify the prevalence of leptospirosis, brucellosis, typhoid fever and urinary tract infections and their rate of co-infections with malaria.

METHODS

A cross-sectional study was conducted at Kilosa district hospital in Tanzania for 6 months. Febrile children aged from 2-13 years were recruited from the outpatient department. Patients were screened by serological tests such as IgM and IgG ELISA, and microscopic agglutination test.

RESULTS

A total of 370 patients were enrolled; of these 85 (23.0%) had malaria parasites, 43 (11.6%) had presumptive acute leptospirosis and 26/200 (13%) had confirmed leptospirosis. Presumptive acute brucellosis due to B. abortus was identified among 26 (7.0%) of patients while B. melitensis was detected in 57 (15.4%) of the enrolled patients. Presumptive typhoid fever due to S. Typhi was identified in thirty eight (10.3%) of the participants and 69 (18.6%) had urinary tract infections. Patients presented with similar symptoms; therefore, the identification of these diseases could not be done based on clinical ground alone. Co-infections between malaria and bacterial febrile illnesses were observed in 146 patients (39.5%). Although antibacterials and/or anti-malarials were prescribed in most patients, some patients did not receive the appropriate treatment.

CONCLUSION

The study has underscored the importance of febrile bacterial diseases including zoonoses such as leptospirosis and brucellosis in febrile children, and thus such illnesses should be considered by clinicians in the differential diagnoses of febrile diseases. However, access to diagnostic tests for discrimination of febrile illnesses is needed. This would allow febrile patients to receive the correct diagnoses and facilitation of accurate and prompt treatment.

Predominant leptospiral serogroups circulating among humans, livestock and wildlife in Katavi-Rukwa ecosystem, Tanzania

Background

Leptospirosis is a worldwide zoonotic disease and a serious, under-reported public health problem, particularly in rural areas of Tanzania. In the Katavi-Rukwa ecosystem, humans, livestock and wildlife live in close proximity, which exposes them to the risk of a number of zoonotic infectious diseases, including leptospirosis.

Methodology/Principal Findings

A cross-sectional epidemiological study was carried out in the Katavi region, South-west Tanzania, to determine the seroprevalence of Leptospira spp in humans, domestic ruminants and wildlife. Blood samples were collected from humans (n = 267), cattle (n = 1,103), goats (n = 248), buffaloes (n = 38), zebra (n = 2), lions (n = 2), rodents (n = 207) and shrews (n = 11). Decanted sera were tested using the Microscopic Agglutination Test (MAT) for antibodies against six live serogroups belonging to the Leptospira spp, with a cutoff point of ≥ 1:160. The prevalence of leptospiral antibodies was 29.96% in humans, 30.37% in cattle, 8.47% in goats, 28.95% in buffaloes, 20.29% in rodents and 9.09% in shrews. Additionally, one of the two samples in lions was seropositive. A significant difference in the prevalence P<0.05 was observed between cattle and goats. No significant difference in prevalence was observed with respect to age and sex in humans or any of the sampled animal species. The most prevalent serogroups with antibodies of Leptospira spp were Sejroe, Hebdomadis, Grippotyphosa, Icterohaemorrhagie and Australis, which were detected in humans, cattle, goats and buffaloes; Sejroe and Grippotyphosa, which were detected in a lion; Australis, Icterohaemorrhagie and Grippotyphosa, which were detected in rodents; and Australis, which was detected in shrews. Antibodies to serogroup Ballum were detected only in humans.

Conclusions

The results of this study demonstrate that leptospiral antibodies are widely prevalent in humans, livestock and wildlife from the Katavi-Rukwa ecosystem. The disease poses a serious economic and public health threat in the study area. This epidemiological study provides information on circulating serogroups, which will be essential in designing intervention measures to reduce the risk of disease transmission.

Leptospirosis is a disease of worldwide significance, and it is also an important zoonotic disease, particularly in developing countries. Subclinically infected rodents maintain leptospires in nature, and some that recover from the primary leptospiral infection may release the bacterium in their urine for the rest of their lives. These rodents serve as a potential source of leptospiral infection to animals and humans. Non-rodent mammals can also be reservoirs of leptospiral infection to animals and humans. Globally, animal and human leptospirosis has been attributed to rodents. There is limited knowledge on the occurrence of the disease in domestic animals, humans, wildlife and rodents in many parts of Tanzania, including the Katavi-Rukwa ecosystem. Serological examination of cattle, goats, humans, buffaloes, zebra, lions, rodents and shrews in the ecosystem revealed the presence of antibodies to serogroups Sejroe, Hebdomadis, Grippotyphosa, Icterohaemorrhagie, Australis and Ballum. These serogroups infect not only their usual hosts but also other animal species, which can in turn act as reservoirs of these serogroups to other animals and humans. This study demonstrates the distribution of leptospiral serogroups in domestic animals, humans, wildlife, rodents and shrews in the Katavi-Rukwa ecosystem. The results of the current study will help in developing appropriate interventions for preventing or mitigating the impacts of infections in domestic animals, humans, wildlife, rodents and shrews. Our results also suggest that human and animal populations are at risk of contracting the infection.