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Moorthy GS, Rubach MP, Maze MJ, Refuerzo RP, Shirima GM, Lukambagire AS, Bodenham RF, Cash-Goldwasser S, Thomas KM, Sakasaka P, Mkenda N, Bowhay TR, Perniciaro JL, Nicholson WL, Kersh GJ, Kazwala RR, Mmbaga BT, Buza JJ, Maro VP, Haydon DT, Crump JA, Halliday JEB. Prevalence and risk factors for Q fever, spotted fever group rickettsioses, and typhus group rickettsioses in a pastoralist community of northern Tanzania, 2016-2017. Trop Med Int Health 2024. [PMID: 38480005 DOI: 10.1111/tmi.13980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
BACKGROUND In northern Tanzania, Q fever, spotted fever group (SFG) rickettsioses, and typhus group (TG) rickettsioses are common causes of febrile illness. We sought to describe the prevalence and risk factors for these zoonoses in a pastoralist community. METHODS Febrile patients ≥2 years old presenting to Endulen Hospital in the Ngorongoro Conservation Area were enrolled from August 2016 through October 2017. Acute and convalescent blood samples were collected, and a questionnaire was administered. Sera were tested by immunofluorescent antibody (IFA) IgG assays using Coxiella burnetii (Phase II), Rickettsia africae, and Rickettsia typhi antigens. Serologic evidence of exposure was defined by an IFA titre ≥1:64; probable cases by an acute IFA titre ≥1:128; and confirmed cases by a ≥4-fold rise in titre between samples. Risk factors for exposure and acute case status were evaluated. RESULTS Of 228 participants, 99 (43.4%) were male and the median (interquartile range) age was 27 (16-41) years. Among these, 117 (51.3%) had C. burnetii exposure, 74 (32.5%) had probable Q fever, 176 (77.2%) had SFG Rickettsia exposure, 134 (58.8%) had probable SFG rickettsioses, 11 (4.8%) had TG Rickettsia exposure, and 4 (1.8%) had probable TG rickettsioses. Of 146 participants with paired sera, 1 (0.5%) had confirmed Q fever, 8 (5.5%) had confirmed SFG rickettsioses, and none had confirmed TG rickettsioses. Livestock slaughter was associated with acute Q fever (adjusted odds ratio [OR] 2.54, 95% confidence interval [CI] 1.38-4.76) and sheep slaughter with SFG rickettsioses case (OR 4.63, 95% CI 1.08-23.50). DISCUSSION Acute Q fever and SFG rickettsioses were detected in participants with febrile illness. Exposures to C. burnetii and to SFG Rickettsia were highly prevalent, and interactions with livestock were associated with increased odds of illness with both pathogens. Further characterisation of the burden and risks for these diseases is warranted.
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Affiliation(s)
- Ganga S Moorthy
- Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Matthew P Rubach
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina, USA
- Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore, Singapore
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
| | - Michael J Maze
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Regina P Refuerzo
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Gabriel M Shirima
- School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - AbdulHamid S Lukambagire
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- EcoHealth Alliance, New York, New York, USA
| | | | | | - Kate M Thomas
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | | | - Nestory Mkenda
- Endulen Hospital, Ngorongoro Conservation Area, Endulen, Tanzania
| | - Thomas R Bowhay
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Jamie L Perniciaro
- Rickettsial Zoonoses Branch, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - William L Nicholson
- Rickettsial Zoonoses Branch, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rudovick R Kazwala
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Blandina T Mmbaga
- Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore, Singapore
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Joram J Buza
- School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Venance P Maro
- Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore, Singapore
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Daniel T Haydon
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - John A Crump
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina, USA
- Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore, Singapore
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Jo E B Halliday
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Mbwambo GA, van Zwetselaar M, Sonda T, Lukambagire AS, Njau JS, Wadugu B, Ignass IP, Amani NB, Hugho EA, Rubach MP, Sakasaka P, Oisso RS, Mkenda N, Shirima G, Ashford RT, Haydon DT, Maro VP, Kazwala RR, Kumburu HH, Mmbaga BT, Halliday JEB. Complete genome sequence of Brucella abortus isolated from a human blood culture sample in Tanzania. Microbiol Resour Announc 2024; 13:e0093023. [PMID: 38289053 PMCID: PMC10871059 DOI: 10.1128/mra.00930-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/07/2024] [Indexed: 02/16/2024] Open
Abstract
Brucella abortus causes infections in humans and livestock. Bacterial isolates are challenging to obtain, and very little is known about the genomic epidemiology of this species in Africa. Here, we report the complete genome sequence of a Brucella abortus isolate cultured from a febrile human in northern Tanzania.
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Affiliation(s)
| | | | - Tolbert Sonda
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | | | - Judith S. Njau
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Boaz Wadugu
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | | | | | - Ephrasia A. Hugho
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Matthew P. Rubach
- Department of Medicine, Division of Infectious Disease and International Health, Duke Global Health Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | | | - Rose S. Oisso
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | | | - Gabriel Shirima
- Nelson Mandela Africa Institute of Science and Technology, Arusha, Tanzania
| | - Roland T. Ashford
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, United Kingdom
| | - Daniel T. Haydon
- School of Biodiversity, One Health & Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Venance P. Maro
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Rudovick R. Kazwala
- Department of Veterinary Medicine and Public Health, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Happiness H. Kumburu
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Blandina T. Mmbaga
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Jo E. B. Halliday
- Department of Bacteriology, Animal and Plant Health Agency, Weybridge, United Kingdom
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3
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Laurie E, Siebert S, Yongolo N, Halliday JEB, Biswaro SM, Krauth SJ, Kilonzo KG, Mmbaga BT, McIntosh E. Evidencing the clinical and economic burden of musculoskeletal disorders in Tanzania: paving the way for urgent rheumatology service development. Rheumatol Adv Pract 2023; 8:rkad110. [PMID: 38143512 PMCID: PMC10748784 DOI: 10.1093/rap/rkad110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2023] [Indexed: 12/26/2023] Open
Affiliation(s)
- Emma Laurie
- School of Geographical and Earth Sciences, University of Glasgow, Glasgow, UK
| | - Stefan Siebert
- School of Infection & Immunity, University of Glasgow, Glasgow, UK
| | - Nateiya Yongolo
- Department of Clinical Research, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Department of Internal Medicine, Kilimanjaro Clinical Medical University College, Moshi, United Republic of Tanzania
| | - Jo E B Halliday
- School of Biodiversity, One Health & Veterinary Medicine, University of Glasgow, Glasgow, UK
| | - Sanjura M Biswaro
- Department of Clinical Research, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
| | | | - Kajiru Gad Kilonzo
- Department for Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Blandina T Mmbaga
- Department of Clinical Research, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Department of Internal Medicine, Kilimanjaro Clinical Medical University College, Moshi, United Republic of Tanzania
| | - Emma McIntosh
- School of Health & Wellbeing, University of Glasgow, Glasgow, UK
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4
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Maze MJ, Shirima GM, Lukambagire AHS, Bodenham RF, Rubach MP, Cash-Goldwasser S, Carugati M, Thomas KM, Sakasaka P, Mkenda N, Allan KJ, Kazwala RR, Mmbaga BT, Buza JJ, Maro VP, Galloway RL, Haydon DT, Crump JA, Halliday JEB. Prevalence and risk factors for human leptospirosis at a hospital serving a pastoralist community, Endulen, Tanzania. PLoS Negl Trop Dis 2023; 17:e0011855. [PMID: 38117858 PMCID: PMC10766184 DOI: 10.1371/journal.pntd.0011855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/04/2024] [Accepted: 12/11/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND Leptospirosis is suspected to be a major cause of illness in rural Tanzania associated with close contact with livestock. We sought to determine leptospirosis prevalence, identify infecting Leptospira serogroups, and investigate risk factors for leptospirosis in a rural area of Tanzania where pastoralist animal husbandry practices and sustained livestock contact are common. METHODS We enrolled participants at Endulen Hospital, Tanzania. Patients with a history of fever within 72 hours, or a tympanic temperature of ≥38.0°C were eligible. Serum samples were collected at presentation and 4-6 weeks later. Sera were tested using microscopic agglutination testing with 20 Leptospira serovars from 17 serogroups. Acute leptospirosis cases were defined by a ≥four-fold rise in antibody titre between acute and convalescent serum samples or a reciprocal titre ≥400 in either sample. Leptospira seropositivity was defined by a single reciprocal antibody titre ≥100 in either sample. We defined the predominant reactive serogroup as that with the highest titre. We explored risk factors for acute leptospirosis and Leptospira seropositivity using logistic regression modelling. RESULTS Of 229 participants, 99 (43.2%) were male and the median (range) age was 27 (0, 78) years. Participation in at least one animal husbandry practice was reported by 160 (69.9%). We identified 18 (7.9%) cases of acute leptospirosis, with Djasiman 8 (44.4%) and Australis 7 (38.9%) the most common predominant reactive serogroups. Overall, 69 (30.1%) participants were Leptospira seropositive and the most common predominant reactive serogroups were Icterohaemorrhagiae (n = 20, 29.0%), Djasiman (n = 19, 27.5%), and Australis (n = 17, 24.6%). Milking cattle (OR 6.27, 95% CI 2.24-7.52) was a risk factor for acute leptospirosis, and milking goats (OR 2.35, 95% CI 1.07-5.16) was a risk factor for Leptospira seropositivity. CONCLUSIONS We identified leptospirosis in approximately one in twelve patients attending hospital with fever from this rural community. Interventions that reduce risks associated with milking livestock may reduce human infections.
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Affiliation(s)
- Michael J. Maze
- Department of Medicine, University of Otago, Christchurch, New Zealand
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Gabriel M. Shirima
- School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | | | | | - Matthew P. Rubach
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, United States
| | - Shama Cash-Goldwasser
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States
| | - Manuela Carugati
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, United States
| | - Kate M. Thomas
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Philoteus Sakasaka
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Nestory Mkenda
- Endulen Hospital, Ngorongoro Conservation Area, Endulen, Tanzania
| | - Kathryn J. Allan
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Rudovick R. Kazwala
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Blandina T. Mmbaga
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Joram J. Buza
- School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Venance P. Maro
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Renee L. Galloway
- Special Pathogens Branch, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Daniel T. Haydon
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - John A. Crump
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Jo E. B. Halliday
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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Moshi B, Yongolo N, Biswaro SM, Maro H, Linus S, Siebert S, Nkenguye W, McIntosh E, Shirima F, Njau RE, Andongolile AA, Mwanswila MJ, Halliday JEB, Krauth S, Kilonzo K, Walker RW, Temu GA, Mmbaga BT. Trends of frequency, mortality and risk factors among patients admitted with stroke from 2017 to 2019 to the medical ward at Kilimanjaro Christian Medical Centre hospital: a retrospective observational study. BMJ Open 2023; 13:e071918. [PMID: 37524544 PMCID: PMC10391824 DOI: 10.1136/bmjopen-2023-071918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVE The burden of stroke has increased in recent years worldwide, particularly in low-income and middle-income countries. In this study we aim to determine the number of stroke admissions, and associated comorbidities, at a referral hospital in Northern Tanzania. DESIGN This was a retrospective observational study. SETTING The study was conducted at a tertiary referral hospital, Kilimanjaro Christian Medical Centre (KCMC), in the orthern zone of Tanzania. PARTICIPANTS The study included adults aged 18 years and above, who were admitted to the medical wards from 2017 to 2019. OUTCOME The primary outcome was the proportion of patients who had a stroke admitted in the medical ward at KCMC and the secondary outcome was clinical outcome such as mortality. METHODS We conducted a retrospective audit of medical records from 2017 to 2019 for adult patients admitted to the medical ward at KCMC. Data extracted included demographic characteristics, previous history of stroke and outcome of the admission. Factors associated with stroke were investigated using logistic regression. RESULTS Among 7976 patients admitted between 2017 and 2019, 972 (12.2%) were patients who had a stroke. Trends show an increase in patients admitted with stroke over the 3 years with 222, 292 and 458 in 2017, 2018 and 2019, respectively. Of the patients who had a stroke, 568 (58.4%) had hypertension while 167 (17.2%) had diabetes mellitus. The proportion of admitted stroke patients aged 18-45 years, increased from 2017 (n=28, 3.4%) to 2019 (n=40, 4.3%). The in-hospital mortality related to stroke was 229 (23.6%) among 972 patients who had a stroke and female patients had 50% higher odds of death as compared with male patients (OR:1.5; CI 1.30 to 1.80). CONCLUSION The burden of stroke on individuals and health services is increasing over time, which reflects a lack of awareness on the cause of stroke and effective preventive measures. Prioritising interventions directed towards the reduction of non-communicable diseases and associated complications, such as stroke, is urgently needed.
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Affiliation(s)
- Baraka Moshi
- Epidemiology and Applied Biostatistics, Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
- Department of Clinical research, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
| | - Nateiya Yongolo
- Department of Clinical research, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Depatment of Epidemiology and Applied Biostatistics and Depatment of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
| | - Sanjura Mandela Biswaro
- Department of Clinical research, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Hans Maro
- Depatment of Epidemiology and Applied Biostatistics and Depatment of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
- Department of Epidemiology, Tanzania Health Promotion Support (THPS), Moshi, United Republic of Tanzania
| | - Sakanda Linus
- Department of Clinical research, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Depatment of Epidemiology and Applied Biostatistics and Depatment of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
| | - Stefan Siebert
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
- Depatment of Inflammation Medicine and Rheumatology, Health Economics and Health Technology Assessment (HEHTA), University of Glasgow Institute of Health and Wellbeing, Glasgow, UK
| | - William Nkenguye
- Depatment of Epidemiology and Applied Biostatistics and Depatment of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
| | - Emma McIntosh
- Depatment of Inflammation Medicine and Rheumatology, Health Economics and Health Technology Assessment (HEHTA), University of Glasgow Institute of Health and Wellbeing, Glasgow, UK
| | - Febronia Shirima
- Department of Clinical research, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Rosalia E Njau
- Department of Clinical research, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Alice A Andongolile
- Department of Clinical research, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Depatment of Epidemiology and Applied Biostatistics and Depatment of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
| | - Manasseh Joel Mwanswila
- Department of Clinical research, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Jo E B Halliday
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, London, UK
| | - Stefanie Krauth
- Depatment of Inflammation Medicine and Rheumatology, Health Economics and Health Technology Assessment (HEHTA), University of Glasgow Institute of Health and Wellbeing, Glasgow, UK
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, London, UK
| | - Kajiru Kilonzo
- Depatment of Epidemiology and Applied Biostatistics and Depatment of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Richard William Walker
- Depatment of One health and Veterinary Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Gloria August Temu
- Depatment of Epidemiology and Applied Biostatistics and Depatment of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Blandina T Mmbaga
- Department of Clinical research, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Depatment of Epidemiology and Applied Biostatistics and Depatment of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
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6
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de Glanville WA, Allan KJ, Nyarobi JM, Thomas KM, Lankester F, Kibona TJ, Claxton JR, Brennan B, Carter RW, Crump JA, Halliday JEB, Ladbury G, Mmbaga BT, Mramba F, Nyasebwa OM, Rubach MP, Rostal MK, Sanka P, Swai ES, Szemiel AM, Willett BJ, Cleaveland S. An outbreak of Rift Valley fever among peri-urban dairy cattle in northern Tanzania. Trans R Soc Trop Med Hyg 2022; 116:1082-1090. [PMID: 36040309 PMCID: PMC9623736 DOI: 10.1093/trstmh/trac076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 07/12/2022] [Accepted: 08/01/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Human and animal cases of Rift Valley fever (RVF) are typically only reported during large outbreaks. The occurrence of RVF cases that go undetected by national surveillance systems in the period between these outbreaks is considered likely. The last reported cases of RVF in Tanzania occurred during a large outbreak in 2007-2008. METHODS Samples collected between 2017 and 2019 from livestock suffering abortion across northern Tanzania were retrospectively tested for evidence of RVF virus infection using serology and reverse transcription quantitative polymerase chain reaction (RT-qPCR). RESULTS A total of 14 RVF-associated cattle abortions were identified among dairy cattle in a peri-urban area surrounding the town of Moshi. RVF cases occurred from May to August 2018 and were considered to represent an undetected, small-scale RVF outbreak. Milk samples from 3 of 14 cases (21%) were found to be RT-qPCR positive. Genotyping revealed circulation of RVF viruses from two distinct lineages. CONCLUSIONS RVF outbreaks can occur more often in endemic settings than would be expected on the basis of detection by national surveillance. The occurrence of RVF cases among peri-urban dairy cattle and evidence for viral shedding in milk, also highlights potentially emerging risks for RVF associated with increasing urban and peri-urban livestock populations.
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Affiliation(s)
- William A de Glanville
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, UK.,University of Global Health Equity, Kigali 6955, Rwanda
| | - Kathryn J Allan
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, UK.,School of Veterinary Medicine, University of Glasgow, Glasgow G61 1QH, UK
| | - James M Nyarobi
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, UK.,Nelson Mandela African Institution of Science and Technology, Arusha 255, Tanzania
| | - Kate M Thomas
- Centre for International Health, University of Otago, Dunedin 9054, New Zealand.,Kilimanjaro Clinical Research Institute, Moshi 2236, Tanzania
| | - Felix Lankester
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA 99164, USA.,Global Animal Health Tanzania, Arusha 1642, Tanzania
| | - Tito J Kibona
- Nelson Mandela African Institution of Science and Technology, Arusha 255, Tanzania
| | - John R Claxton
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Benjamin Brennan
- MRC-University of Glasgow Centre for Virus Research, University of Glasgow, Glasgow, G61 1QH, UK
| | - Ryan W Carter
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, UK
| | - John A Crump
- Centre for International Health, University of Otago, Dunedin 9054, New Zealand.,Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC 27710, USA.,Duke Global Health Institute, Duke University, Durham, NC 27710, USA.,Kilimanjaro Christian Medical University College, Tumaini University, Moshi 3010, Tanzania
| | - Jo E B Halliday
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Georgia Ladbury
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Blandina T Mmbaga
- Kilimanjaro Clinical Research Institute, Moshi 2236, Tanzania.,Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC 27710, USA.,Kilimanjaro Christian Medical University College, Tumaini University, Moshi 3010, Tanzania
| | - Furaha Mramba
- Tanzania Veterinary Laboratory Agency, Dar es Salaam 9254, Tanzania
| | | | - Matthew P Rubach
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC 27710, USA.,Duke Global Health Institute, Duke University, Durham, NC 27710, USA.,Programme in Emerging Infectious Diseases, Duke-National University of Singapore, Singapore 169857, Singapore
| | - Melinda K Rostal
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, UK.,EcoHealth Alliance, New York, NY 10018, USA
| | - Paul Sanka
- Tanzania Veterinary Laboratory Agency, Dar es Salaam 9254, Tanzania
| | | | - Agnieszka M Szemiel
- MRC-University of Glasgow Centre for Virus Research, University of Glasgow, Glasgow, G61 1QH, UK
| | - Brian J Willett
- MRC-University of Glasgow Centre for Virus Research, University of Glasgow, Glasgow, G61 1QH, UK
| | - Sarah Cleaveland
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, UK
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7
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de Glanville WA, Nyarobi JM, Kibona T, Halliday JEB, Thomas KM, Allan KJ, Johnson PCD, Davis A, Lankester F, Claxton JR, Rostal MK, Carter RW, de Jong RMF, Rubach MP, Crump JA, Mmbaga BT, Nyasebwa OM, Swai ES, Willett B, Cleaveland S. Inter-epidemic Rift Valley fever virus infection incidence and risks for zoonotic spillover in northern Tanzania. PLoS Negl Trop Dis 2022; 16:e0010871. [PMID: 36306281 PMCID: PMC9665400 DOI: 10.1371/journal.pntd.0010871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 11/15/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022] Open
Abstract
Rift Valley fever virus (RVFV) is a mosquito-borne pathogen that has caused epidemics involving people and animals across Africa and the Arabian Peninsula. A number of studies have found evidence for the circulation of RVFV among livestock between these epidemics but the population-level incidence of infection during this inter-epidemic period (IEP) is rarely reported. General force of infection (FOI) models were applied to age-adjusted cross-sectional serological data to reconstruct the annual FOI and population-level incidence of RVFV infection among cattle, goats, and sheep in northern Tanzania from 2009 through 2015, a period without reported Rift Valley fever (RVF) cases in people or animals. To evaluate the potential for zoonotic RVFV spillover during this period, the relationship between village-level livestock RVFV FOI and human RVFV seropositivity was quantified using multi-level logistic regression. The predicted average annual incidence was 72 (95% Credible Interval [CrI] 63, 81) RVFV infections per 10,000 animals and 96 (95% CrI 81, 113), 79 (95% CrI 62, 98), and 39 (95% CrI 28, 52) per 10,000 cattle, sheep, and goats, respectively. There was variation in transmission intensity between study villages, with the highest estimated village-level FOI 2.49% (95% CrI 1.89, 3.23) and the lowest 0.12% (95% CrI 0.02, 0.43). The human RVFV seroprevalence was 8.2% (95% Confidence Interval 6.2, 10.9). Human seropositivity was strongly associated with the village-level FOI in livestock, with the odds of seropositivity in an individual person increasing by around 1.2 times (95% CrI 1.1, 1.3) for each additional annual RVFV seroconversion per 1,000 animals. A history of raw milk consumption was also positively associated with human seropositivity. RVFV has circulated at apparently low levels among livestock in northern Tanzania in the period since the last reported epidemic. Although our data do not allow us to confirm human RVFV infections during the IEP, a strong association between human seropositivity and the FOI in cattle, goats, and sheep supports the hypothesis that RVFV circulation among livestock during the IEP poses a risk for undetected zoonotic spillover in northern Tanzania. We provide further evidence for the likely role of raw milk consumption in RVFV transmission from animals to people.
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Affiliation(s)
- William A. de Glanville
- School of Biodiversity, One Health, and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- University of Global Health Equity, Kigali, Rwanda
- * E-mail: (WAdG); (SC)
| | - James M. Nyarobi
- School of Biodiversity, One Health, and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Tito Kibona
- Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Jo E. B. Halliday
- School of Biodiversity, One Health, and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Kate M. Thomas
- Centre for International Health, University of Otago, Dunedin, New Zealand
- Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
| | - Kathryn J. Allan
- School of Biodiversity, One Health, and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Paul C. D. Johnson
- School of Biodiversity, One Health, and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Alicia Davis
- School of Social and Political Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Felix Lankester
- Paul G. Allen School for Global Health, Washington State University, Pullman, Washington, United States of America
- Global Animal Health Tanzania, Arusha, Tanzania
| | - John R. Claxton
- School of Biodiversity, One Health, and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Melinda K. Rostal
- School of Biodiversity, One Health, and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- EcoHealth Alliance, New York, New York, United States of America
| | - Ryan W. Carter
- School of Biodiversity, One Health, and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Rosanne M. F. de Jong
- School of Biodiversity, One Health, and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Matthew P. Rubach
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina, United States of America
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Programme in Emerging Infectious Diseases, Duke-National University of Singapore, Singapore
| | - John A. Crump
- Centre for International Health, University of Otago, Dunedin, New Zealand
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina, United States of America
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
| | - Blandina T. Mmbaga
- Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
| | - Obed M. Nyasebwa
- Ministry of Livestock and Fisheries, Dodoma, United Republic of Tanzania
| | - Emanuel S. Swai
- Ministry of Livestock and Fisheries, Dodoma, United Republic of Tanzania
| | - Brian Willett
- MRC University of Glasgow Centre for Virus Research, Glasgow, United Kingdom
| | - Sarah Cleaveland
- School of Biodiversity, One Health, and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- * E-mail: (WAdG); (SC)
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8
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Thomas KM, Kibona T, Claxton JR, de Glanville WA, Lankester F, Amani N, Buza JJ, Carter RW, Chapman GE, Crump JA, Dagleish MP, Halliday JEB, Hamilton CM, Innes EA, Katzer F, Livingstone M, Longbottom D, Millins C, Mmbaga BT, Mosha V, Nyarobi J, Nyasebwa OM, Russell GC, Sanka PN, Semango G, Wheelhouse N, Willett BJ, Cleaveland S, Allan KJ. Prospective cohort study reveals unexpected aetiologies of livestock abortion in northern Tanzania. Sci Rep 2022; 12:11669. [PMID: 35803982 PMCID: PMC9270399 DOI: 10.1038/s41598-022-15517-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 06/24/2022] [Indexed: 11/15/2022] Open
Abstract
Livestock abortion is an important cause of productivity losses worldwide and many infectious causes of abortion are zoonotic pathogens that impact on human health. Little is known about the relative importance of infectious causes of livestock abortion in Africa, including in subsistence farming communities that are critically dependent on livestock for food, income, and wellbeing. We conducted a prospective cohort study of livestock abortion, supported by cross-sectional serosurveillance, to determine aetiologies of livestock abortions in livestock in Tanzania. This approach generated several important findings including detection of a Rift Valley fever virus outbreak in cattle; high prevalence of C. burnetii infection in livestock; and the first report of Neospora caninum, Toxoplasma gondii, and pestiviruses associated with livestock abortion in Tanzania. Our approach provides a model for abortion surveillance in resource-limited settings. Our findings add substantially to current knowledge in sub-Saharan Africa, providing important evidence from which to prioritise disease interventions.
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Affiliation(s)
- Kate M Thomas
- Centre for International Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. .,Kilimanjaro Clinical Research Institute, Good Samaritan Foundation, Moshi, United Republic of Tanzania. .,Ministry for Primary Industries, New Zealand Food Safety, Wellington, New Zealand.
| | - Tito Kibona
- Nelson Mandela African Institution of Science and Technology (NM-AIST), Tengeru, United Republic of Tanzania
| | - John R Claxton
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - William A de Glanville
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Felix Lankester
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, USA.,Global Animal Health Tanzania, Arusha, United Republic of Tanzania
| | - Nelson Amani
- Kilimanjaro Clinical Research Institute, Good Samaritan Foundation, Moshi, United Republic of Tanzania
| | - Joram J Buza
- Nelson Mandela African Institution of Science and Technology (NM-AIST), Tengeru, United Republic of Tanzania
| | - Ryan W Carter
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Gail E Chapman
- School of Veterinary Medicine, University of Glasgow, Glasgow, UK
| | - John A Crump
- Centre for International Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.,Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
| | | | - Jo E B Halliday
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | | | | | | | | | - Caroline Millins
- School of Veterinary Medicine, University of Glasgow, Glasgow, UK.,Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Blandina T Mmbaga
- Kilimanjaro Clinical Research Institute, Good Samaritan Foundation, Moshi, United Republic of Tanzania.,Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
| | - Victor Mosha
- Kilimanjaro Clinical Research Institute, Good Samaritan Foundation, Moshi, United Republic of Tanzania
| | - James Nyarobi
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Obed M Nyasebwa
- Ministry of Livestock and Fisheries, Zonal Veterinary Centre-Arusha, Arusha, United Republic of Tanzania
| | | | - Paul N Sanka
- Tanzania Veterinary Laboratory Agency, Arusha, United Republic of Tanzania
| | - George Semango
- Nelson Mandela African Institution of Science and Technology (NM-AIST), Tengeru, United Republic of Tanzania
| | - Nick Wheelhouse
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Brian J Willett
- Medical Research Council, University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Sarah Cleaveland
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Kathryn J Allan
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.,School of Veterinary Medicine, University of Glasgow, Glasgow, UK
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9
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Dennis TPW, Mable BK, Brunelle B, Devault A, Carter RW, Ling CL, Mmbaga BT, Halliday JEB, Oravcova K, Forde TL. Target-enrichment sequencing yields valuable genomic data for challenging-to-culture bacteria of public health importance. Microb Genom 2022; 8. [PMID: 35622897 PMCID: PMC9465068 DOI: 10.1099/mgen.0.000836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Genomic data contribute invaluable information to the epidemiological investigation of pathogens of public health importance. However, whole-genome sequencing (WGS) of bacteria typically relies on culture, which represents a major hurdle for generating such data for a wide range of species for which culture is challenging. In this study, we assessed the use of culture-free target-enrichment sequencing as a method for generating genomic data for two bacterial species: (1) Bacillus anthracis, which causes anthrax in both people and animals and whose culture requires high-level containment facilities; and (2) Mycoplasma amphoriforme, a fastidious emerging human respiratory pathogen. We obtained high-quality genomic data for both species directly from clinical samples, with sufficient coverage (>15×) for confident variant calling over at least 80% of the baited genomes for over two thirds of the samples tested. Higher qPCR cycle threshold (Ct) values (indicative of lower pathogen concentrations in the samples), pooling libraries prior to capture, and lower captured library concentration were all statistically associated with lower capture efficiency. The Ct value had the highest predictive value, explaining 52 % of the variation in capture efficiency. Samples with Ct values ≤30 were over six times more likely to achieve the threshold coverage than those with a Ct > 30. We conclude that target-enrichment sequencing provides a valuable alternative to standard WGS following bacterial culture and creates opportunities for an improved understanding of the epidemiology and evolution of many clinically important pathogens for which culture is challenging.
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Affiliation(s)
- Tristan P. W. Dennis
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Barbara K. Mable
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | | | - Ryan W. Carter
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Clare L. Ling
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Blandina T. Mmbaga
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Jo E. B. Halliday
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Katarina Oravcova
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Taya L. Forde
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- *Correspondence: Taya L. Forde,
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10
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Lukambagire AS, Shirima GM, Shayo DD, Mathew C, Yapi RB, Kasanga CJ, Mmbaga BT, Kazwala RR, Halliday JEB. Brucellosis testing patterns at health facilities in Arusha region, northern Tanzania. PLoS One 2022; 17:e0265612. [PMID: 35320293 PMCID: PMC8942238 DOI: 10.1371/journal.pone.0265612] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 03/04/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Brucellosis is listed as one of six priority zoonoses in Tanzania's One Health strategic plan which highlights gaps in data needed for the surveillance and estimation of human brucellosis burdens. This study collected data on current testing practices and test results for human brucellosis in Arusha region, northern Tanzania. METHODS Retrospective data were extracted from records at 24 health facilities in Arusha region for the period January 2012 to May 2018. Data were captured on: the test reagents used for brucellosis, procurement and testing protocols, the monthly number of patients tested for brucellosis and the monthly number testing positive. Generalised linear mixed models were used to evaluate relationships between health facility characteristics and the probability that brucellosis testing was conducted in a given month, and the proportion of individuals testing positive. RESULTS Four febrile Brucella agglutination tests were used widely. The probability of testing for brucellosis in a given month was significantly associated with an interaction between year of testing and facility ownership. Test probability increased over time with more pronounced increases in privately owned as compared to government facilities. The proportion of individuals testing positive for brucellosis was significantly associated with facility type and district, with individuals tested in hospitals in Meru, Monduli and Ngorongoro districts more likely to test positive. CONCLUSIONS Febrile Brucella agglutination tests, known for their poor performance, were the mainstay of brucellosis testing at health facilities in northern Tanzania. The study indicates that historical data on human brucellosis in Arusha and other regions are likely to provide an inaccurate measure of true disease burden due to poor performance of the tests used and variation in testing practices. Measures to address these identified shortcomings could greatly improve quality of testing and surveillance data on brucellosis and ultimately inform prevention and control of this priority disease.
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Affiliation(s)
- AbdulHamid Settenda Lukambagire
- College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
- Kilimanjaro Christian Medical University College-Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | | | - Damas Davis Shayo
- Regional Health Management Team, Arusha Regional Medical Office, Arusha, Tanzania
| | - Coletha Mathew
- College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Richard B. Yapi
- Centre d’Entomologie Médicale et Vétérinaire Université Alassane Ouattara, Bouaké, Côte d’Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Christopher Julius Kasanga
- College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Blandina Theophile Mmbaga
- Kilimanjaro Christian Medical University College-Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Duke Global Health Institute, Durham, North Carolina, United States of America
| | - Rudovick Reuben Kazwala
- College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Jo E. B. Halliday
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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11
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Wheelhouse N, Kemp S, Halliday JEB, Tingas EA, Duncan WC, Horne AW. Q fever and early pregnancy failure: a Scottish case–control study. Reproduction and Fertility 2022; 3:L1-L2. [PMID: 35118418 PMCID: PMC8789011 DOI: 10.1530/raf-21-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/24/2021] [Indexed: 11/30/2022] Open
Abstract
Q fever is a bacterial disease that passes between animals and humans and causes disease in both. The disease has been associated with pregnancy complications including miscarriage. This study was undertaken to identify if Q fever exposure was correlated with miscarriage in 369 women attending a pregnancy support unit in Edinburgh. The women in the study were in two groups, the miscarriage group with 251 women who had experienced a miscarriage and a control group of 118 women who had not experienced miscarriage. Three women were found to be positive for Q fever antibodies, suggesting that they had previously been exposed to the infection and all of them were from the group who had experienced miscarriage. The study indicates that Q fever is relatively rare in women attending an urban Scottish hospital suggesting that the infection is not a major cause of miscarriage in this population. However, as Q fever antibodies could only be found in women within the miscarriage group, it suggests that the infection cannot be ruled out as a potential cause of miscarriage in individual cases.
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Affiliation(s)
- Nick Wheelhouse
- 1School of Applied Sciences, Edinburgh Napier University, Sighthill Court, Edinburgh, UK
- 2Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Sadie Kemp
- 1School of Applied Sciences, Edinburgh Napier University, Sighthill Court, Edinburgh, UK
| | - Jo E B Halliday
- 2Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | - W Colin Duncan
- 4MRC Centre for Reproductive Health, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh Bioquarter, Edinburgh, UK
| | - Andrew W Horne
- 4MRC Centre for Reproductive Health, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh Bioquarter, Edinburgh, UK
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12
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Pisharody S, Rubach MP, Carugati M, Nicholson WL, Perniciaro JL, Biggs HM, Maze MJ, Hertz JT, Halliday JEB, Allan KJ, Mmbaga BT, Saganda W, Lwezaula BF, Kazwala RR, Cleaveland S, Maro VP, Crump JA. Incidence Estimates of Acute Q Fever and Spotted Fever Group Rickettsioses, Kilimanjaro, Tanzania, from 2007 to 2008 and from 2012 to 2014. Am J Trop Med Hyg 2021; 106:494-503. [PMID: 34929672 PMCID: PMC8832940 DOI: 10.4269/ajtmh.20-1036] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 08/04/2021] [Indexed: 11/30/2022] Open
Abstract
Q fever and spotted fever group rickettsioses (SFGR) are common causes of severe febrile illness in northern Tanzania. Incidence estimates are needed to characterize the disease burden. Using hybrid surveillance—coupling case-finding at two referral hospitals and healthcare utilization data—we estimated the incidences of acute Q fever and SFGR in Moshi, Kilimanjaro, Tanzania, from 2007 to 2008 and from 2012 to 2014. Cases were defined as fever and a four-fold or greater increase in antibody titers of acute and convalescent paired sera according to the indirect immunofluorescence assay of Coxiella burnetii phase II antigen for acute Q fever and Rickettsia conorii (2007–2008) or Rickettsia africae (2012–2014) antigens for SFGR. Healthcare utilization data were used to adjust for underascertainment of cases by sentinel surveillance. For 2007 to 2008, among 589 febrile participants, 16 (4.7%) of 344 and 27 (8.8%) of 307 participants with paired serology had Q fever and SFGR, respectively. Adjusted annual incidence estimates of Q fever and SFGR were 80 (uncertainty range, 20–454) and 147 (uncertainty range, 52–645) per 100,000 persons, respectively. For 2012 to 2014, among 1,114 febrile participants, 52 (8.1%) and 57 (8.9%) of 641 participants with paired serology had Q fever and SFGR, respectively. Adjusted annual incidence estimates of Q fever and SFGR were 56 (uncertainty range, 24–163) and 75 (uncertainty range, 34–176) per 100,000 persons, respectively. We found substantial incidences of acute Q fever and SFGR in northern Tanzania during both study periods. To our knowledge, these are the first incidence estimates of either disease in sub-Saharan Africa. Our findings suggest that control measures for these infections warrant consideration.
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Affiliation(s)
- Sruti Pisharody
- Division of Infectious Diseases, Department of Medicine, Duke University, Durham, North Carolina
| | - Matthew P Rubach
- Division of Infectious Diseases, Department of Medicine, Duke University, Durham, North Carolina.,Duke Global Health Institute, Duke University, Durham, North Carolina.,Programme in Emerging Infectious Diseases, Duke-National University of Singapore, Singapore.,Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Manuela Carugati
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - William L Nicholson
- Centers for Disease Control and Prevention, Rickettsial Zoonoses Branch, Atlanta, Georgia
| | - Jamie L Perniciaro
- Centers for Disease Control and Prevention, Rickettsial Zoonoses Branch, Atlanta, Georgia
| | - Holly M Biggs
- Division of Infectious Diseases, Department of Medicine, Duke University, Durham, North Carolina
| | - Michael J Maze
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Centre for International Health, University of Otago, Dunedin, New Zealand.,Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Julian T Hertz
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Jo E B Halliday
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.,Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Kathryn J Allan
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.,Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Blandina T Mmbaga
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Wilbrod Saganda
- Mawenzi Regional Referral Hospital, Moshi, Tanzania.,Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Bingileki F Lwezaula
- Mawenzi Regional Referral Hospital, Moshi, Tanzania.,Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | | | - Sarah Cleaveland
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.,Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Venance P Maro
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - John A Crump
- Division of Infectious Diseases, Department of Medicine, Duke University, Durham, North Carolina.,Duke Global Health Institute, Duke University, Durham, North Carolina.,Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Centre for International Health, University of Otago, Dunedin, New Zealand.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
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13
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Davis A, Virhia J, Buza J, Crump JA, de Glanville WA, Halliday JEB, Lankester F, Mappi T, Mnzava K, Swai ES, Thomas KM, Toima M, Cleaveland S, Mmbaga BT, Sharp J. " He Who Relies on His Brother's Property Dies Poor": The Complex Narratives of Livestock Care in Northern Tanzania. Front Vet Sci 2021; 8:749561. [PMID: 34805339 PMCID: PMC8595325 DOI: 10.3389/fvets.2021.749561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Endemic zoonoses have important impacts for livestock-dependent households in East Africa. In these communities, people's health and livelihoods are severely affected by livestock disease losses. Understanding how livestock keepers undertake remedial actions for livestock illness has the potential for widespread benefits such as improving health interventions. Yet, studies about livestock and human health behaviours in the global south tend to focus on individual health choices. In reality, health behaviours are complex, and not solely about individualised health experiences. Rather, they are mediated by a range of “upstream” factors (such as unequal provision of services), which are beyond the control of the individual. Methods: This paper presents qualitative research conducted from 2014 to 2019 for a study focused on the Social, Economic, and Environmental Drivers of Zoonoses in Tanzania (SEEDZ). Qualitative data were collected via focus group discussions, community meetings, informal interviews, formal in-depth interviews, observations and surveys that addressed issues of health, disease, zoonotic disease risks, and routes for treatment across 21 villages. Thematic analysis was carried out on in-depth interviews and focus group discussions. Conceptual analyses and observations were made through application of social science theories of health. Findings: Livestock keepers undertake a range of health seeking strategies loosely categorised around self and formal treatment. Two key themes emerged that are central to why people make the decisions they do: access to resources and trust in health care providers. These two issues affect individual sense of agency which impacts their ability to act to improve livestock health outcomes. We suggest that individual choice and agency in veterinary health seeking decisions are only beneficial if health systems can offer adequate care and health equity is addressed. Significance: This study demonstrates the value of in-depth qualitative research which reveals the nuance and complexity of people's decisions around livestock health. Most importantly, it explains why “better” knowledge does not always translate into “better” practise. The paper suggests that acknowledging and addressing these aspects of veterinary health seeking will lead to more effective provision.
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Affiliation(s)
- Alicia Davis
- Social and Political Sciences/Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Jennika Virhia
- Social and Political Sciences/Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Joram Buza
- The Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - John A Crump
- Centre for International Health, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - William A de Glanville
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Jo E B Halliday
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Felix Lankester
- Paul G. Allen School for Global Health, Pullman, WA, United States
| | - Tauta Mappi
- The Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Kunda Mnzava
- Kilimanjaro Christian Medical Centre, Kilimanjaro Clinical Research Institute, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | | | - Kate M Thomas
- Centre for International Health, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Mamus Toima
- The Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Sarah Cleaveland
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Blandina T Mmbaga
- Kilimanjaro Christian Medical Centre, Kilimanjaro Clinical Research Institute, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Jo Sharp
- School of Geography and Sustainable Development, University of St. Andrews, St. Andrews, United Kingdom
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14
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Bodenham RF, Mazeri S, Cleaveland S, Crump JA, Fasina FO, de Glanville WA, Haydon DT, Kazwala RR, Kibona TJ, Maro VP, Maze MJ, Mmbaga BT, Mtui-Malamsha NJ, Shirima GM, Swai ES, Thomas KM, Bronsvoort BMD, Halliday JEB. Latent class evaluation of the performance of serological tests for exposure to Brucella spp. in cattle, sheep, and goats in Tanzania. PLoS Negl Trop Dis 2021; 15:e0009630. [PMID: 34428205 PMCID: PMC8384210 DOI: 10.1371/journal.pntd.0009630] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 07/06/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Brucellosis is a neglected zoonosis endemic in many countries, including regions of sub-Saharan Africa. Evaluated diagnostic tools for the detection of exposure to Brucella spp. are important for disease surveillance and guiding prevention and control activities. METHODS AND FINDINGS Bayesian latent class analysis was used to evaluate performance of the Rose Bengal plate test (RBT) and a competitive ELISA (cELISA) in detecting Brucella spp. exposure at the individual animal-level for cattle, sheep, and goats in Tanzania. Median posterior estimates of RBT sensitivity were: 0.779 (95% Bayesian credibility interval (BCI): 0.570-0.894), 0.893 (0.636-0.989), and 0.807 (0.575-0.966), and for cELISA were: 0.623 (0.443-0.790), 0.409 (0.241-0.644), and 0.561 (0.376-0.713), for cattle, sheep, and goats, respectively. Sensitivity BCIs were wide, with the widest for cELISA in sheep. RBT and cELISA median posterior estimates of specificity were high across species models: RBT ranged between 0.989 (0.980-0.998) and 0.995 (0.985-0.999), and cELISA between 0.984 (0.974-0.995) and 0.996 (0.988-1). Each species model generated seroprevalence estimates for two livestock subpopulations, pastoralist and non-pastoralist. Pastoralist seroprevalence estimates were: 0.063 (0.045-0.090), 0.033 (0.018-0.049), and 0.051 (0.034-0.076), for cattle, sheep, and goats, respectively. Non-pastoralist seroprevalence estimates were below 0.01 for all species models. Series and parallel diagnostic approaches were evaluated. Parallel outperformed a series approach. Median posterior estimates for parallel testing were ≥0.920 (0.760-0.986) for sensitivity and ≥0.973 (0.955-0.992) for specificity, for all species models. CONCLUSIONS Our findings indicate that Brucella spp. surveillance in Tanzania using RBT and cELISA in parallel at the animal-level would give high test performance. There is a need to evaluate strategies for implementing parallel testing at the herd- and flock-level. Our findings can assist in generating robust Brucella spp. exposure estimates for livestock in Tanzania and wider sub-Saharan Africa. The adoption of locally evaluated robust diagnostic tests in setting-specific surveillance is an important step towards brucellosis prevention and control.
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Affiliation(s)
- Rebecca F. Bodenham
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- * E-mail: ,
| | - Stella Mazeri
- The Epidemiology, Economics and Risk Assessment (EERA) group, The Roslin Institute and The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, United Kingdom
| | - Sarah Cleaveland
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - John A. Crump
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Centre for International Health, University of Otago, Dunedin, New Zealand
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Folorunso O. Fasina
- Emergency Centre for Transboundary Animal Diseases, Food and Agriculture Organization (FAO) of the United Nations, Dar es Salaam, Tanzania
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
| | - William A. de Glanville
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Daniel T. Haydon
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | - Tito J. Kibona
- Nelson Mandela African Institution for Science and Technology, Arusha, Tanzania
| | - Venance P. Maro
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Michael J. Maze
- Centre for International Health, University of Otago, Dunedin, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Blandina T. Mmbaga
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Niwael J. Mtui-Malamsha
- Emergency Centre for Transboundary Animal Diseases, Food and Agriculture Organization (FAO) of the United Nations, Dar es Salaam, Tanzania
| | - Gabriel M. Shirima
- Nelson Mandela African Institution for Science and Technology, Arusha, Tanzania
| | - Emanuel S. Swai
- Directorate of Veterinary Services, Ministry of Livestock and Fisheries, Dodoma, Tanzania
| | - Kate M. Thomas
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Barend M. deC. Bronsvoort
- The Epidemiology, Economics and Risk Assessment (EERA) group, The Roslin Institute and The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, United Kingdom
| | - Jo E. B. Halliday
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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15
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Akoko JM, Pelle R, Lukambagire AS, Machuka EM, Nthiwa D, Mathew C, Fèvre EM, Bett B, Cook EAJ, Othero D, Bonfoh B, Kazwala RR, Shirima G, Schelling E, Halliday JEB, Ouma C. Molecular epidemiology of Brucella species in mixed livestock-human ecosystems in Kenya. Sci Rep 2021; 11:8881. [PMID: 33893352 PMCID: PMC8065124 DOI: 10.1038/s41598-021-88327-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 04/09/2021] [Indexed: 12/12/2022] Open
Abstract
Brucellosis, caused by several species of the genus Brucella, is a zoonotic disease that affects humans and animal species worldwide. Information on the Brucella species circulating in different hosts in Kenya is largely unknown, thus limiting the adoption of targeted control strategies. This study was conducted in multi-host livestock populations in Kenya to detect the circulating Brucella species and assess evidence of host-pathogen associations. Serum samples were collected from 228 cattle, 162 goats, 158 sheep, 49 camels, and 257 humans from Narok and Marsabit counties in Kenya. Information on age, location and history of abortion or retained placenta were obtained for sampled livestock. Data on age, gender and location of residence were also collected for human participants. All samples were tested using genus level real-time PCR assays with primers specific for IS711 and bcsp31 targets for the detection of Brucella. All genus positive samples (positive for both targets) were further tested with a speciation assay for AlkB and BMEI1162 targets, specific for B. abortus and B. melitensis, respectively. Samples with adequate quantities aggregating to 577 were also tested with the Rose Bengal Test (RBT). A total of 199 (33.3%) livestock and 99 (38.5%) human samples tested positive for genus Brucella. Animal Brucella PCR positive status was positively predicted by RBT positive results (OR = 8.3, 95% CI 4.0-17.1). Humans aged 21-40 years had higher odds (OR = 2.8, 95% CI 1.2-6.6) of being Brucella PCR positive compared to the other age categories. The data on detection of different Brucella species indicates that B. abortus was detected more often in cattle (OR = 2.3, 95% CI 1.1-4.6) and camels (OR = 2.9, 95% CI 1.3-6.3), while B. melitensis was detected more in sheep (OR = 3.6, 95% CI 2.0-6.7) and goats (OR = 1.7, 95% CI 1.0-3.1). Both B. abortus and B. melitensis DNA were detected in humans and in multiple livestock host species, suggesting cross-transmission of these species among the different hosts. The detection of these two zoonotic Brucella species in humans further underpins the importance of One Health prevention strategies that target multiple host species, especially in the multi-host livestock populations.
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Affiliation(s)
- James M Akoko
- Department of Biomedical Sciences and Technology, Maseno University, Kisumu, Kenya.
- Biosciences Eastern and Central Africa-International Livestock Research Institute (BecA-ILRI) Hub KE, Nairobi, Kenya.
- International Livestock Research Institute, Nairobi, Kenya.
| | - Roger Pelle
- Biosciences Eastern and Central Africa-International Livestock Research Institute (BecA-ILRI) Hub KE, Nairobi, Kenya
| | | | - Eunice M Machuka
- Biosciences Eastern and Central Africa-International Livestock Research Institute (BecA-ILRI) Hub KE, Nairobi, Kenya
| | - Daniel Nthiwa
- Department of Biological Sciences, University of Embu, Embu, Kenya
| | | | - Eric M Fèvre
- International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Bernard Bett
- International Livestock Research Institute, Nairobi, Kenya
| | - Elizabeth A J Cook
- International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Doreen Othero
- Department of Public Health, Maseno University, Kisumu, Kenya
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | | | - Gabriel Shirima
- Nelson Mandela African Institute of Science and Technology, Arusha, Tanzania
| | | | - Jo E B Halliday
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Collins Ouma
- Department of Biomedical Sciences and Technology, Maseno University, Kisumu, Kenya
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16
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Lukambagire AS, Mendes ÂJ, Bodenham RF, McGiven JA, Mkenda NA, Mathew C, Rubach MP, Sakasaka P, Shayo DD, Maro VP, Shirima GM, Thomas KM, Kasanga CJ, Kazwala RR, Halliday JEB, Mmbaga BT. Performance characteristics and costs of serological tests for brucellosis in a pastoralist community of northern Tanzania. Sci Rep 2021; 11:5480. [PMID: 33750848 PMCID: PMC7943594 DOI: 10.1038/s41598-021-82906-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/21/2021] [Indexed: 01/31/2023] Open
Abstract
The control of brucellosis across sub-Saharan Africa is hampered by the lack of standardized testing and the use of tests with poor performance. This study evaluated the performance and costs of serological assays for human brucellosis in a pastoralist community in northern Tanzania. Serum collected from 218 febrile hospital patients was used to evaluate the performance of seven index tests, selected based on international recommendation or current use. We evaluated the Rose Bengal test (RBT) using two protocols, four commercial agglutination tests and a competitive enzyme-linked immunosorbent assay (cELISA). The sensitivity, specificity, positive predictive value, negative predictive value, Youden's index, diagnostic accuracy, and per-sample cost of each index test were estimated. The diagnostic accuracy estimates ranged from 95.9 to 97.7% for the RBT, 55.0 to 72.0% for the commercial plate tests, and 89.4% for the cELISA. The per-sample cost range was $0.69-$0.79 for the RBT, $1.03-$1.14 for the commercial plate tests, and $2.51 for the cELISA. The widely used commercial plate tests performed poorly and cost more than the RBT. These findings provide evidence for the public health value of discontinuing the use of commercial agglutination tests for human brucellosis in Tanzania.
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Affiliation(s)
- AbdulHamid S Lukambagire
- College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania.
| | - Ângelo J Mendes
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Rebecca F Bodenham
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - John A McGiven
- OIE/FAO Brucellosis Reference Laboratory, Department of Bacteriology, Animal and Plant Health Agency, Surrey, UK
| | | | - Coletha Mathew
- College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Matthew P Rubach
- Kilimanjaro Christian Medical Center, Moshi, Tanzania
- Duke Global Health Institute, Durham, NC, USA
| | - Philoteus Sakasaka
- Duke Global Health Institute, Durham, NC, USA
- Kilimanjaro Clinical Research Institute-Biotechnology Laboratory, Moshi, Tanzania
| | | | - Venance P Maro
- Kilimanjaro Christian Medical Center, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Gabriel M Shirima
- The Nelson Mandela African Institution for Science and Technology, Arusha, Tanzania
| | - Kate M Thomas
- Kilimanjaro Clinical Research Institute-Biotechnology Laboratory, Moshi, Tanzania
- Centre for International Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Christopher J Kasanga
- College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Rudovick R Kazwala
- College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Jo E B Halliday
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Blandina T Mmbaga
- Kilimanjaro Christian Medical Center, Moshi, Tanzania
- Duke Global Health Institute, Durham, NC, USA
- Kilimanjaro Clinical Research Institute-Biotechnology Laboratory, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
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17
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de Glanville WA, Davis A, Allan KJ, Buza J, Claxton JR, Crump JA, Halliday JEB, Johnson PCD, Kibona TJ, Mmbaga BT, Swai ES, Uzzell CB, Yoder J, Sharp J, Cleaveland S. Classification and characterisation of livestock production systems in northern Tanzania. PLoS One 2020; 15:e0229478. [PMID: 33378382 PMCID: PMC7773236 DOI: 10.1371/journal.pone.0229478] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 12/07/2020] [Indexed: 01/03/2023] Open
Abstract
Livestock keepers in sub-Saharan Africa face a range of pressures, including climate change, land loss, restrictive policies, and population increase. Widespread adaptation in response can lead to the emergence of new, non-traditional typologies of livestock production. We sought to characterise livestock production systems in two administrative regions in northern Tanzania, an area undergoing rapid social, economic, and environmental change. Questionnaire and spatial data were collected from 404 livestock-keeping households in 21 villages in Arusha and Manyara Regions in 2016. Multiple factor analysis and hierarchical cluster analysis were used to classify households into livestock production systems based on household-level characteristics. Adversity-based indicators of vulnerability, including reports of hunger, illness, and livestock, land and crop losses were compared between production systems. Three distinct clusters emerged through this process. The ethnic, environmental and livestock management characteristics of households in each cluster broadly mapped onto traditional definitions of 'pastoral', 'agro-pastoral' and 'smallholder' livestock production in the study area, suggesting that this quantitative classification system is complementary to more qualitative classification methods. Our approach allowed us to demonstrate a diversity in typologies of livestock production at small spatial scales, with almost half of study villages comprising more than one production system. We also found indicators of change within livestock production systems, most notably the adoption of crop agriculture in the majority of pastoral households. System-level heterogeneities in vulnerability were evident, with agro-pastoral households most likely to report hunger and pastoral households most likely to report illness in people and livestock, and livestock losses. We demonstrate that livestock production systems can provide context for assessing household vulnerability in northern Tanzania. Policy initiatives to improve household and community well-being should recognise the continuing diversity of traditional livestock production systems in northern Tanzania, including the diversity that can exist at small spatial scales.
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Affiliation(s)
- William A. de Glanville
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Alicia Davis
- School of Social and Political Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Kathryn J. Allan
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Joram Buza
- Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - John R. Claxton
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - John A. Crump
- Centre for International Health, University of Otago, Dunedin, New Zealand
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, United States of America
- Duke Global Health Institute, Duke University, Durham, NC, United States of America
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
| | - Jo E. B. Halliday
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Paul C. D. Johnson
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Tito J. Kibona
- Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Blandina T. Mmbaga
- Duke Global Health Institute, Duke University, Durham, NC, United States of America
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Emmanuel S. Swai
- Department of Veterinary Services, Ministry of Livestock and Fisheries, Dhaka, Tanzania
| | - Christopher B. Uzzell
- School of Geographical and Earth Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Jonathan Yoder
- School of Economic Sciences, Washington State University, Pullman, WA, United States of America
| | - Jo Sharp
- School of Geography and Sustainable Development, University of St Andrews, St Andrews, United Kingdom
| | - Sarah Cleaveland
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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18
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Mendes ÂJ, Haydon DT, McIntosh E, Hanley N, Halliday JEB. Socially vs. Privately Optimal Control of Livestock Diseases: A Case for Integration of Epidemiology and Economics. Front Vet Sci 2020; 7:558409. [PMID: 33324694 PMCID: PMC7723844 DOI: 10.3389/fvets.2020.558409] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 10/19/2020] [Indexed: 12/29/2022] Open
Abstract
This paper aims to illustrate the interdependencies between key epidemiological and economic factors that influence the control of many livestock infectious diseases. The factors considered here are (i) farmer heterogeneity (i.e., differences in how farmers respond to a perceived disease risk), (ii) off-farm effects of farmers' actions to control a disease (i.e., costs and benefits borne by agents that are external to the farm), and (iii) misalignment between privately and socially optimal control efforts (i.e., privately optimal behavior not conducive to a socially optimal outcome). Endemic chronic diseases cause a wide range of adverse social and economic impacts, particularly in low-income countries. The actions taken by farmers to control livestock diseases minimize some of these impacts, and heterogeneity in those actions leads to variation in prevalence at the farm level. While some farmers respond to perceived disease risks, others free-ride on the actions of these individuals, thereby compromising the potential benefits of collective, coordinated behavior. When evaluating a plausible range of disease cost to price of control ratios and assuming that farmers choose their privately optimal control effort, we demonstrate that achievement of a socially optimal disease control target is unlikely, occurring in <25% of all price-cost combinations. To achieve a socially optimal disease control outcome (reliant on farmers' voluntary actions), control policies must consider farmer heterogeneity, off-farm effects, and the predicted uptake of control measures under the assumption of optimized behavior.
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Affiliation(s)
- Ângelo J Mendes
- College of Medical, Veterinary and Life Sciences, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Daniel T Haydon
- College of Medical, Veterinary and Life Sciences, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Emma McIntosh
- College of Medical, Veterinary and Life Sciences, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Nick Hanley
- College of Medical, Veterinary and Life Sciences, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Jo E B Halliday
- College of Medical, Veterinary and Life Sciences, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
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19
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Allan KJ, Maze MJ, Galloway RL, Rubach MP, Biggs HM, Halliday JEB, Cleaveland S, Saganda W, Lwezaula BF, Kazwala RR, Mmbaga BT, Maro VP, Crump JA. Molecular Detection and Typing of Pathogenic Leptospira in Febrile Patients and Phylogenetic Comparison with Leptospira Detected among Animals in Tanzania. Am J Trop Med Hyg 2020; 103:1427-1434. [PMID: 32748767 PMCID: PMC7543812 DOI: 10.4269/ajtmh.19-0703] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Molecular data are required to improve our understanding of the epidemiology of leptospirosis in Africa and to identify sources of human infection. We applied molecular methods to identify the infecting Leptospira species and genotypes among patients hospitalized with fever in Tanzania and compared these with Leptospira genotypes detected among animals in Tanzania to infer potential sources of human infection. We performed lipL32 real-time PCR to detect the presence of pathogenic Leptospira in acute-phase plasma, serum, and urine samples obtained from study participants with serologically confirmed leptospirosis and participants who had died with febrile illness. Leptospira blood culture was also performed. In positive specimens, we performed species-specific PCR and compared participant Leptospira secY sequences with Leptospira reference sequences and sequences previously obtained from animals in Tanzania. We detected Leptospira DNA in four (3.6%) of 111 participant blood samples. We detected Leptospira borgpetersenii (one participant, 25.0%), Leptospira interrogans (one participant, 25.0%), and Leptospira kirschneri (one participant, 25.0%) (one [25%] undetermined). Phylogenetic comparison of secY sequence from the L. borgpetersenii and L. kirschneri genotypes detected from participants was closely related to but distinct from genotypes detected among local livestock species. Our results indicate that a diverse range of Leptospira species is causing human infection. Although our analysis suggests a close relationship between Leptospira genotypes found in people and livestock, continued efforts are needed to obtain more Leptospira genetic material from human leptospirosis cases to help prioritize Leptospira species and genotypes for control.
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Affiliation(s)
- Kathryn J. Allan
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Michael J. Maze
- Centre for International Health, University of Otago, Dunedin, New Zealand;,Department of Medicine, University of Otago, Christchurch, New Zealand;,Address correspondence to Michael J. Maze, Department of Medicine, University of Otago, PO Box 4345, Christchurch 8140, New Zealand. E-mail:
| | - Renee L. Galloway
- Bacterial Special Pathogens Branch, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Matthew P. Rubach
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina;,Duke Global Health Institute, Duke University, Durham, North Carolina;,Programme for Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Holly M. Biggs
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina
| | - Jo E. B. Halliday
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Sarah Cleaveland
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | | | | | - Rudovick R. Kazwala
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Blandina T. Mmbaga
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania;,Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania;,Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Venance P. Maro
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania;,Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
| | - John A. Crump
- Centre for International Health, University of Otago, Dunedin, New Zealand;,Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina;,Duke Global Health Institute, Duke University, Durham, North Carolina
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20
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Akoko J, Pelle R, Kivali V, Schelling E, Shirima G, Machuka EM, Mathew C, Fèvre EM, Kyallo V, Falzon LC, Lukambagire AS, Halliday JEB, Bonfoh B, Kazwala R, Ouma C. Serological and molecular evidence of Brucella species in the rapidly growing pig sector in Kenya. BMC Vet Res 2020; 16:133. [PMID: 32393374 PMCID: PMC7216537 DOI: 10.1186/s12917-020-02346-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/29/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Brucellosis is an emerging yet neglected zoonosis that has been reported in Kenya. Epidemiological data on brucellosis in ruminants is readily accessible; however, reports on brucellosis in pigs remain limited. This study sought to detect Brucella infection in pig serum by both serological and molecular techniques. Serum from 700 pigs randomly collected at a centralized abattoir in Nairobi region, Kenya were screened in parallel, using both Rose Bengal Test (RBT) and competitive Enzyme-Linked Immuno-sorbent Assay (cELISA) for antibodies against Brucella spp. All sera positive by RBT and 16 randomly selected negative samples were further tested using conventional PCR targeting bcsp31 gene and real-time PCR (RT-PCR) assays targeting IS711 and bcsp31 genes. RESULTS A prevalence of 0.57% (n = 4/700) was estimated using RBT; none of these samples was positive on cELISA. All RBT positive sera were also positive by both PCRs, while two sero-negative samples also tested positive on RT-PCR (n = 6/20). Brucella abortus was detected in four out of the six PCR positive samples through a real-time multiplex PCR. CONCLUSION The detection of antibodies against Brucella spp. and DNA in serum from slaughterhouse pigs confirm the presence of Brucella in pigs. Therefore, investigation of the epidemiology and role of pigs in the transmission of brucellosis in Kenya is needed. Further targeted studies would be useful to systematically quantify and identify the spp. of Brucella in pigs.
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Affiliation(s)
- James Akoko
- Department of Biomedical Sciences and Technology, Maseno University, Kisumu, Kenya.
- Biosciences Eastern And Central Africa - International Livestock Research Institute, Nairobi, Kenya.
| | - Roger Pelle
- Biosciences Eastern And Central Africa - International Livestock Research Institute, Nairobi, Kenya
| | - Velma Kivali
- International Livestock Research Institute, Nairobi, Kenya
| | - Esther Schelling
- Department of Public Health and Epidemiology, Swiss Tropical Institute, Basel, Switzerland
| | - Gabriel Shirima
- Nelson Mandela African Institute of Science and Technology, Arusha, Tanzania
| | - Eunice M Machuka
- Biosciences Eastern And Central Africa - International Livestock Research Institute, Nairobi, Kenya
| | | | - Eric M Fèvre
- International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | | | - Laura C Falzon
- International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | | | | | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Neuchâtel, Switzerland
| | | | - Collins Ouma
- Department of Biomedical Sciences and Technology, Maseno University, Kisumu, Kenya
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21
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Maze MJ, Sharples KJ, Allan KJ, Biggs HM, Cash-Goldwasser S, Galloway RL, de Glanville WA, Halliday JEB, Kazwala RR, Kibona T, Mmbaga BT, Maro VP, Rubach MP, Cleaveland S, Crump JA. Estimating acute human leptospirosis incidence in northern Tanzania using sentinel site and community behavioural surveillance. Zoonoses Public Health 2020; 67:496-505. [PMID: 32374085 PMCID: PMC7497209 DOI: 10.1111/zph.12712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/23/2019] [Accepted: 03/30/2020] [Indexed: 01/07/2023]
Abstract
Many infectious diseases lack robust estimates of incidence from endemic areas, and extrapolating incidence when there are few locations with data remains a major challenge in burden of disease estimation. We sought to combine sentinel surveillance with community behavioural surveillance to estimate leptospirosis incidence. We administered a questionnaire gathering responses on established locally relevant leptospirosis risk factors and recent fever to livestock-owning community members across six districts in northern Tanzania and applied a logistic regression model predicting leptospirosis risk on the basis of behavioural factors that had been previously developed among patients with fever in Moshi Municipal and Moshi Rural Districts. We aggregated probability of leptospirosis by district and estimated incidence in each district by standardizing probabilities to those previously estimated for Moshi Districts. We recruited 286 community participants: Hai District (n = 11), Longido District (59), Monduli District (56), Moshi Municipal District (103), Moshi Rural District (44) and Rombo District (13). The mean predicted probability of leptospirosis by district was Hai 0.029 (0.005, 0.095), Longido 0.071 (0.009, 0.235), Monduli 0.055 (0.009, 0.206), Moshi Rural 0.014 (0.002, 0.049), Moshi Municipal 0.015 (0.004, 0.048) and Rombo 0.031 (0.006, 0.121). We estimated the annual incidence (upper and lower bounds of estimate) per 100,000 people of human leptospirosis among livestock owners by district as Hai 35 (6, 114), Longido 85 (11, 282), Monduli 66 (11, 247), Moshi Rural 17 (2, 59), Moshi Municipal 18 (5, 58) and Rombo 47 (7, 145). Use of community behavioural surveillance may be a useful tool for extrapolating disease incidence beyond sentinel surveillance sites.
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Affiliation(s)
- Michael J Maze
- Centre for International Health, University of Otago, Dunedin, New Zealand.,Department of Medicine, University of Otago, Christchurch, New Zealand.,Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Katrina J Sharples
- Department of Mathematics and Statistics, University of Otago, Dunedin, New Zealand
| | - Kathryn J Allan
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Holly M Biggs
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | | | - Renee L Galloway
- Bacterial Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - William A de Glanville
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Jo E B Halliday
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Rudovick R Kazwala
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Tito Kibona
- Nelson Mandela African Institution for Science and Technology, Arusha, Tanzania
| | - Blandina T Mmbaga
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Venance P Maro
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Matthew P Rubach
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA.,Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Sarah Cleaveland
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - John A Crump
- Centre for International Health, University of Otago, Dunedin, New Zealand.,Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA.,Duke Global Health Institute, Duke University, Durham, NC, USA.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
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22
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Bodenham RF, Lukambagire AS, Ashford RT, Buza JJ, Cash-Goldwasser S, Crump JA, Kazwala RR, Maro VP, McGiven J, Mkenda N, Mmbaga BT, Rubach MP, Sakasaka P, Shirima GM, Swai ES, Thomas KM, Whatmore AM, Haydon DT, Halliday JEB. Prevalence and speciation of brucellosis in febrile patients from a pastoralist community of Tanzania. Sci Rep 2020; 10:7081. [PMID: 32341414 PMCID: PMC7184621 DOI: 10.1038/s41598-020-62849-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/11/2020] [Indexed: 01/18/2023] Open
Abstract
Brucellosis is an endemic zoonosis in sub-Saharan Africa. Pastoralists are at high risk of infection but data on brucellosis from these communities are scarce. The study objectives were to: estimate the prevalence of human brucellosis, identify the Brucella spp. causing illness, describe non-Brucella bloodstream infections, and identify risk factors for brucellosis in febrile patients from a pastoralist community of Tanzania. Fourteen (6.1%) of 230 participants enrolled between August 2016 and October 2017 met study criteria for confirmed (febrile illness and culture positivity or ≥four-fold rise in SAT titre) or probable (febrile illness and single SAT titre ≥160) brucellosis. Brucella spp. was the most common bloodstream infection, with B. melitensis isolated from seven participants and B. abortus from one. Enterococcus spp., Escherichia coli, Salmonella enterica, Staphylococcus aureus and Streptococcus pneumoniae were also isolated. Risk factors identified for brucellosis included age and herding, with a greater probability of brucellosis in individuals with lower age and who herded cattle, sheep or goats in the previous 12 months. Disease prevention activities targeting young herders have potential to reduce the impacts of human brucellosis in Tanzania. Livestock vaccination strategies for the region should include both B. melitensis and B. abortus.
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Affiliation(s)
- Rebecca F Bodenham
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | - Roland T Ashford
- OIE/FAO Brucellosis Reference Laboratory, Department of Bacteriology, Animal & Plant Health Agency, Surrey, UK
| | - Joram J Buza
- Nelson Mandela African Institution for Science and Technology, Arusha, Tanzania
| | - Shama Cash-Goldwasser
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA.,Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - John A Crump
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA.,Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Clinical Research Institute, Moshi, Tanzania.,Centre for International Health, University of Otago, Dunedin, New Zealand.,Kilimanjaro Christian Medical University College, Moshi, Tanzania.,Division of Infectious Diseases and International Health, Duke University Medical Center, North Carolina, USA
| | | | - Venance P Maro
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - John McGiven
- OIE/FAO Brucellosis Reference Laboratory, Department of Bacteriology, Animal & Plant Health Agency, Surrey, UK
| | - Nestory Mkenda
- Endulen Hospital, Ngorongoro Conservation Area, Arusha, Tanzania
| | - Blandina T Mmbaga
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA.,Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Clinical Research Institute, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Matthew P Rubach
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA.,Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Division of Infectious Diseases and International Health, Duke University Medical Center, North Carolina, USA.,Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
| | | | - Gabriel M Shirima
- Nelson Mandela African Institution for Science and Technology, Arusha, Tanzania
| | - Emanuel S Swai
- Directorate of Veterinary Services, Ministry of Livestock and Fisheries, Dodoma, Tanzania
| | - Kate M Thomas
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania.,Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Adrian M Whatmore
- OIE/FAO Brucellosis Reference Laboratory, Department of Bacteriology, Animal & Plant Health Agency, Surrey, UK
| | - Daniel T Haydon
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Jo E B Halliday
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
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23
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Carugati M, Biggs HM, Maze MJ, Stoddard RA, Cash-Goldwasser S, Hertz JT, Halliday JEB, Saganda W, Lwezaula BF, Kazwala RR, Cleaveland S, Maro VP, Rubach MP, Crump JA. Incidence of human brucellosis in the Kilimanjaro Region of Tanzania in the periods 2007-2008 and 2012-2014. Trans R Soc Trop Med Hyg 2019; 112:136-143. [PMID: 29697848 PMCID: PMC5961162 DOI: 10.1093/trstmh/try033] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 03/23/2018] [Indexed: 11/23/2022] Open
Abstract
Background Brucellosis causes substantial morbidity among humans and their livestock. There are few robust estimates of the incidence of brucellosis in sub-Saharan Africa. Using cases identified through sentinel hospital surveillance and health care utilization data, we estimated the incidence of brucellosis in Moshi Urban and Moshi Rural Districts, Kilimanjaro Region, Tanzania, for the periods 2007–2008 and 2012–2014. Methods Cases were identified among febrile patients at two sentinel hospitals and were defined as having either a 4-fold increase in Brucella microscopic agglutination test titres between acute and convalescent serum or a blood culture positive for Brucella spp. Findings from a health care utilization survey were used to estimate multipliers to account for cases not seen at sentinel hospitals. Results Of 585 patients enrolled in the period 2007–2008, 13 (2.2%) had brucellosis. Among 1095 patients enrolled in the period 2012–2014, 32 (2.9%) had brucellosis. We estimated an incidence (range based on sensitivity analysis) of brucellosis of 35 (range 32–93) cases per 100 000 persons annually in the period 2007–2008 and 33 (range 30–89) cases per 100 000 persons annually in the period 2012–2014. Conclusions We found a moderate incidence of brucellosis in northern Tanzania, suggesting that the disease is endemic and an important human health problem in this area.
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Affiliation(s)
- Manuela Carugati
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA.,Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Division of Infectious Diseases, San Gerardo Hospital, Monza, Italy
| | - Holly M Biggs
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - Michael J Maze
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Robyn A Stoddard
- Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, GA, USA
| | - Shama Cash-Goldwasser
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Julian T Hertz
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Jo E B Halliday
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | | | | | | | - Sarah Cleaveland
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Venance P Maro
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Matthew P Rubach
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA.,Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Duke Global Health Institute, Duke University, Durham, NC, USA
| | - John A Crump
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA.,Centre for International Health, University of Otago, Dunedin, New Zealand.,Duke Global Health Institute, Duke University, Durham, NC, USA.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
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24
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Behdenna A, Lembo T, Calatayud O, Cleaveland S, Halliday JEB, Packer C, Lankester F, Hampson K, Craft ME, Czupryna A, Dobson AP, Dubovi EJ, Ernest E, Fyumagwa R, Hopcraft JGC, Mentzel C, Mzimbiri I, Sutton D, Willett B, Haydon DT, Viana M. Transmission ecology of canine parvovirus in a multi-host, multi-pathogen system. Proc Biol Sci 2019; 286:20182772. [PMID: 30914008 PMCID: PMC6452066 DOI: 10.1098/rspb.2018.2772] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 02/27/2019] [Indexed: 12/25/2022] Open
Abstract
Understanding multi-host pathogen maintenance and transmission dynamics is critical for disease control. However, transmission dynamics remain enigmatic largely because they are difficult to observe directly, particularly in wildlife. Here, we investigate the transmission dynamics of canine parvovirus (CPV) using state-space modelling of 20 years of CPV serology data from domestic dogs and African lions in the Serengeti ecosystem. We show that, although vaccination reduces the probability of infection in dogs, and despite indirect enhancement of population seropositivity as a result of vaccine shedding, the vaccination coverage achieved has been insufficient to prevent CPV from becoming widespread. CPV is maintained by the dog population and has become endemic with approximately 3.5-year cycles and prevalence reaching approximately 80%. While the estimated prevalence in lions is lower, peaks of infection consistently follow those in dogs. Dogs exposed to CPV are also more likely to become infected with a second multi-host pathogen, canine distemper virus. However, vaccination can weaken this coupling, raising questions about the value of monovalent versus polyvalent vaccines against these two pathogens. Our findings highlight the need to consider both pathogen- and host-level community interactions when seeking to understand the dynamics of multi-host pathogens and their implications for conservation, disease surveillance and control programmes.
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Affiliation(s)
- Abdelkader Behdenna
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Tiziana Lembo
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | - Sarah Cleaveland
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Jo E. B. Halliday
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Craig Packer
- Ecology Evolution and Behavior, University of Minnesota, Saint Paul, MN 55108, USA
| | - Felix Lankester
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA 99164, USA
| | - Katie Hampson
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Meggan E. Craft
- Department of Veterinary Population Medicine, University of Minnesota, Saint Paul, MN 55108, USA
| | - Anna Czupryna
- Lincoln Park Zoo, Chicago, IL 60614, USA
- Department of Ecology and Evolution, University of Illinois, Chicago, IL 60607, USA
| | - Andrew P. Dobson
- Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA
| | - Edward J. Dubovi
- Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, NY 14851, USA
| | - Eblate Ernest
- Tanzania Wildlife Research Institute, Arusha, Tanzania
| | - Robert Fyumagwa
- Conservation Areas and Species Diversity Programme, South Africa Country Office, International Union for the Conservation of Nature, Pretoria, South Africa
| | - J. Grant C. Hopcraft
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Christine Mentzel
- Conservation Areas and Species Diversity Programme, South Africa Country Office, International Union for the Conservation of Nature, Pretoria, South Africa
| | | | - David Sutton
- MSD Animal Health, Walton Manor, Walton, Milton Keynes MK7 7AJ, UK
| | - Brian Willett
- MRC-University of Glasgow Centre for Virus Research, University of Glasgow, Glasgow G6 1QH, UK
| | - Daniel T. Haydon
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Mafalda Viana
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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25
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Paul E, Kiwelu I, Mmbaga B, Nazareth R, Sabuni E, Maro A, Ndaro A, Halliday JEB, Chilongola J. Toxoplasma gondii seroprevalence among pregnant women attending antenatal clinic in Northern Tanzania. Trop Med Health 2018; 46:39. [PMID: 30479556 PMCID: PMC6245905 DOI: 10.1186/s41182-018-0122-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 11/08/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Acute Toxoplasma gondii infection during pregnancy represents a risk for congenital disease, especially among women without previous exposure to infection. There is, however, a paucity of information about the epidemiology of T. gondii infection in pregnant women in Tanzania. This study aimed to determine the seroprevalence of T. gondii infection and associated demographic, clinical, and behavioral risk factors in pregnant women attending ante-natal clinic (ANC) at Kilimanjaro Christian Medical Center (KCMC), a referral medical center in Northern Tanzania. METHODS A hospital-based cross-sectional study was carried out from 1 February to 30 April 2017. Data on maternal demographic characteristics, obstetric history, knowledge, and practices related to T. gondii infection were collected from 254 pregnant women attending antenatal care at KCMC. A sample of 4 mL of blood was collected from each participant and sera prepared from each sample. Serum samples were tested for the presence of specific T. gondii IgG and IgM antibodies by indirect Enzyme-Linked Immunosorbent Assay (ELISA). DNA was extracted from whole blood for polymerase chain reaction (PCR) testing, targeting the DNA sequence coding for the Internal Transcribed Spacer 1 (ITS1). RESULTS The overall T. gondii seroprevalence, including both IgM- and IgG-positive individuals, was 44.5%. Of the 254 tested women, 102 and 23 were seropositive for T. gondii-specific IgG and IgM antibodies respectively and 113 individuals had antibodies of either or both classes. All IgM-positive samples were also tested by PCR, and all were negative. The majority (90%) of the women surveyed had never heard about toxoplasmosis. Consumption of raw vegetables [aOR = 0. 344; 95% CI 0.151-0.784; p = 0.011] and having regular contact with soil [aOR = 0.482; 95% CI 0.268-0.8681; p = 0.015] were both associated with T. gondii antibody status. Inverse relationships with probability of T. gondii exposure were observed, such that these practices were associated with reduced probability of antibody detection. CONCLUSION Based on serology results, we report widespread exposure to T. gondii infection among pregnant women attending ANC in KCMC. The complex interaction of risk factors for T. gondii infection needs to be studied in larger longitudinal studies.
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Affiliation(s)
- Eliakimu Paul
- Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| | - Ireen Kiwelu
- Kilimanjaro Clinical Research Institute, P.O. Box 2236, Moshi, Tanzania
- Kilimanjaro Christian Medical Center, P.O. Box 3010, Moshi, Tanzania
| | - Blandina Mmbaga
- Kilimanjaro Clinical Research Institute, P.O. Box 2236, Moshi, Tanzania
- Kilimanjaro Christian Medical Center, P.O. Box 3010, Moshi, Tanzania
| | - Rebeka Nazareth
- Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| | - Elias Sabuni
- Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| | - Athanasia Maro
- Kilimanjaro Clinical Research Institute, P.O. Box 2236, Moshi, Tanzania
| | - Arnold Ndaro
- Kilimanjaro Clinical Research Institute, P.O. Box 2236, Moshi, Tanzania
- Kilimanjaro Christian Medical Center, P.O. Box 3010, Moshi, Tanzania
| | - Jo E. B. Halliday
- Boyd Orr Center for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ UK
| | - Jaffu Chilongola
- Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, P.O. Box 2236, Moshi, Tanzania
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26
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Maze MJ, Cash-Goldwasser S, Rubach MP, Biggs HM, Galloway RL, Sharples KJ, Allan KJ, Halliday JEB, Cleaveland S, Shand MC, Muiruri C, Kazwala RR, Saganda W, Lwezaula BF, Mmbaga BT, Maro VP, Crump JA. Risk factors for human acute leptospirosis in northern Tanzania. PLoS Negl Trop Dis 2018; 12:e0006372. [PMID: 29879114 PMCID: PMC5991637 DOI: 10.1371/journal.pntd.0006372] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 03/07/2018] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Leptospirosis is a major cause of febrile illness in Africa but little is known about risk factors for human infection. We conducted a cross-sectional study to investigate risk factors for acute leptospirosis and Leptospira seropositivity among patients with fever attending referral hospitals in northern Tanzania. METHODS We enrolled patients with fever from two referral hospitals in Moshi, Tanzania, 2012-2014, and performed Leptospira microscopic agglutination testing on acute and convalescent serum. Cases of acute leptospirosis were participants with a four-fold rise in antibody titers, or a single reciprocal titer ≥800. Seropositive participants required a single titer ≥100, and controls had titers <100 in both acute and convalescent samples. We administered a questionnaire to assess risk behaviors over the preceding 30 days. We created cumulative scales of exposure to livestock urine, rodents, and surface water, and calculated odds ratios (OR) for individual behaviors and for cumulative exposure variables. RESULTS We identified 24 acute cases, 252 seropositive participants, and 592 controls. Rice farming (OR 14.6), cleaning cattle waste (OR 4.3), feeding cattle (OR 3.9), farm work (OR 3.3), and an increasing cattle urine exposure score (OR 1.2 per point) were associated with acute leptospirosis. CONCLUSIONS In our population, exposure to cattle and rice farming were risk factors for acute leptospirosis. Although further data is needed, these results suggest that cattle may be an important source of human leptospirosis. Further investigation is needed to explore the potential for control of livestock Leptospira infection to reduce human disease.
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Affiliation(s)
- Michael J. Maze
- Centre for International Health, University of Otago, Dunedin, New Zealand
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Shama Cash-Goldwasser
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Matthew P. Rubach
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Holly M. Biggs
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Renee L. Galloway
- Bacterial Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Katrina J. Sharples
- Centre for International Health, University of Otago, Dunedin, New Zealand
- Department of Mathematics and Statistics, University of Otago, Dunedin, New Zealand
| | - Kathryn J. Allan
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Jo E. B. Halliday
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Sarah Cleaveland
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Michael C. Shand
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Charles Muiruri
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Rudovick R. Kazwala
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | | | | | - Blandina T. Mmbaga
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, United States of America
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Venance P. Maro
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - John A. Crump
- Centre for International Health, University of Otago, Dunedin, New Zealand
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, United States of America
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Allan KJ, Halliday JEB, Moseley M, Carter RW, Ahmed A, Goris MGA, Hartskeerl RA, Keyyu J, Kibona T, Maro VP, Maze MJ, Mmbaga BT, Tarimo R, Crump JA, Cleaveland S. Assessment of animal hosts of pathogenic Leptospira in northern Tanzania. PLoS Negl Trop Dis 2018; 12:e0006444. [PMID: 29879104 PMCID: PMC5991636 DOI: 10.1371/journal.pntd.0006444] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 04/11/2018] [Indexed: 12/29/2022] Open
Abstract
Leptospirosis is a zoonotic bacterial disease that affects more than one million people worldwide each year. Human infection is acquired through direct or indirect contact with the urine of an infected animal. A wide range of animals including rodents and livestock may shed Leptospira bacteria and act as a source of infection for people. In the Kilimanjaro Region of northern Tanzania, leptospirosis is an important cause of acute febrile illness, yet relatively little is known about animal hosts of Leptospira infection in this area. The roles of rodents and ruminant livestock in the epidemiology of leptospirosis were evaluated through two linked studies. A cross-sectional study of peri-domestic rodents performed in two districts with a high reported incidence of human leptospirosis found no evidence of Leptospira infection among rodent species trapped in and around randomly selected households. In contrast, pathogenic Leptospira infection was detected in 7.08% cattle (n = 452 [5.1-9.8%]), 1.20% goats (n = 167 [0.3-4.3%]) and 1.12% sheep (n = 89 [0.1-60.0%]) sampled in local slaughterhouses. Four Leptospira genotypes were detected in livestock. Two distinct clades of L. borgpetersenii were identified in cattle as well as a clade of novel secY sequences that showed only 95% identity to known Leptospira sequences. Identical L. kirschneri sequences were obtained from qPCR-positive kidney samples from cattle, sheep and goats. These results indicate that ruminant livestock are important hosts of Leptospira in northern Tanzania. Infected livestock may act as a source of Leptospira infection for people. Additional work is needed to understand the role of livestock in the maintenance and transmission of Leptospira infection in this region and to examine linkages between human and livestock infections.
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Affiliation(s)
- Kathryn J. Allan
- The Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Jo E. B. Halliday
- The Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Mark Moseley
- Institute of Biological and Environmental Science, University of Aberdeen, Aberdeen, United Kingdom
| | - Ryan W. Carter
- The Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Ahmed Ahmed
- WHO/FAO/OIE Collaborating Leptospirosis Reference Laboratory, Royal Tropical Institute, Amsterdam, The Netherlands
| | - Marga G. A. Goris
- WHO/FAO/OIE Collaborating Leptospirosis Reference Laboratory, Royal Tropical Institute, Amsterdam, The Netherlands
| | - Rudy A. Hartskeerl
- WHO/FAO/OIE Collaborating Leptospirosis Reference Laboratory, Royal Tropical Institute, Amsterdam, The Netherlands
| | - Julius Keyyu
- Tanzania Wildlife Research Institute, Arusha, Tanzania
| | - Tito Kibona
- Nelson Mandela African Institution for Science and Technology, Arusha, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Venance P. Maro
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Michael J. Maze
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Blandina T. Mmbaga
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Rigobert Tarimo
- Nelson Mandela African Institution for Science and Technology, Arusha, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - John A. Crump
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Centre for International Health, University of Otago, Dunedin, New Zealand
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Sarah Cleaveland
- The Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
- Nelson Mandela African Institution for Science and Technology, Arusha, Tanzania
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28
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Cash-Goldwasser S, Maze MJ, Rubach MP, Biggs HM, Stoddard RA, Sharples KJ, Halliday JEB, Cleaveland S, Shand MC, Mmbaga BT, Muiruri C, Saganda W, Lwezaula BF, Kazwala RR, Maro VP, Crump JA. Risk Factors for Human Brucellosis in Northern Tanzania. Am J Trop Med Hyg 2018; 98:598-606. [PMID: 29231152 PMCID: PMC5929176 DOI: 10.4269/ajtmh.17-0125] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 10/08/2017] [Indexed: 11/27/2022] Open
Abstract
Little is known about the epidemiology of human brucellosis in sub-Saharan Africa. This hampers prevention and control efforts at the individual and population levels. To evaluate risk factors for brucellosis in northern Tanzania, we conducted a study of patients presenting with fever to two hospitals in Moshi, Tanzania. Serum taken at enrollment and at 4-6 week follow-up was tested by Brucella microagglutination test. Among participants with a clinically compatible illness, confirmed brucellosis cases were defined as having a ≥ 4-fold rise in agglutination titer between paired sera or a blood culture positive for Brucella spp., and probable brucellosis cases were defined as having a single reciprocal titer ≥ 160. Controls had reciprocal titers < 20 in paired sera. We collected demographic and clinical information and administered a risk factor questionnaire. Of 562 participants in the analysis, 50 (8.9%) had confirmed or probable brucellosis. Multivariable analysis showed that risk factors for brucellosis included assisting goat or sheep births (Odds ratio [OR] 5.9, 95% confidence interval [CI] 1.4, 24.6) and having contact with cattle (OR 1.2, 95% CI 1.0, 1.4). Consuming boiled or pasteurized dairy products was protective against brucellosis (OR 0.12, 95% CI 0.02, 0.93). No participants received a clinical diagnosis of brucellosis from their healthcare providers. The under-recognition of brucellosis by healthcare workers could be addressed with clinician education and better access to brucellosis diagnostic tests. Interventions focused on protecting livestock keepers, especially those who assist goat or sheep births, are needed.
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Affiliation(s)
- Shama Cash-Goldwasser
- Duke Global Health Institute, Duke University, Durham, North Carolina
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Michael J. Maze
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Matthew P. Rubach
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
| | - Holly M. Biggs
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
| | - Robyn A. Stoddard
- Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia
| | - Katrina J. Sharples
- Department of Mathematics and Statistics, University of Otago, Dunedin, New Zealand
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Jo E. B. Halliday
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Sarah Cleaveland
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Michael C. Shand
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Blandina T. Mmbaga
- Duke Global Health Institute, Duke University, Durham, North Carolina
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Charles Muiruri
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | | | | | - Rudovick R. Kazwala
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Venance P. Maro
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - John A. Crump
- Duke Global Health Institute, Duke University, Durham, North Carolina
- Centre for International Health, University of Otago, Dunedin, New Zealand
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
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29
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Halliday JEB, Hampson K, Hanley N, Lembo T, Sharp JP, Haydon DT, Cleaveland S. Driving improvements in emerging disease surveillance through locally relevant capacity strengthening. Science 2018; 357:146-148. [PMID: 28706036 DOI: 10.1126/science.aam8332] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Emerging infectious diseases (EIDs) threaten the health of people, animals, and crops globally, but our ability to predict their occurrence is limited. Current public health capacity and ability to detect and respond to EIDs is typically weakest in low- and middle-income countries (LMICs). Many known drivers of EID emergence also converge in LMICs. Strengthening capacity for surveillance of diseases of relevance to local populations can provide a mechanism for building the cross-cutting and flexible capacities needed to tackle both the burden of existing diseases and EID threats. A focus on locally relevant diseases in LMICs and the economic, social, and cultural contexts of surveillance can help address existing inequalities in health systems, improve the capacity to detect and contain EIDs, and contribute to broader global goals for development.
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Affiliation(s)
- Jo E B Halliday
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK.
| | - Katie Hampson
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Nick Hanley
- School of Geography and Sustainable Development, University of St Andrews, St Andrews, Scotland, UK
| | - Tiziana Lembo
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Joanne P Sharp
- School of Geographical and Earth Sciences, University of Glasgow, Glasgow, UK
| | - Daniel T Haydon
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Sarah Cleaveland
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
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30
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Cleaveland S, Sharp J, Abela-Ridder B, Allan KJ, Buza J, Crump JA, Davis A, Del Rio Vilas VJ, de Glanville WA, Kazwala RR, Kibona T, Lankester FJ, Lugelo A, Mmbaga BT, Rubach MP, Swai ES, Waldman L, Haydon DT, Hampson K, Halliday JEB. One Health contributions towards more effective and equitable approaches to health in low- and middle-income countries. Philos Trans R Soc Lond B Biol Sci 2017; 372:20160168. [PMID: 28584176 PMCID: PMC5468693 DOI: 10.1098/rstb.2016.0168] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2016] [Indexed: 02/06/2023] Open
Abstract
Emerging zoonoses with pandemic potential are a stated priority for the global health security agenda, but endemic zoonoses also have a major societal impact in low-resource settings. Although many endemic zoonoses can be treated, timely diagnosis and appropriate clinical management of human cases is often challenging. Preventive 'One Health' interventions, e.g. interventions in animal populations that generate human health benefits, may provide a useful approach to overcoming some of these challenges. Effective strategies, such as animal vaccination, already exist for the prevention, control and elimination of many endemic zoonoses, including rabies, and several livestock zoonoses (e.g. brucellosis, leptospirosis, Q fever) that are important causes of human febrile illness and livestock productivity losses in low- and middle-income countries. We make the case that, for these diseases, One Health interventions have the potential to be more effective and generate more equitable benefits for human health and livelihoods, particularly in rural areas, than approaches that rely exclusively on treatment of human cases. We hypothesize that applying One Health interventions to tackle these health challenges will help to build trust, community engagement and cross-sectoral collaboration, which will in turn strengthen the capacity of fragile health systems to respond to the threat of emerging zoonoses and other future health challenges. One Health interventions thus have the potential to align the ongoing needs of disadvantaged communities with the concerns of the broader global community, providing a pragmatic and equitable approach to meeting the global goals for sustainable development and supporting the global health security agenda.This article is part of the themed issue 'One Health for a changing world: zoonoses, ecosystems and human well-being'.
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Affiliation(s)
- S Cleaveland
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, and
| | - J Sharp
- School of Geographical and Earth Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - B Abela-Ridder
- Department for the Control of Neglected Tropical Diseases, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - K J Allan
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, and
| | - J Buza
- School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, PO Box 447, Arusha, Tanzania
| | - J A Crump
- Centre for International Health, University of Otago, PO Box 56, Dunedin 9054, New Zealand
| | - A Davis
- School of Geographical and Earth Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - V J Del Rio Vilas
- School of Veterinary Medicine, University of Surrey, Guildford GU2 7XH, UK
| | - W A de Glanville
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, and
| | - R R Kazwala
- College of Veterinary Medicine and Medical Sciences, Sokoine University of Agriculture, PO Box 3105, Morogoro, Tanzania
| | - T Kibona
- School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, PO Box 447, Arusha, Tanzania
| | - F J Lankester
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA 99164, USA
| | - A Lugelo
- College of Veterinary Medicine and Medical Sciences, Sokoine University of Agriculture, PO Box 3105, Morogoro, Tanzania
| | - B T Mmbaga
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, PO Box 2236, Moshi, Tanzania
| | - M P Rubach
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC 27710, USA
| | - E S Swai
- Ministry of Agriculture, Livestock and Fisheries, PO Box 9152, Dar es Salaam, Tanzania
| | - L Waldman
- Institute for Development Studies, Library Road, Brighton BN1 9RE, UK
| | - D T Haydon
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, and
| | - K Hampson
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, and
| | - J E B Halliday
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, and
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31
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Ladbury G, J Allan K, Cleaveland S, Davis A, A de Glanville W, L Forde T, E B Halliday J, T Haydon D, Kibiki G, Kiwelu I, Lembo T, Maro V, T Mmbaga B, Ndyetabura T, Sharp J, Thomas K, N Zadoks R. One Health Research in Northern Tanzania - Challenges and Progress. East Afr Health Res J 2017. [DOI: 10.24248/eahrj.v1i1.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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32
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Ladbury G, Allan KJ, Cleaveland S, Davis A, de Glanville WA, Forde TL, Halliday JEB, Haydon DT, Kibiki G, Kiwelu I, Lembo T, Maro V, Mmbaga BT, Ndyetabura T, Sharp J, Thomas K, Zadoks RN. One Health Research in Northern Tanzania - Challenges and Progress. East Afr Health Res J 2017; 1:8-18. [PMID: 34308154 PMCID: PMC8279194 DOI: 10.24248/eahrj-d-16-00379] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/02/2017] [Indexed: 11/20/2022] Open
Abstract
East Africa has one of the world's fastest growing human populations-many of whom are dependent on livestock-as well as some of the world's largest wildlife populations. Humans, livestock, and wildlife often interact closely, intimately linking human, animal, and environmental health. The concept of One Health captures this interconnectedness, including the social structures and beliefs driving interactions between species and their environments. East African policymakers and researchers are recognising and encouraging One Health research, with both groups increasingly playing a leading role in this subject area. One Health research requires interaction between scientists from different disciplines, such as the biological and social sciences and human and veterinary medicine. Different disciplines draw on norms, methodologies, and terminologies that have evolved within their respective institutions and that may be distinct from or in conflict with one another. These differences impact interdisciplinary research, both around theoretical and methodological approaches and during project operationalisation. We present experiential knowledge gained from numerous ongoing projects in northern Tanzania, including those dealing with bacterial zoonoses associated with febrile illness, foodborne disease, and anthrax. We use the examples to illustrate differences between and within social and biological sciences and between industrialised and traditional societies, for example, with regard to consenting procedures or the ethical treatment of animals. We describe challenges encountered in ethical approval processes, consenting procedures, and field and laboratory logistics and offer suggestions for improvement. While considerable investment of time in sensitisation, communication, and collaboration is needed to overcome interdisciplinary challenges inherent in One Health research, this can yield great rewards in paving the way for successful implementation of One Health projects. Furthermore, continued investment in African institutions and scientists will strengthen the role of East Africa as a world leader in One Health research.
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Affiliation(s)
- Georgia Ladbury
- Institute of Biodiversity Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Kathryn J Allan
- Institute of Biodiversity Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Sarah Cleaveland
- Institute of Biodiversity Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Alicia Davis
- School of Geographical and Earth Sciences, College of Science and Engineering, University of Glasgow, Glasgow, UK
| | - William A de Glanville
- Institute of Biodiversity Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Taya L Forde
- Institute of Biodiversity Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Jo E B Halliday
- Institute of Biodiversity Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Daniel T Haydon
- Institute of Biodiversity Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Gibson Kibiki
- Kilimanjaro Clinical Research Institute, Good Samaritan Foundation, Moshi, Tanzania.,East African Health Research Commission, Arusha, Tanzania
| | - Ireen Kiwelu
- Kilimanjaro Clinical Research Institute, Good Samaritan Foundation, Moshi, Tanzania
| | - Tiziana Lembo
- Institute of Biodiversity Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Venance Maro
- Kilimanjaro Christian Medical Centre, Good Samaritan Foundation, Moshi, Tanzania
| | - Blandina T Mmbaga
- Kilimanjaro Clinical Research Institute, Good Samaritan Foundation, Moshi, Tanzania.,Kilimanjaro Christian Medical Centre, Good Samaritan Foundation, Moshi, Tanzania
| | - Theonest Ndyetabura
- Kilimanjaro Clinical Research Institute, Good Samaritan Foundation, Moshi, Tanzania
| | - Jo Sharp
- School of Geographical and Earth Sciences, College of Science and Engineering, University of Glasgow, Glasgow, UK
| | - Kate Thomas
- Kilimanjaro Clinical Research Institute, Good Samaritan Foundation, Moshi, Tanzania.,Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Ruth N Zadoks
- Kilimanjaro Clinical Research Institute, Good Samaritan Foundation, Moshi, Tanzania
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33
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Maze MJ, Biggs HM, Rubach MP, Galloway RL, Cash-Goldwasser S, Allan KJ, Halliday JEB, Hertz JT, Saganda W, Lwezaula BF, Cleaveland S, Mmbaga BT, Maro VP, Crump JA. Comparison of the Estimated Incidence of Acute Leptospirosis in the Kilimanjaro Region of Tanzania between 2007-08 and 2012-14. PLoS Negl Trop Dis 2016; 10:e0005165. [PMID: 27911902 PMCID: PMC5135036 DOI: 10.1371/journal.pntd.0005165] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 11/06/2016] [Indexed: 12/27/2022] Open
Abstract
Background The sole report of annual leptospirosis incidence in continental Africa of 75–102 cases per 100,000 population is from a study performed in August 2007 through September 2008 in the Kilimanjaro Region of Tanzania. To evaluate the stability of this estimate over time, we estimated the incidence of acute leptospirosis in Kilimanjaro Region, northern Tanzania for the time period 2012–2014. Methodology and Principal Findings Leptospirosis cases were identified among febrile patients at two sentinel hospitals in the Kilimanjaro Region. Leptospirosis was diagnosed by serum microscopic agglutination testing using a panel of 20 Leptospira serovars belonging to 17 separate serogroups. Serum was taken at enrolment and patients were asked to return 4–6 weeks later to provide convalescent serum. Confirmed cases required a 4-fold rise in titre and probable cases required a single titre of ≥800. Findings from a healthcare utilisation survey were used to estimate multipliers to adjust for cases not seen at sentinel hospitals. We identified 19 (1.7%) confirmed or probable cases among 1,115 patients who presented with a febrile illness. Of cases, the predominant reactive serogroups were Australis 8 (42.1%), Sejroe 3 (15.8%), Grippotyphosa 2 (10.5%), Icterohaemorrhagiae 2 (10.5%), Pyrogenes 2 (10.5%), Djasiman 1 (5.3%), Tarassovi 1 (5.3%). We estimated that the annual incidence of leptospirosis was 11–18 cases per 100,000 population. This was a significantly lower incidence than 2007–08 (p<0.001). Conclusions We estimated a much lower incidence of acute leptospirosis than previously, with a notable absence of cases due to the previously predominant serogroup Mini. Our findings indicate a dynamic epidemiology of leptospirosis in this area and highlight the value of multi-year surveillance to understand leptospirosis epidemiology. Leptospirosis is an infectious disease that causes a fever. It can be severe or fatal. Understanding how many people get leptospirosis helps to determine priorities in allocating resources for disease diagnosis, treatment, and prevention. There are few data about leptospirosis incidence in sub-Saharan African countries. The only mainland estimate is from northern Tanzania for the years 2007–08. To see if leptospirosis incidence had changed since 2007–08, we measured leptospirosis incidence in the same location in 2012–2014. To do this, we systematically approached people at two hospitals in the Kilimanjaro Region and tested them for leptospirosis. We adjusted the number of identified cases of leptospirosis found at the hospitals to account for people with fever who did not come to hospital for testing and care. We also adjusted for imperfect testing methods. We found that the number of people who developed leptospirosis annually had dropped from 75–102 cases per 100,000 people during 2007–08 to 11–18 cases per 100,000 people during 2012–14. Also, the subtype of leptospirosis responsible for the most cases during 2007–08 was not present during 2012–14. The number of people developing leptospirosis was not stable, highlighting the value of measuring how commonly leptospirosis occurs over several years.
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Affiliation(s)
- Michael J. Maze
- Centre for International Health, University of Otago, Dunedin, New Zealand
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- * E-mail:
| | - Holly M. Biggs
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Matthew P. Rubach
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, United States of America
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Renee L. Galloway
- Centers for Disease Control and Prevention, Bacterial Special Pathogens Branch, Atlanta, Georgia, United States of America
| | - Shama Cash-Goldwasser
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Kathryn J. Allan
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Jo E. B. Halliday
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Julian T. Hertz
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | | | | | | | - Blandina T. Mmbaga
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Venance P. Maro
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - John A. Crump
- Centre for International Health, University of Otago, Dunedin, New Zealand
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, United States of America
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
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34
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Affiliation(s)
- Kathryn J Allan
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G12 8QQ, UK
| | - Jo E B Halliday
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G12 8QQ, UK
| | - Sarah Cleaveland
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G12 8QQ, UK
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Mtema Z, Changalucha J, Cleaveland S, Elias M, Ferguson HM, Halliday JEB, Haydon DT, Jaswant G, Kazwala R, Killeen GF, Lembo T, Lushasi K, Malishee AD, Mancy R, Maziku M, Mbunda EM, Mchau GJM, Murray-Smith R, Rysava K, Said K, Sambo M, Shayo E, Sikana L, Townsend SE, Urassa H, Hampson K. Mobile Phones As Surveillance Tools: Implementing and Evaluating a Large-Scale Intersectoral Surveillance System for Rabies in Tanzania. PLoS Med 2016; 13:e1002002. [PMID: 27070315 PMCID: PMC4829224 DOI: 10.1371/journal.pmed.1002002] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Katie Hampson and colleagues describe their experience of developing and deploying a large-scale rabies surveillance system based on mobile phones in southern Tanzania.
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Affiliation(s)
- Zacharia Mtema
- Ifakara Health Institute, Ifakara, Morogoro, Tanzania
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- School of Computing Science, University of Glasgow, Glasgow, United Kingdom
| | | | - Sarah Cleaveland
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Martin Elias
- Ministry of Health and Social Welfare, Dar es Salaam, Tanzania
| | - Heather M. Ferguson
- Ifakara Health Institute, Ifakara, Morogoro, Tanzania
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Jo E. B. Halliday
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Daniel T. Haydon
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Gurdeep Jaswant
- Sokoine University of Agriculture, Department of Preventative Veterinary Medicine, Morogoro, Tanzania
| | - Rudovick Kazwala
- Sokoine University of Agriculture, Department of Preventative Veterinary Medicine, Morogoro, Tanzania
| | - Gerry F. Killeen
- Ifakara Health Institute, Ifakara, Morogoro, Tanzania
- Liverpool School of Tropical Medicine, Department of Vector Biology, Liverpool, United Kingdom
| | - Tiziana Lembo
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Kennedy Lushasi
- Ifakara Health Institute, Ifakara, Morogoro, Tanzania
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | - Rebecca Mancy
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- School of Computing Science, University of Glasgow, Glasgow, United Kingdom
| | - Matthew Maziku
- Ministry of Agriculture, Livestock and Fisheries, Dar es Salaam, Tanzania
- World Health Organization, Country Office, Dar es Salaam, Tanzania
| | - Eberhard M. Mbunda
- Ministry of Agriculture, Livestock and Fisheries, Dar es Salaam, Tanzania
| | | | | | - Kristyna Rysava
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Khadija Said
- Sokoine University of Agriculture, Department of Preventative Veterinary Medicine, Morogoro, Tanzania
| | - Maganga Sambo
- Ifakara Health Institute, Ifakara, Morogoro, Tanzania
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Elizabeth Shayo
- Ministry of Agriculture, Livestock and Fisheries, Dar es Salaam, Tanzania
| | | | - Sunny E Townsend
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | - Katie Hampson
- Ifakara Health Institute, Ifakara, Morogoro, Tanzania
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- * E-mail:
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Zhang HL, Mnzava KW, Mitchell ST, Melubo ML, Kibona TJ, Cleaveland S, Kazwala RR, Crump JA, Sharp JP, Halliday JEB. Mixed Methods Survey of Zoonotic Disease Awareness and Practice among Animal and Human Healthcare Providers in Moshi, Tanzania. PLoS Negl Trop Dis 2016; 10:e0004476. [PMID: 26943334 PMCID: PMC4778930 DOI: 10.1371/journal.pntd.0004476] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 01/30/2016] [Indexed: 12/12/2022] Open
Abstract
Background Zoonoses are common causes of human and livestock illness in Tanzania. Previous studies have shown that brucellosis, leptospirosis, and Q fever account for a large proportion of human febrile illness in northern Tanzania, yet they are infrequently diagnosed. We conducted this study to assess awareness and knowledge regarding selected zoonoses among healthcare providers in Moshi, Tanzania; to determine what diagnostic and treatment protocols are utilized; and obtain insights into contextual factors contributing to the apparent under-diagnosis of zoonoses. Methodology/Results We conducted a questionnaire about zoonoses knowledge, case reporting, and testing with 52 human health practitioners and 10 livestock health providers. Immediately following questionnaire administration, we conducted semi-structured interviews with 60 of these respondents, using the findings of a previous fever etiology study to prompt conversation. Sixty respondents (97%) had heard of brucellosis, 26 (42%) leptospirosis, and 20 (32%) Q fever. Animal sector respondents reported seeing cases of animal brucellosis (4), rabies (4), and anthrax (3) in the previous 12 months. Human sector respondents reported cases of human brucellosis (15, 29%), rabies (9, 18%) and anthrax (6, 12%). None reported leptospirosis or Q fever cases. Nineteen respondents were aware of a local diagnostic test for human brucellosis. Reports of tests for human leptospirosis or Q fever, or for any of the study pathogens in animals, were rare. Many respondents expressed awareness of malaria over-diagnosis and zoonoses under-diagnosis, and many identified low knowledge and testing capacity as reasons for zoonoses under-diagnosis. Conclusions This study revealed differences in knowledge of different zoonoses and low case report frequencies of brucellosis, leptospirosis, and Q fever. There was a lack of known diagnostic services for leptospirosis and Q fever. These findings emphasize a need for improved diagnostic capacity alongside healthcare provider education and improved clinical guidelines for syndrome-based disease management to provoke diagnostic consideration of locally relevant zoonoses in the absence of laboratory confirmation. Zoonoses are diseases that are naturally transmitted between animals and humans. In Tanzania, research has shown that several zoonoses, including brucellosis, leptospirosis, and Q fever, are common, but under-diagnosed, causes of human illness. We conducted a mixed methods survey, combining quantitative and qualitative research techniques, of healthcare providers in Moshi, Tanzania. Four (40%) of 10 animal sector respondents and 15 (29%) of 52 human sector respondents reported seeing brucellosis cases in the past 12 months, while none reported cases of leptospirosis or Q fever. Nineteen (31%) respondents reported awareness of a local diagnostic test for human brucellosis, while one reported locally available diagnostic tests for human leptospirosis and Q fever. One (2%) respondent reported a locally available animal brucellosis test, and none reported tests for leptospirosis or Q fever in animals. Many respondents mentioned a lack of diagnostic testing resources during interviews. Our findings suggest that diagnostic testing capacity improvements alongside public health campaigns and healthcare provider education are key steps toward improving recognition and accurate diagnosis of zoonoses in this setting. An improved understanding of healthcare provider awareness, perceptions, and practices regarding zoonoses is critical for the design of effective programs to improve diagnosis and treatment of these diseases.
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Affiliation(s)
- Helen L. Zhang
- Duke University Medical Center, Durham, North Carolina, United States of America
| | - Kunda W. Mnzava
- Nelson Mandela African Institute of Science and Technology, Arusha, Tanzania
- Sokoine University of Agriculture, Morogoro, Tanzania
| | - Sarah T. Mitchell
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Matayo L. Melubo
- Nelson Mandela African Institute of Science and Technology, Arusha, Tanzania
- Sokoine University of Agriculture, Morogoro, Tanzania
| | - Tito J. Kibona
- Nelson Mandela African Institute of Science and Technology, Arusha, Tanzania
- Sokoine University of Agriculture, Morogoro, Tanzania
| | - Sarah Cleaveland
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | | | - John A. Crump
- Duke University Medical Center, Durham, North Carolina, United States of America
- Centre for International Health, University of Otago, Dunedin, New Zealand
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Joanne P. Sharp
- School of Geographical and Earth Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Jo E. B. Halliday
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
- * E-mail:
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Abstract
Zoonotic diseases are a significant burden on animal and human health, particularly in developing countries. Despite recognition of this fact, endemic zoonoses often remain undiagnosed in people, instead being mistaken for febrile diseases such as malaria. Here, as part of Veterinary Record's ongoing series of articles on One Health, a multidisciplinary team of researchers from Scotland, Tanzania and New Zealand argues that a One Health approach is needed to effectively combat these diseases
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Affiliation(s)
- Jo E B Halliday
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Kathryn J Allan
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Divine Ekwem
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Sarah Cleaveland
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Rudovick R Kazwala
- Faculty of Veterinary Medicine, Sokoine University of Agriculture, P. O. Box 3015, Chuo Kikuu, Morogoro, Tanzania
| | - John A Crump
- Centre for International Health, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand
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Allan KJ, Biggs HM, Halliday JEB, Kazwala RR, Maro VP, Cleaveland S, Crump JA. Epidemiology of Leptospirosis in Africa: A Systematic Review of a Neglected Zoonosis and a Paradigm for 'One Health' in Africa. PLoS Negl Trop Dis 2015; 9:e0003899. [PMID: 26368568 PMCID: PMC4569256 DOI: 10.1371/journal.pntd.0003899] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 06/10/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Leptospirosis is an important but neglected bacterial zoonosis that has been largely overlooked in Africa. In this systematic review, we aimed to summarise and compare current knowledge of: (1) the geographic distribution, prevalence, incidence and diversity of acute human leptospirosis in Africa; and (2) the geographic distribution, host range, prevalence and diversity of Leptospira spp. infection in animal hosts in Africa. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, we searched for studies that described (1) acute human leptospirosis and (2) pathogenic Leptospira spp. infection in animals. We performed a literature search using eight international and regional databases for English and non-English articles published between January 1930 to October 2014 that met out pre-defined inclusion criteria and strict case definitions. RESULTS AND DISCUSSION We identified 97 studies that described acute human leptospirosis (n = 46) or animal Leptospira infection (n = 51) in 26 African countries. The prevalence of acute human leptospirosis ranged from 2 3% to 19 8% (n = 11) in hospital patients with febrile illness. Incidence estimates were largely restricted to the Indian Ocean islands (3 to 101 cases per 100,000 per year (n = 6)). Data from Tanzania indicate that human disease incidence is also high in mainland Africa (75 to 102 cases per 100,000 per year). Three major species (Leptospira borgpetersenii, L. interrogans and L. kirschneri) are predominant in reports from Africa and isolates from a diverse range of serogroups have been reported in human and animal infections. Cattle appear to be important hosts of a large number of Leptospira serogroups in Africa, but few data are available to allow comparison of Leptospira infection in linked human and animal populations. We advocate a 'One Health' approach to promote multidisciplinary research efforts to improve understanding of the animal to human transmission of leptospirosis on the African continent.
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Affiliation(s)
- Kathryn J. Allan
- The Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Holly M. Biggs
- Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Jo E. B. Halliday
- The Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | | | - Venance P. Maro
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
| | - Sarah Cleaveland
- The Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - John A. Crump
- Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Centre for International Health, University of Otago, Dunedin, New Zealand
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Halliday JEB, Knobel DL, Agwanda B, Bai Y, Breiman RF, Cleaveland S, Njenga MK, Kosoy M. Prevalence and diversity of small mammal-associated Bartonella species in rural and urban Kenya. PLoS Negl Trop Dis 2015; 9:e0003608. [PMID: 25781015 PMCID: PMC4362764 DOI: 10.1371/journal.pntd.0003608] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 02/08/2015] [Indexed: 11/22/2022] Open
Abstract
Several rodent-associated Bartonella species are human pathogens but little is known about their epidemiology. We trapped rodents and shrews around human habitations at two sites in Kenya (rural Asembo and urban Kibera) to determine the prevalence of Bartonella infection. Bartonella were detected by culture in five of seven host species. In Kibera, 60% of Rattus rattus were positive, as compared to 13% in Asembo. Bartonella were also detected in C. olivieri (7%), Lemniscomys striatus (50%), Mastomys natalensis (43%) and R. norvegicus (50%). Partial sequencing of the citrate synthase (gltA) gene of isolates showed that Kibera strains were similar to reference isolates from Rattus trapped in Asia, America, and Europe, but that most strains from Asembo were less similar. Host species and trapping location were associated with differences in infection status but there was no evidence of associations between host age or sex and infection status. Acute febrile illness occurs at high incidence in both Asembo and Kibera but the etiology of many of these illnesses is unknown. Bartonella similar to known human pathogens were detected in small mammals at both sites and investigation of the ecological determinants of host infection status and of the public health significance of Bartonella infections at these locations is warranted. Bartonella are bacteria that infect many different mammal species and can cause illness in people. Several Bartonella species carried by rodents cause disease in humans but little is known about their distribution or the importance of bartonellosis as a cause of human illness. Data from Africa are particularly scarce. This study involved trapping of rodents and other small mammals at two sites in Kenya: Asembo, a rural area in Western Kenya, and Kibera, an informal urban settlement in Nairobi. Blood samples were collected from trapped animals to detect and characterize the types of Bartonella carried. At the Kibera site over half of the trapped rats were infected with Bartonella very similar to human pathogenic strains isolated from rats from other global regions. In Asembo, Bartonella were detected in four of the five animal species trapped and these Bartonella were less similar to previously identified isolates. All of the small mammals included in this study were trapped in or around human habitations. The data from this study show that Bartonella that can cause human illness are carried by the small mammals at these two sites and indicate that the public health impacts of human bartonellosis should be investigated.
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Affiliation(s)
- Jo E. B. Halliday
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- * E-mail:
| | - Darryn L. Knobel
- Center for Conservation Medicine and Ecosystem Health, Ross University School of Veterinary Medicine, Basseterre, St. Kitts
| | | | - Ying Bai
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Fort Collins, Colorado, United States of America
| | - Robert F. Breiman
- Division of Global Health Protection, Atlanta, Georgia, United States of America
- Emory Global Health Institute, Emory University, Atlanta, Georgia, United States of America
| | - Sarah Cleaveland
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - M. Kariuki Njenga
- Kenya Medical Research Institute/CDC Public Health and Research Collaboration, Kisumu and Nairobi, Kenya
- Global Disease Detection Division, CDC-Kenya, Nairobi, Kenya
| | - Michael Kosoy
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Fort Collins, Colorado, United States of America
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Abstract
PURPOSE OF REVIEW Human brucellosis is a neglected, underrecognized infection of widespread geographic distribution. It causes acute febrile illness and a potentially debilitating chronic infection in humans, and livestock infection has substantial socioeconomic impact. This review describes new information regarding the epidemiology of brucellosis in the developing world and advances in diagnosis and treatment. RECENT FINDINGS The highest recorded incidence of human brucellosis occurs in the Middle East and Central Asia. Fever etiology studies demonstrate brucellosis as a cause of undifferentiated febrile illness in the developing world. Brucellosis is a rare cause of fever among returning travelers, but is more common among travelers returning from the Middle East and North Africa. Sensitive and specific rapid diagnostic tests appropriate for resource-limited settings have been validated. Randomized controlled trials demonstrate that optimal treatment for human brucellosis consists of doxycycline and an aminoglycoside. Decreasing the burden of human brucellosis requires control of animal brucellosis, but evidence to inform the design of control programs in the developing world is needed. SUMMARY Brucellosis causes substantial morbidity in human and animal populations. While improvements in diagnostic options for resource-limited settings and stronger evidence for optimal therapy should enhance identification and treatment of human brucellosis, prevention of human disease through control in animals remains paramount.
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Affiliation(s)
- Matthew P Rubach
- Division of Infectious Diseases and International Health, Department of Medicine, Duke University, Durham, North Carolina, USA
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Halliday JEB, Knobel DL, Allan KJ, de C. Bronsvoort BM, Handel I, Agwanda B, Cutler SJ, Olack B, Ahmed A, Hartskeerl RA, Njenga MK, Cleaveland S, Breiman RF. Urban leptospirosis in Africa: a cross-sectional survey of Leptospira infection in rodents in the Kibera urban settlement, Nairobi, Kenya. Am J Trop Med Hyg 2013; 89:1095-1102. [PMID: 24080637 PMCID: PMC3854886 DOI: 10.4269/ajtmh.13-0415] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Leptospirosis is a widespread but under-reported cause of morbidity and mortality. Global re-emergence of leptospirosis has been associated with the growth of informal urban settlements in which rodents are thought to be important reservoir hosts. Understanding the multi-host epidemiology of leptospirosis is essential to control and prevent disease. A cross-sectional survey of rodents in the Kibera settlement in Nairobi, Kenya was conducted in September–October 2008 to demonstrate the presence of pathogenic leptospires. A real-time quantitative polymerase chain reaction showed that 41 (18.3%) of 224 rodents carried pathogenic leptospires in their kidneys, and sequence data identified Leptospira interrogans and L. kirschneri in this population. Rodents of the genus Mus (37 of 185) were significantly more likely to be positive than those of the genus Rattus (4 of 39; odds ratio = 15.03). Questionnaire data showed frequent contact between humans and rodents in Kibera. This study emphasizes the need to quantify the public health impacts of this neglected disease at this and other urban sites in Africa.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Sarah Cleaveland
- *Address correspondence to Sarah Cleaveland, Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G11 8QQ, United Kingdom. E-mail:
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Knobel DL, Maina AN, Cutler SJ, Ogola E, Feikin DR, Junghae M, Halliday JEB, Richards AL, Breiman RF, Cleaveland S, Njenga MK. Coxiella burnetii in humans, domestic ruminants, and ticks in rural western Kenya. Am J Trop Med Hyg 2013; 88:513-518. [PMID: 23382156 PMCID: PMC3592534 DOI: 10.4269/ajtmh.12-0169] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We conducted serological surveys for Coxiella burnetii in archived sera from patients that visited a rural clinic in western Kenya from 2007 to 2008 and in cattle, sheep, and goats from the same area in 2009. We also conducted serological and polymerase chain reaction-based surveillance for the pathogen in 2009-2010, in human patients with acute lower respiratory illness, in ruminants following parturition, and in ticks collected from ruminants and domestic dogs. Antibodies against C. burnetii were detected in 30.9% (N = 246) of archived patient sera and in 28.3% (N = 463) of cattle, 32.0% (N = 378) of goats, and 18.2% (N = 159) of sheep surveyed. Four of 135 (3%) patients with acute lower respiratory illness showed seroconversion to C. burnetii. The pathogen was detected by polymerase chain reaction in specimens collected from three of six small ruminants that gave birth within the preceding 24 hours, and in five of 10 pools (50%) of Haemaphysalis leachi ticks collected from domestic dogs.
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Affiliation(s)
- Darryn L. Knobel
- *Address correspondence to Darryn L. Knobel, Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, 0110, South Africa. E-mail:
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Halliday JEB, Meredith AL, Knobel DL, Shaw DJ, Bronsvoort BMDC, Cleaveland S. A framework for evaluating animals as sentinels for infectious disease surveillance. J R Soc Interface 2007; 4:973-84. [PMID: 17504735 PMCID: PMC2394544 DOI: 10.1098/rsif.2007.0237] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The dynamics of infectious diseases are highly variable. Host ranges, host responses to pathogens and the relationships between hosts are heterogeneous. Here, we argue that the use of animal sentinels has the potential to use this variation and enable the exploitation of a wide range of pathogen hosts for surveillance purposes. Animal sentinels may be used to address many surveillance questions, but they may currently be underused as a surveillance tool and there is a need for improved interdisciplinary collaboration and communication in order to fully explore the potential of animal sentinels. In different contexts, different animal hosts will themselves vary in their capacity to provide useful information. We describe a conceptual framework within which the characteristics of different host populations and their potential value as sentinels can be evaluated in a broad range of settings.
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Affiliation(s)
- Jo E B Halliday
- Wildlife and Emerging Diseases Section, R(D)SVS, University of Edinburgh, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG, UK.
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