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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 JE. 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; 29:365-376. [PMID: 38480005 PMCID: PMC11073910 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] [MESH Headings] [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, United States of America
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Matthew P. Rubach
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, United States of America
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
- Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - 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
- Nelson Mandela African Institution of Science and Technology, School of Life Sciences and Bioengineering, Arusha, Tanzania
| | - AbdulHamid S. Lukambagire
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- EcoHealth Alliance, New York, United States of America
| | | | - Shama Cash-Goldwasser
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Kate M. Thomas
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | | | - Nestory Mkenda
- Endulen Hospital, Endulen, Ngorongoro Conservation Area, 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, United States of America
| | - William L. Nicholson
- Rickettsial Zoonoses Branch, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Gilbert J. Kersh
- Rickettsial Zoonoses Branch, US Centers for Disease Control and Prevention, Atlanta, Georgia, 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 University College, Tumaini University, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Joram J. Buza
- Nelson Mandela African Institution of Science and Technology, School of Life Sciences and Bioengineering, Arusha, Tanzania
| | - Venance P. Maro
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
- 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, United States of America
- Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, United States of America
- Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania
- 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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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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Bodenham RF, Mtui-Malamsha N, Gatei W, Woldetsadik MA, Cassell CH, Salyer SJ, Halliday JE, Nonga HE, Swai ES, Makungu S, Mwakapeje E, Bernard J, Bebay C, Makonnen YJ, Fasina FO. Multisectoral cost analysis of a human and livestock anthrax outbreak in Songwe Region, Tanzania (December 2018-January 2019), using a novel Outbreak Costing Tool. One Health 2021; 13:100259. [PMID: 34013015 PMCID: PMC8113743 DOI: 10.1016/j.onehlt.2021.100259] [Citation(s) in RCA: 3] [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: 03/19/2021] [Revised: 04/27/2021] [Accepted: 04/27/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES We applied a novel Outbreak Costing Tool (OCT), developed by the US Centers for Disease Control and Prevention (CDC), to estimate the costs of investigating and responding to an anthrax outbreak in Tanzania. We also evaluated the OCT's overall utility in its application to a multisectoral outbreak response. METHODS We collected data on direct costs associated with a human and animal anthrax outbreak in Songwe Region (December 2018 to January 2019) using structured questionnaires from key-informants. We performed a cost analysis by entering direct costs data into the OCT, grouped into seven cost categories: labor, office, travel and transport, communication, laboratory support, medical countermeasures, and consultancies. RESULTS The total cost for investigating and responding to this outbreak was estimated at 102,232 United States dollars (USD), with travel and transport identified as the highest cost category (62,536 USD) and communication and consultancies as the lowest, with no expenditure, for the combined human and animal health sectors. CONCLUSIONS Multisectoral investigation and response may become complex due to coordination challenges, thus allowing escalation of public health impacts. A standardized framework for collecting and analysing cost data is vital to understanding the nature of outbreaks, in anticipatory planning, in outbreak investigation and in reducing time to intervention. Pre-emptive use of the OCT will also reduce overall and specific (response period) intervention costs for the disease. Additional aggregation of the costs by government ministries, departments and tiers will improve the use of the tool to enhance sectoral budget planning for disease outbreaks in a multisectoral response.
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Affiliation(s)
- Rebecca F. Bodenham
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
- Emergency Centre for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), Dar es Salaam, United Republic of Tanzania
| | - Niwael Mtui-Malamsha
- Emergency Centre for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), Dar es Salaam, United Republic of Tanzania
| | - Wangeci Gatei
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Mahlet A. Woldetsadik
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Cynthia H. Cassell
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Stephanie J. Salyer
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Jo E.B. Halliday
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Hezron E. Nonga
- Directorate of Veterinary Services, Ministry of Livestock and Fisheries, Dodoma, United Republic of Tanzania
| | - Emmanuel S. Swai
- Directorate of Veterinary Services, Ministry of Livestock and Fisheries, Dodoma, United Republic of Tanzania
| | - Selemani Makungu
- Directorate of Veterinary Services, Ministry of Livestock and Fisheries, Dodoma, United Republic of Tanzania
| | - Elibariki Mwakapeje
- Emergency Centre for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), Dar es Salaam, United Republic of Tanzania
- Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, United Republic of Tanzania
| | - Jubilate Bernard
- Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, United Republic of Tanzania
- One Health Coordination Desk, Office of the Prime Minister, Dodoma, United Republic of Tanzania
| | - Charles Bebay
- Emergency Centre for Transboundary Animal Diseases (ECTAD) Regional Office for Eastern Africa, Food and Agriculture Organization of the United Nations (FAO), Nairobi, Kenya
| | - Yilma J. Makonnen
- Emergency Centre for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
| | - Folorunso O. Fasina
- Emergency Centre for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), Dar es Salaam, United Republic of Tanzania
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4
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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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5
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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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6
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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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7
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Edwards KL, Walker SL, Bodenham RF, Ritchie H, Shultz S. Associations between social behaviour and adrenal activity in female Barbary macaques: consequences of study design. Gen Comp Endocrinol 2013; 186:72-9. [PMID: 23474330 DOI: 10.1016/j.ygcen.2013.02.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 02/20/2013] [Indexed: 11/26/2022]
Abstract
Faecal glucocorticoid metabolite (fGCM) concentrations have been used to evaluate adrenal activity in a variety of species; including as an indicator of the physiological response to social stress. However, across studies, the relationships between dominance rank, social behaviours and adrenal responses can be inconsistent. Differences in the relationship between rank and glucocorticoids may be due to the relative costs of social status, and the relative frequencies of social stressors and potential coping mechanisms. However, the differences in observed relationships between specific social behaviours and glucocorticoids may be partly explained by sampling frequency, as studies often use average fGCM concentrations collected over a period of weeks or months, rather than fGCM concentrations that are temporally-matched with behavioural data. In this study, we directly compared long-term average and temporally-matched data to determine whether particular social behaviours were related to adrenal activity in female Barbary macaques (Macaca sylvanus) at Trentham Monkey Forest, UK; and whether observed relationships were consistent using these two approaches. Average rates of autogrooming were positively correlated with average fGCM; however, this relationship was not robust in temporally-matched samples. Instead, specific social behaviours associated with agonism were associated with fGCM in temporally-matched samples within individuals. These results indicate that analyses of relationships using long-term average fGCM and temporally-matched samples do not necessarily provide comparable results, highlighting that study design is critical in determining associations between an individual's social behaviour and the relative physiological costs involved.
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Affiliation(s)
- Katie L Edwards
- Institute of Integrative Biology, University of Liverpool, Liverpool, UK.
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