Population Structure and Antimicrobial Resistance in Campylobacter jejuni and C. coli Isolated from Humans with Diarrhea and from Poultry, East Africa.

Campylobacteriosis and antimicrobial resistance (AMR) are global public health concerns. Africa is estimated to have the world's highest incidence of campylobacteriosis and a relatively high prevalence of AMR in Campylobacter spp. from humans and animals. Few studies have compared Campylobacter spp. isolated from humans and poultry in Africa using whole-genome sequencing and antimicrobial susceptibility testing. We explored the population structure and AMR of 178 Campylobacter isolates from East Africa, 81 from patients with diarrhea in Kenya and 97 from 56 poultry samples in Tanzania, collected during 2006-2017. Sequence type diversity was high in both poultry and human isolates, with some sequence types in common. The estimated prevalence of multidrug resistance, defined as resistance to >3 antimicrobial classes, was higher in poultry isolates (40.9%, 95% credible interval 23.6%-59.4%) than in human isolates (2.5%, 95% credible interval 0.3%-6.8%), underlining the importance of antimicrobial stewardship in livestock systems.

Investigating the Meat Pathway as a Source of Human Nontyphoidal Salmonella Bloodstream Infections and Diarrhea in East Africa.

BACKGROUND: Salmonella Enteritidis and Salmonella Typhimurium are major causes of bloodstream infection and diarrheal disease in East Africa. Sources of human infection, including the role of the meat pathway, are poorly understood. METHODS: We collected cattle, goat, and poultry meat pathway samples from December 2015 through August 2017 in Tanzania and isolated Salmonella using standard methods. Meat pathway isolates were compared with nontyphoidal serovars of Salmonella enterica (NTS) isolated from persons with bloodstream infections and diarrheal disease from 2007 through 2017 from Kenya by core genome multi-locus sequence typing (cgMLST). Isolates were characterized for antimicrobial resistance, virulence genes, and diversity. RESULTS: We isolated NTS from 164 meat pathway samples. Of 172 human NTS isolates, 90 (52.3%) from stool and 82 (47.7%) from blood, 53 (30.8%) were Salmonella Enteritidis sequence type (ST) 11 and 62 (36.0%) were Salmonella Typhimurium ST313. We identified cgMLST clusters within Salmonella Enteritidis ST11, Salmonella Heidelberg ST15, Salmonella Typhimurium ST19, and Salmonella II 42:r:- ST1208 that included both human and meat pathway isolates. Salmonella Typhimurium ST313 was isolated exclusively from human samples. Human and poultry isolates bore more antimicrobial resistance and virulence genes and were less diverse than isolates from other sources. CONCLUSIONS: Our findings suggest that the meat pathway may be an important source of human infection with some clades of Salmonella Enteritidis ST11 in East Africa, but not of human infection by Salmonella Typhimurium ST313. Research is needed to systematically examine the contributions of other types of meat, animal products, produce, water, and the environment to nontyphoidal Salmonella disease in East Africa.

Association of Brucellosis with Abortion Prevalence in Humans and Animals in Africa: A Review.

Brucellosis is a worldwide zoonotic disease suspected to be the cause of abortions which remain largely undiagnosed in both humans and animals. A review of literature was performed to elucidate the contribution of brucellosis to abortions in humans, livestock and wildlife in Africa. A total number of 18 published articles associated brucellosis to abortions observed in humans and livestock in some parts of Africa. The contribution of brucellosis to abortions in humans was less reported in the literature compared to livestock; and no report was done in wildlife in Africa. The association of brucellosis to abortions in Africa was mostly based on bacteriologic, serologic or molecular techniques and Brucella abortus biovar 3 seemed more associated to abortions in cattle. The isolation and molecular characterization of Brucella species could advance the assessment of the contribution of brucellosis to abortions in Africa, focusing much in humans. The epidemiologic approach based on case-control comparisons could elucidate more about the contribution of brucellosis to abortions in Africa. The economic impact evaluation of abortions due to brucellosis could justify implementation of eradication programs of this disease in Africa, such as occupational and food hygiene in humans; with a vaccination and culling in animals.

Potential use of mobile phones in improving animal health service delivery in underserved rural areas: experience from Kilosa and Gairo districts in Tanzania.

BACKGROUND: Sub-optimal performance of the animal health delivery system in rural areas is common in developing countries including Tanzania. However, penetration of mobile phones and availability of good road network and public transport systems offer opportunities for improving the access of rural communities to diagnostic and advisory services from facilities and expertise located in urban areas. A questionnaire survey on possession and use of mobile phones by pastoral and agro-pastoral communities in Kilosa and Gairo districts was carried out between November and December 2015. A total number of 138 livestock keepers from three villages of Chakwale (54), Mvumi (41) and Parakuyo (43) participated in the study. An e-based system was designed and tested to link rural communities with urban diagnostic facilities. RESULTS: It was observed that the average number of phones possessed by individuals interviewed and household families was 1.1 ± 0.26 (1-2) and 3.5 ± 2.23 (1-10), respectively. It was further observed that out of 138 livestock keepers interviewed, 133 (96.4 %) had feature phones while 10 (7.2 %) of them possessed smartphones. Mobile phone is currently used to support livestock production by communicating on animal health in Parakuyo (18, 41.9 %), Mvumi (18, 43.9 %) and Chakwale (14, 25.9 %). Other contributions of mobile phones in livestock and crop agriculture observed in the study area include: exchange of livestock price information, crop price information, communicating on plant health/diseases, livestock extension and advisory services as well as crop farming extension and advisory services. We also designed and tested an e-based SUAVetDiag® system to support timely diagnosis of infectious disease conditions and prompt advice on case management in veterinary underserved areas. CONCLUSIONS: Availability of mobile phones in rural areas, in combination with supporting infrastructure and facilities in urban areas, has potential to stimulate local development and improving delivery of animal health and extension services. It is recommended that more development and refinement of the system should be conducted to ensure that this potential is tapped to revolutionalise delivery of animal health services in rural areas.

Development of a One Health National Capacity in Africa : the Southern African Centre for Infectious Disease Surveillance (SACIDS) One Health Virtual Centre Model.

Among the many challenges to health, infectious diseases stand out for their ability to have a profound impact on humans and animals. The recent years have witnessed an increasing number of novel infectious diseases. The numerous examples of infections which originated from animals suggest that the zoonotic pool is an important and potentially rich source of emerging diseases. Since emergence and re-emergence of pathogens, and particularly zoonotic agents, occur at unpredictable rates in animal and human populations, infectious diseases will constitute a significant challenge for the public health and animal health communities in the twenty-first century. The African continent suffers from one of the highest burdens of infectious diseases of humans and animals in the world but has the least capacity for their detection, identification and monitoring. Lessons learnt from recent zoonotic epidemics in Africa and elsewhere clearly indicate the need for coordinated research, interdisciplinary centres, response systems and infrastructures, integrated surveillance systems and workforce development strategies. More and stronger partnerships across national and international sectors (human health, animal health, environment) and disciplines (natural and social sciences) involving public, academic and private organisations and institutions will be required to meet the present and future challenges of infectious diseases. In order to strengthen the efficiency of early warning systems, monitoring trends and disease prediction and timely outbreak interventions for the benefit of the national and international community, it is essential that each nation improves its own capacity in disease recognition and laboratory competence. The SACIDS, a One Health African initiative linking southern African academic and research institutions in smart partnership with centres of science excellence in industrialised countries as well as international research centres, strives to strengthen Africa's capacity to detect, identify and monitor infectious diseases of humans and animals, to better manage health and socio-economic risks posed by them, and to improve research capacity in investigating the biologic, socio-economic, ecologic and anthropogenic factors responsible for emergence and re-emergence of infectious diseases.

Tick burden and prevalence of Theileria parva infection in Tarime zebu cattle in the lake zone of Tanzania.

This study was carried out to assess the distribution, abundance of different tick genera and prevalence of Theileria parva infection in Tarime zebu cattle kept in selected wards of Serengeti and Tarime districts in Mara region. Adult ticks were identified and counted from half body parts of 360 animals which were extensively managed in communal land with natural pastures. Concurrently, blood samples were collected and thereafter DNA extracted and a nested polymerase chain reaction (nPCR) was done using primers specific for p104 gene to detect the presence of T. parva DNA. Ticks were identified into four groups: Amblyomma genus, Boophilus sub-genus of Rhipicephalus genus, other species of Rhipicephalus, and Hyalomma genus. Rhipicephalus genus accounted for 71.8 % of the total ticks, whereas Amblyomma, Boophilus sub-genus of Rhipicephalus genus and Hyalomma constituted 14.1, 14.0 and 0.1 %, respectively. There were more animals (p < 0.05) infested with ticks in Tarime district (96.1 %) than in Serengeti (61.7 %). The average counts of ticks were higher in adult animals (p < 0.05) than in young animals. The overall prevalence of T. parva was 27.7 % and was higher (p < 0.05) in Serengeti (38.3 %) than in Tarime district (16.7 %). However, all animals tested positive for T. parva did not show any clinical signs of East Coast fever (ECF), suggesting the existence of subclinical infection in Tarime zebu. These results suggest that Tarime cattle can tolerate ECF infection and are likely to serve as potential carriers of T. parva to other less-tolerant cattle breeds in mixed herds. Since Tarime cattle are preferred by most farmers with mixed herds, routine screening for T. parva is highly recommended to minimize introduction of infected cattle into an immunologically naive population.

Taenia solium Cysticercosis and Taeniosis Reporting in the Current Medical and Veterinary Diseases Reporting Systems in Tanzania: A Cross-Sectional Study.

Taenia solium cysticercosis and taeniosis (TSCT) are two forms of a zoonotic disease caused by T. solium tapeworm. Towards promotion of a One Health approach to the control of TSCT, we assessed TSCT reporting in the medical and veterinay sectors in Tanzania. We conducted a cross-sectional study between January and April 2020 in Babati and Mbulu districts (northern Tanzania), Kongwa district (central Tanzania), Mbinga and Nyasa districts (southern Tanzania), and the Zonal Veterinary Centres in Iringa (southern Tanzania) and Arusha (northern Tanzania) regions. A questionnaire was administered to 154 officers in charge (OsIC) of primary healthcare facilities (PHFs) and 110 meat inspectors (MIs) to collect quantitative data. Key informant interviews (KIIs) were conducted to 16 medical and 17 veterinary officers from level one healthcare facilities and district livestock offices, respectively, to their respective ministries. OsIC admitted absence of specific reporting (100%, n = 154) of T. solium taeniosis and neurocysticercosis (NCC) in the medical diseases reporting system (MDRS) despite the presence of optimum facilitation in terms of report preparation and submission (92.2%, n = 154) with 83.8% (n = 154) timely report submission rate. The veterinary diseases reporting system (VDRS) accommodated porcine cysticercosis (PCC) reporting. Nevertheless, approximately 77.3% (n = 110) of the MIs admitted inadequate facilitation in VDRS that hindered efficient reporting of PCC among other diseases. In addition, all MIs admitted that disease reports submitted were incomplete, submitted late (73.3%, n = 110), or not submitted at all (88.8%, n = 110). Similarly, KIIs results revealed suboptimal facilitation and reporting efficiency in VDRS than it was with the MDRS. It is concluded that the MDRS did not provide for specific reporting of taeniosis and NCC. Inadequate facilitation of the general VDRS hindered efficient PCC reporting despite its provision for PCC reporting. A One Health approach in strengthening the medical and veterinary diseases reporting systems for efficient TSCT reporting is recommended.

Prevalence and risk factors for infection of bovine tuberculosis in indigenous cattle in the Serengeti ecosystem, Tanzania.

BACKGROUND: Bovine tuberculosis (bTB) is a chronic debilitating disease and is a cause of morbidity and mortality in livestock, wildlife and humans. This study estimated the prevalence and risk factors associated with bovine tuberculosis transmission in indigenous cattle at the human-animal interface in the Serengeti ecosystem of Tanzania. RESULTS: A total of 1,103 indigenous cattle from 32 herds were investigated for the presence of bTB using the Single Intradermal Comparative Tuberculin Test. Epidemiological data on herd structure, management and grazing system were also collected.The apparent individual animal prevalence of tuberculin reactors was 2.4% (95% confidence interval (CI), 1.7 - 3.5%), whereas the true prevalence was 0.6% CI, 0.6 - 0.7% as indicated by a reaction to avian tuberculin purified protein derivatives (PPD) which is more than 4 mm greater than the reaction to avian tuberculin PPD. The results showed that 10.6% (117/1,103) showed non-specific reactions (atypical mycobacterium). The herd prevalence of 50% (16/32) was found. Tuberculin skin test results were found to be significantly associated with age, location, size of the household and animal tested. Of 108 respondents, 70 (64.8%) individuals had not heard about bovine tuberculosis at all. Thirty five percent (38/108) of respondents at least were aware of bTB. About 60% (23/38) of respondents who were aware of bTB had some knowledge on how bTB is spread. Eighty one percent (87/108) of respondents were not aware of the presence of bTB in wildlife. There is regular contact between cattle and wild animals due to sharing of grazing land and water sources, with 99% (107/108) of households grazing cattle in communal pastures. CONCLUSION: The study has demonstrated a high reported interaction of livestock with wildlife and poor knowledge of most cattle owners concerning bTB and its transmission pathways among people, livestock and wildlife. Although the overall proportion of animals with bTB is relatively low, herd prevalence is 50% and prevalence within herds varied considerably. Thus there is a possibility of cross transmission of bTB at wildlife-livestock interface areas that necessitates use of genetic strain typing methods to characterize them accurately.

Effect of awareness training to frontline health workers and the use of e-based technology on reporting of brucellosis cases in selected pastoral communities, Tanzania: a quasi-experimental study.

INTRODUCTION: Brucellosis is a serious community health problem and endemic disease in Tanzania in both humans and animals. Frontline health workers (FHWs) play a vital role in reporting and hence prevent and control brucellosis in rural settings. This study aims to evaluate the effect of awareness training to frontline health workers and use of electronic technology (e- technology) on reporting of brucellosis cases. METHODS: A quasi-experimental design was implemented in two pastoral communities in eastern part of Tanzania with one as control and another as treatment involving 64 FHWs who were purposively selected from May 2020 to December 2020. A total of 32 FHWs from treatment pastoral community were purposively selected for awareness training, rapid diagnosis using Rose Bengal test (RBT) and use of electronic technology (AfyaData app) for brucellosis reporting while nothing was done in control community. Before and after training information about their knowledge, attitude and practices were collected from all participants using a structured questionnaires uploaded in the mobile phone powered by AfyaData application. Blood samples were collected from 141 febrile patients attending the selected facilities in treatment community. Serum obtained from collected blood were analyzed using RBT and Competitive Enzyme Linked Immunosorbent Assay (c-ELISA) for brucellosis screening and confirmatory, respectively. Results from this analysis were reported back to the health facility using AfyaData app. Chi-square was used to analyze categorical variables and t-test and/Anova test was used to assess the effectiveness of the intervention. RESULTS: Results revealed that before the training majority of the participants were ignorant about brucellosis, although they had good attitude towards brucellosis prevention. Participant's awareness, practice and attitude increased significantly (p = 0.003, p = 0.001, p = 0.032) respectively, after the intervention. Total of 17(12.1%) patients were positive on RBT and four (2.8%) were confirmed by c-ELISA. AfyaData app was proven to provide quick reports regarding brucellosis in the study area. CONCLUSION: The training program was effective in increasing the level of knowledge and practice about brucellosis. Electronic based technology (AfyaData app) improved the reporting of brucellosis cases. There is a need for the use of electronic based technology to improve timely management of brucellosis in pastoral communities. Also, continuous training on FHWs regarding the disease is needed to improved their awareness and practices.

Occurrence and Risk Factors of Brucellosis in Commercial Cattle Farms from Selected Districts of the Eastern Coast Zone, Tanzania.

Brucellosis is a disease of major socio-economic importance worldwide, particularly in low-income countries. This retrospective study aimed to estimate seroprevalence and risk factors associated with brucellosis in commercial cattle farms in the eastern coast zone of Tanzania (ECZT). A total of 1,052 serum samples collected from 20 commercial farms were subjected to rose bengal plate test (RBPT) and indirect enzyme-linked immunosorbent assay (i-ELISA). Descriptive analysis was employed to determine frequencies and proportions. To establish risk factors, a multivariate logistic regression analysis was carried out using a backward elimination procedure, following a univariate analysis, with 0.1 set as a cut-off point for the selection of putative risk factors. Agreement between RBPT and i-ELISA was determined using a Kappa coefficient (κ). The overall animal-level seroprevalence was 25.9% based on i-ELISA. Logistic regression analysis revealed that odds of infection were significantly higher in females (OR = 1.8, 95% CI: 1.2-2.5, p = 0.002) and in young animals than in adults (OR = 3.6, CI: 2.1-6.2, p < 0.001). In addition, odds of infection were higher during the wet season (OR = 3.4, CI: 3.2-5.2, p < 0.001), in cattle reared in rural farms (OR = 4.8, CI: 2.0-11.5, p < 0.001), in cattle reared in areas, not in contact with wildlife (OR = 2.9, CI: 1.4-2.3, p = 0.004), and in medium-sized farms (OR = 12.5, CI: 6.9-22.9, p < 0.001). These findings confirm that bovine brucellosis was prevalent among commercial cattle farms in the ECZT, posing a serious public health concern to the community living in these settings. The one health approach should be adopted for effective control of brucellosis.

Spatiosurvival analysis of mortality on smallholder dairy farms in Tanga and Iringa regions of Tanzania.

A combination of survival and spatial analyses was applied to a dataset containing cattle mortalities on smallholder dairy farms in two separate regions (Tanga and Iringa) of Tanzania. Cattle mortality data for the year 1998 were collected retrospectively during the period January to April 1999. The objectives of the current study were, firstly, to quantify the hazard of mortality and, secondly, to investigate whether there was a spatial pattern in the variation that was unaccounted for in the hazard of mortality. A Cox regression model with farm as a frailty term was used to quantify the hazard of mortality. Geostatistical techniques were used to explore the first- and second-order spatial distribution of the farm frailty term. A total of 1,790 cattle from 400 randomly sampled smallholder dairy farms were included in the study. The overall mortality incidence rate for the study was 11.8 per 100 animal years (95% CI 10.0-13.8). The hazard of mortality for male cattle was 2.4 (95% CI 1.7-3.4) times higher than that of female cattle. There was evidence of a first-order spatial pattern, i.e., a tendency for farms with higher frailty to aggregate.

Exclusive Breastfeeding and Its Determinants in Yaoundé, Cameroon: A Retrospective Survival Analysis.

Exclusive breastfeeding (EBF) of infants for the first six months of life is a global public health goal that is linked to the reduction of morbidity and mortality in infants, especially in low middle-income countries. In low middle-income countries like Cameroon, it is realistic that compliance with EBF can significantly reduce the burden of under five mortality rate. The purpose of this study was to assess adherence and determinants influencing the duration of exclusive breastfeeding in Yaoundé, Cameroon. Data was collected through a mixed method and systematically through a retrospective survival analysis approach where a total number of 503 randomly selected individuals in Yaoundé, Cameroon, participated in the study. Data was collected between November 2019 and May 2020. A Cox proportional hazard modelling and Kaplan-Meier analysis were employed to identify prognostic factors affecting survival time defined as the duration, in months, from birth until the time of stopping EBF. The average time for nursing mothers to practice EBF was 3.61 ± 0.010 months. This study found that more than 90% of mothers were aware of the importance of compliance with EBF but only 38% practiced EBF and 62% of mothers could not adhere to EBF recommendations. Factors that influence compliance with EBF included a mother being married (HR: 0.70; 95% CI = [0.55-0.89], P =0.003) which was a protective factor while mother's tertiary education (HR: 1.43; 95% CI = [1.11-1.84], P =0.005) was a risk factor with non-compliance with EBF when compared to those with basic or no formal education. The Kaplan-Meier curve indicated that as time goes on, babies are less likely to be exclusively breastfed after a specific time period within two and three months. This implies that the chance for a baby to remain exclusively breastfed after five months is 74.3% (0.74). Continuous sensitization and enforcement measures are recommended to promote EBF.

Challenges in the Diagnosis of Taenia solium Cysticercosis and Taeniosis in Medical and Veterinary Settings in Selected Regions of Tanzania: A Cross-Sectional Study.

Background: Taenia solium (neuro) cysticercosis/taeniosis (TSCT) is a zoonotic disease complex. There is a perceived inefficient diagnosis of infections by either form, the adult pork tapeworm (taeniosis) and the larval stage of it (cysticercosis), in low-income settings, including Tanzania. This study aimed at identifying potential gaps around TSCT diagnosis and knowledge of primary healthcare providers (officers in charge (OICs) of primary healthcare facilities (PHFs)) and veterinarians (meat inspectors (MIs)) on various aspects of TSCT disease complex and addressing effective disease control in Tanzania. Methodology. A cross-sectional study was conducted between January and April 2020 in Manyara, Dodoma, Ruvuma, Iringa, and Arusha regions in Babati, Mbulu, Kongwa, Mbinga, and Nyasa districts. We interviewed 152 OICs of PHFs and 108 MIs using a structured questionnaire and 33 medical and veterinary officers from level I healthcare facilities and district livestock offices, respectively, from selected study districts to the respective ministerial level using key informant interviews. Results: Quantitative data revealed inadequate microscopic diagnostic facilities (54.6%) and personnel (100%) for taeniosis diagnosis in PHFs (n = 152). Approximately 81.2% of MIs compared with only 42.1% of OICs of PHFs scored above average regarding T. solium cysticerci knowledge. Nevertheless, 61.2% of OICs of PHFs compared with only 42.6% of MIs scored above average regarding the adult T. solium tapeworm knowledge. Qualitative data revealed inadequate availability of advanced diagnostic facilities (neuroimaging) and trained personnel for specific diagnosis of TSCT with a focus on neurocysticercosis (NCC) in secondary and tertiary healthcare facilities. Inadequately number of qualified MIs, slaughter slabs, and resource facilitation challenged porcine cysticercosis diagnosis. Conclusion: It is concluded that diagnostic capacity and knowledge of OICs of PHFs and MIs regarding TSCT are insufficient in both medical and veterinary sectors. A One Health approach should be adopted to improve TSCT diagnostic capacity and practitioners' knowledge in both medical and veterinary sectors.

Knowledge, attitude and practices of frontline health workers in relation to detection of brucellosis in rural settings of Tanzania: a cross-sectional study.

BACKGROUND: Brucellosis an important zoonotic disease worldwide, which frequently presents as an undifferentiated febrile illness with otherwise varied and non-specific clinical manifestations. Despite its importance, there are few reports on its awareness among frontline health workers. This study aimed at assessing the baseline knowledge, attitude and practice (KAP) related to detection and management of brucellosis among frontline health workers (FHWs) namely; healthcare workers (HWs) and community health workers (CHWs). METHODS: A cross-sectional study was conducted from December 2019 to January 2020 in Kilosa and Chalinze districts of Tanzania. Data on demographic characteristics, knowledge, attitude and practices regarding brucellosis were collected from the study participants using a structured questionnaire. Interviews were conducted with 32 HWs and 32 CHWs who were systematically selected in study districts. Chi square/fisher Exact was used to assess the association between sociodemographic variables and those related to knowledge, attitude and practices. RESULTS: Overall, a total of 30 (93.8%) HWs and nine (28.1%) CHWs from the study districts heard about brucellosis, with (34.4%) of HWs having knowledge about the causative organism. Overall, knowledge showed almost half (46.9%) HWs and (28.1%) CHWs were aware of the symptoms, clinical signs, diagnosis and control regarding brucellosis. Knowledge difference was statistically significant with HWs' age (p = 0.016). Almost half (46.9%) HWs and less than quarter (12.5%) CHWs had good practices regarding brucellosis control. Almost three quarters (71.9%) of HWs and (21.9%) CHWs had positive attitude regarding brucellosis control; overall attitude was statistically significant with CHWs age (p = 0.028) and education level (p = 0.024). Lack of awareness and unavailability of diagnostic tools were the main challenges faced by FHWs in the two districts. CONCLUSION: The majority of participants were not aware of human brucellosis. Moreover, their overall knowledge was inadequate and the common practices were diagnostic tools, and adequate knowledge to manage brucellosis cases. These findings highlight the need to strengthen frontline health workers knowledge, practices and diagnostic capacities related to brucellosis.

Rift Valley fever seropositivity in humans and domestic ruminants and associated risk factors in Sengerema, Ilala, and Rufiji districts, Tanzania.

OBJECTIVES: Data on Rift Valley fever virus (RVFV) prevalence in urban settings and pastoral areas of Tanzania are scarce. We performed a cross-sectional study of RVFV seroprevalence and determinants in humans and animals from Ilala, Rufiji, and Sengerema districts of Tanzania. METHODS: Blood samples from the study participants were tested for anti-RVFV immunoglobulin G (IgG) antibodies using an enzyme-linked immunosorbent assay. Logistic regression was used to determine association between exposure risk practices and RVFV seropositivity. RESULTS: The study involved 664 humans, 361 cattle, 394 goats, and 242 sheep. The overall anti-RVFV IgG seroprevalence in humans and animals was 2.1% (95% confidence interval [CI] 0.01-0.04) and 9.5% (n = 95, 95% CI 0.08-0.12), respectively. Seroprevalence in humans in Rufiji, Ilala, and Sengerema was 3.0% (n = 225, 95% CI 0.01-0.06), 1.8% (n = 230, 95% CI-0.005- 0.04), and 1.4% (n = 209, 95% CI 0.01-0.04), respectively (P >0.05). Seroprevalence in animals in Sengerema, Rufiji, and Ilala was 12.1% (n = 40, 95% CI 0.09-0.16), 11.1% (n = 37, 95% CI 0.08-0.15), and 5.4% (n = 18, 95% CI 0.03-0.08), respectively (P = 0.006). Handling of carcasses increased the odds of RVFV seropositivity 12-fold (odds ratio 11.84, 95% CI 1.97-71.16). CONCLUSION: The study confirms previous occurrence of RVFV in multiple species in the study districts. Animal handling practices appear to be essential determinants of seropositivity.

Slaughter stock abattoir survey of carcasses and organ/offal condemnations in Arusha region, northern Tanzania.

The current study reviews a 3-year record of slaughtered animals in Arusha abattoir to determine the causes of carcasses and organ/offal condemnations. A total of 115,186 cattle, 61,551 sheep, 37,850 goats and 13,310 pigs were slaughtered. Out of the slaughtered cattle, 8.6% were pregnant. Up to 125 (0.108%), 39 (0.063%), 40 (0.106%) and 132 (0.992%) of all cattle, sheep, goats and pig carcasses, respectively, were totally condemned. Cysticercosis was the leading cause of total carcass condemnations in cattle (0.051%) and in pig (1.397%), while emaciation accounted for 0.045% and 0.074% of carcass condemnations in sheep and goats, respectively. Livers and lungs were the most condemned organs in all four animal species. The main cause of condemnations of cattle livers was fasciolosis (8.6%), while stilesiosis in sheep and goats accounted for 8.1% and 7.3%, respectively. Ascariasis (4.03%) was the only cause of liver condemnation in pigs. Pneumonia was the leading cause of lung condemnations at the rates of 3.99%, 2.43% and 2.83% in cattle, sheep and goats, respectively. Because of their zoonotic nature, occurrences of hydatidosis, cysticercosis, fasciolosis and tuberculosis may pose a public health risk. Thus, there is a need to introduce appropriate control measures of livestock diseases to minimise the rate of infection and reduce economic losses.

Brucellosis and its associated risk factors to humans and domestic ruminants in Kagera Ecosystem, Tanzania.

BACKGROUND: Brucellosis is an important disease for both veterinary and public health. A study was conducted to understand the seroprevalence of brucellosis and its associated risk factors in pastoral areas of Kagera, Tanzania. METHODS: Sera from 156 patients with malaria-like symptoms were analyzed using the commercial rapid agglutination test (specific for B.abortus and B.melitensis detection) and Fluorescence Polarization Assay (FPA). Sera from 426 cattle, 206 goats and 197 sheep were analyzed using Rose Bengal Plate (RBPT) and Competitive ELISA (c-ELISA) tests. RESULTS: In humans, overall brucellosis, B. abortus, and B. melitensis sero-prevalences were 7.7% (95%CI: 3.8-12.2%), 1.9% (95% CI: 0.4-4.5%), and 5.8 % (95%CI: 2.6-10.6%), respectively. At animal level, seropositivity was 5.9% (95%CI: 4.0-8.6%), 2.5% (95%CI: 0.8-5.7%) and 0.5% (95%CI: 0.01-2.8%) in cattle, goats and sheep, respectively. At herd level, seropositivity was 18.2% (95%CI: 12.0-25.8%) in cattle and 6.9% (95%CI: 2.2-15.3%) in small ruminants. Brucellosis was associated with assisting in parturition without wearing protective gears (OR= 5.6; p= 0.02) in humans, herds of 50-200 animals (OR= 4.2, p= 0.01) and cattle (OR=3.5; p=0.01). The knowledge of brucellosis among pastoralists (OR=0.1; p<0.01) was a protective factor. CONCLUSION: Brucella infections could be occurring in pastoralists and domestic ruminants in Kagera. Community health education is necessary for the control of brucellosis in Tanzania.

Community Health Workers and Disease Surveillance in Tanzania: Promoting the Use of Mobile Technologies in Detecting and Reporting Health Events.

This cross-sectional study was conducted in the Kilosa, Morogoro Urban, Ngorongoro, and Ulanga districts of Tanzania to investigate the practices of community health workers (CHWs) related to disease surveillance functions and to establish their needs and technology capacities. We also established the strength of mobile phone networks and internet connections in the study areas to inform the feasibility of using mobile-based applications in community-based disease surveillance. A total of 135 CHWs from 85 villages participated in the study. Health events captured at the community level were entirely paper-based. CHWs submitted reports to higher-level health authorities mainly on foot (100%), but they also used public transport (65%) and telephone calls (56%). The median number of days between the onset of a suspected disease outbreak at the community level and reporting to a primary healthcare facility was 10 days (interquartile range [IQR] 2-30). The median number of days between submitting a report and receiving a response was 7 days (IQR 2-30). Of the 53 CHWs who reported the most recent health events to a higher-level health authority, 39 (74%) never received feedback. All 85 villages had a reliable mobile phone network and 74 (87%) had a mobile phone internet connection that was strong enough to support data transmission using digital technology. Almost all (n = 132, 98%) of the CHWs owned mobile phones. The practices related to detection and reporting of health events could be improved to enhance early warning disease surveillance. Reliable mobile networks and internet connections and the ownership of mobile phones among CHWs in the study areas present opportunities to strengthen community event-based surveillance using mobile-based solutions.

Occurrence of Extended Spectrum Beta Lactamase (ESBL) Producers, Quinolone and Carbapenem Resistant Enterobacteriaceae Isolated from Environmental Samples along Msimbazi River Basin Ecosystem in Tanzania.

We conducted environmental surveillance of antimicrobial resistance (AMR) bacteria in the Msimbazi river basin in Tanzania to determine the occurrence of extended-spectrum ß-lactamase (ESBL)-producing, carbapenem resistant Enterobacteriaceae (CRE) and quinolone resistant Escherichia coli and Klebsiella spp. A total of 213 Enterobacteriaceae isolates were recovered from 219 samples. Out of the recovered isolates, 45.5% (n = 97) were Klebsiella pneumoniae and 29.6% (n = 63) were Escherichia coli. K. pneumoniae isolates were more resistant in effluent (27.9%) compared to the E. coli (26.6%). The E. coli had a higher resistance in river water, sediment and crop soil than the K. pneumoniae (35 versus 25%), respectively. Higher resistance in K. pneumoniae was found in nalidixic acid (54.6%) and ciprofloxacin (33.3%) while the E. coli isolates were highly resistant to ciprofloxacin (39.7%) and trimethoprim/sulfamethoxazole (38%). Resistance increased from 28.3% in Kisarawe, where the river originates, to 59.9% in Jangwani (the middle section) and 66.7% in Upanga West, where the river enters the Indian Ocean. Out of 160 E. coli and K. pneumoniae isolates, 53.2% (n = 85) were resistant to more than three classes of the antibiotic tested, occurrence being higher among ESBL producers, quinolone resistant and carbapenem resistant strains. There is an urgent need to curb environmental contamination with antimicrobial agents in the Msimbazi Basin.

Safety, Immunogenicity and Antibody Persistence of Rift Valley Fever Virus Clone 13 Vaccine in Sheep, Goats and Cattle in Tanzania.

Background: Vaccination is considered to be the best approach to control Rift Valley fever (RVF) in animals and consequently in humans. This study assessed the efficacy and safety of the RVF virus (RVFV) Clone 13 vaccine under field conditions. Methodology: A vaccine trial was conducted in sheep (230), goats (230), and cattle (140) in Ngorongoro district, Tanzania. Half of each of the animal species were vaccinated and the other half received the placebo. Animals were clinically monitored and bled before vaccination and at days 15, 30, 60, 180 and 360 (+/- 10) post-vaccination to measure Immunoglobulin M (IgM) and IgG antibody responses to RVFV. Survival analysis was conducted using cox-proportional hazard regression model to measure the time until an event of interest had occurred and to compare the cumulative proportion of events over time. Results: Of 600 animals included in the study, 120 animals were lost during the study, leaving a total of 480 (243 in the vaccinated group and 237 in the control group) for complete follow-up sampling. There was no adverse reaction reported at the injection site of the vaccine/placebo in all animals. Abortions, deaths, or body temperature variations were not associated with vaccination (p > 0.05). By day 15 post-inoculation, the IgG seroconversion in vaccinated goats, cattle and sheep was 27.0% (n = 115), 20.0% (n = 70) and 10.4% (n = 115), respectively. By day 30 post-inoculation, it was 75.0% (n = 113), 74.1% (n = 112) and 57.1% (n = 70) in vaccinated sheep, goats and cattle, respectively. By day 60 post-inoculation, IgG seroconversion in sheep, goats and cattle was 88.1% (n = 109), 84.3% (n = 108) and 64.60% (n = 65), respectively. By day 180, the IgG seroconversion in sheep, goats and cattle was 88.0% (n = 108), 83.8% (n = 105) and 66.1% (n = 62), respectively. By day 360, the IgG seroconversion in sheep, goats and cattle was 87.2% (n = 94), 85.6% (n = 90) and 66.1% (n = 59), respectively. Only five animals from the vaccinated group were RVFV IgM positive, which included four sheep and a goat. Conclusion: RVFV Clone 13 vaccine was well tolerated by sheep, goats, and cattle. The vaccine induced detectable, but variable levels of IgG responses, and of different duration. The vaccine is considered safe, with high immunogenicity in sheep and goats and moderate in cattle.