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.

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.

Association of brucellosis to abortions in humans and domestic ruminants in Kagera ecosystem, Tanzania.

Brucellosis is a worldwide zoonotic disease of socio-economic importance. Understanding the association of this disease with pregnancy outcome has the potential of contributing to the reduction of its reproductive burden in humans and animals among pastoral communities in Tanzania. A prospective cohort study was conducted in Kagera Region on pregnant women (n = 76) and gravid ruminants (121 cattle, 125 goats and 111 sheep). Exposed and non-exposed groups to brucellosis were followed for 6 months (from 15 November 2017 to 15 April 2018). Sera were collected and analysed using Rose Bengal Test (RBT) and Fluorescence polarization assay (FPA) test. Measures of effect, univariable and multivariable logistic regression analyses were computed. Positivity to both RBT and FPA tests was 21% (95% CI: 12.5-32) in pregnant women and 5% (95% CI: 3.1-8) in gravid ruminants. Among aborted cases, four women (out of nine), two cows (out of seven), two goats (out of 26) and zero sheep (out of 11) were positive to brucellosis. The abortion rate in humans and ruminants was 11.8% and 12.3%, respectively. Seropositivity to brucellosis was similar in aborted and non-aborted cases in humans (p = .08) and in ruminants (p = .2). At the population level, brucellosis was associated with abortions (population attributable risk: PAR) at 3.5% in pregnant women and at 0.5% in gravid ruminants in the study area. Infections to brucellosis were increased in exposed pregnant women (OR = 19; 95% CI: 1.8-203, p = .01) and in cattle (OR = 11; 95% CI: 1.3-88, p = .02). There is an indication that brucellosis could be contributing to abortions in pregnant women and domestic ruminants Kagera Region. Molecular tools could support more the results from serological tests to avoid cross-reaction with other pathogen agents. Control of brucellosis in animals is likely to reduce the threat of abortions in humans.

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.

A Smartphone App (AfyaData) for Innovative One Health Disease Surveillance from Community to National Levels in Africa: Intervention in Disease Surveillance.

BACKGROUND: We describe the development and initial achievements of a participatory disease surveillance system that relies on mobile technology to promote Community Level One Health Security (CLOHS) in Africa. OBJECTIVE: The objective of this system, Enhancing Community-Based Disease Outbreak Detection and Response in East and Southern Africa (DODRES), is to empower community-based human and animal health reporters with training and information and communication technology (ICT)-based solutions to contribute to disease detection and response, thereby complementing strategies to improve the efficiency of infectious disease surveillance at national, regional, and global levels. In this study, we refer to techno-health as the application of ICT-based solutions to enhance early detection, timely reporting, and prompt response to health events in human and animal populations. METHODS: An EpiHack, involving human and animal health experts as well as ICT programmers, was held in Tanzania in 2014 to identify major challenges facing early detection, timely reporting, and prompt response to disease events. This was followed by a project inception workshop in 2015, which brought together key stakeholders, including policy makers and community representatives, to refine the objectives and implementation plan of the DODRES project. The digital ICT tools were developed and packaged together as the AfyaData app to support One Health disease surveillance. Community health reporters (CHRs) and officials from animal and human health sectors in Morogoro and Ngorongoro districts in Tanzania were trained to use the AfyaData app. The AfyaData supports near- to real-time data collection and submission at both community and health facility levels as well as the provision of feedback to reporters. The functionality of the One Health Knowledge Repository (OHKR) app has been integrated into the AfyaData app to provide health information on case definitions of diseases of humans and animals and to synthesize advice that can be transmitted to CHRs with next step response activities or interventions. Additionally, a WhatsApp social group was made to serve as a platform to sustain interactions between community members, local government officials, and DODRES team members. RESULTS: Within the first 5 months (August-December 2016) of AfyaData tool deployment, a total of 1915 clinical cases in livestock (1816) and humans (99) were reported in Morogoro (83) and Ngorongoro (1832) districts. CONCLUSIONS: These initial results suggest that the DODRES community-level model creates an opportunity for One Health engagement of people in their own communities in the detection of infectious human and animal disease threats. Participatory approaches supported by digital and mobile technologies should be promoted for early disease detection, timely reporting, and prompt response at the community, national, regional, and global levels.

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.

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.