Prevalence of plasmodium, leptospira and rickettsia species in Northern Tanzania: a community based survey.

BACKGROUND: The overlap of symptoms, geographic and seasonal co-occurrence of Plasmodium, Leptospira and Rickettsia infections makes malaria diagnosis difficult, increasing the chances of misdiagnosis. The paucity of data on the prevalence Plasmodium, Leptospira and Rickettsia infections contributes to an overly diagnosis of malaria. We aimed to determine the prevalence and distribution of Plasmodium, Leptospira and Rickettsia infections in northern Tanzania. METHODS: A community based, cross sectional survey was conducted in two sites in Northern Tanzania. PCR was used to detect Plasmodium, Leptospira and Rickettsia infections. RESULTS: The prevalence of P. falciparum and Leptospira spp were 31/128 (24.2%) and 3/128 (2.3%), respectively. No Rickettsia infection was detected in any of the two sites. Taking study sites separately, Plasmodium infection was detected in 31/63(49.2%) of participants in Bondo while Leptospira infection was detected in 3/65(4.6%) of participants in Magugu. Plasmodium was not detected in Magugu while no Leptospira infections were detected in Bondo. Fever was significantly associated with Plasmodium infection (χ2= 12.44, p<0.001) and age (χ2=17.44, p=0.000). CONCLUSION: Results from this study indicate Plasmodium infection as the main cause of fever in the studied sites. While Plasmodium and Leptospira contribute to fevers, Rickettsia infection is an insignificant cause of fever in Northern Tanzania.

Toxoplasma gondii seroprevalence among pregnant women attending antenatal clinic in Northern Tanzania.

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.

Prevalence of Plasmodium falciparum and Salmonella typhi Infection and Coinfection and Their Association With Fever in Northern Tanzania.

BACKGROUND: Plasmodium falciparum and Salmonella typhi are major causes of fever in the tropics. Although these infections are caused by different organisms and are transmitted via different mechanisms, they have similar epidemio-logic and clinical features. This study aimed to determine the prevalence of S. typhi and P. falciparum infections and their associations with fever at 2 sites in Northern Tanzania. METHODS: This was a community-based, cross-sectional study, conducted from February to June 2016, involving 128 randomly selected individuals, aged between 1 and 70 years. Sixty-three (49.2%) participants were recruited from Bondo Ward, Tanga Region, and 65 (50.8%) were recruited from Magugu Ward, Manyara Region. Blood samples were collected by venepuncture into sterile microtubes. Detection of pathogen DNA was achieved via a multiplex real-time polymerase chain reaction assay. Data analysis was done using Stata, version 14. Prevalence data were presented as numbers and percentages, and chi-square analysis was used to assess associations. P values of .05 or less were considered statistically significant. RESULTS: Of 128 participants, 31 (24.2%) and 17 (13.3%) tested positive for P. falciparum and S. typhi infection, respectively. Of the 63 participants from Bondo, 31 (49.2%) had P. falciparum parasitaemia. None of the participants from Magugu tested positive for Plasmodium parasitaemia. S. typhi bacteraemia was detected in 11 (17.5%) of 63 and 6 (9.2%) of 65 participants in Bondo and Magugu, respectively. P. falciparum-S. typhi coinfection was only detected in Bondo (n=6, 9.5%). Age was the only variable that showed a significant association with both P. falciparum and S. typhi infection; falling within the 5-to 9-year or 10-to 15-year age groups was associated with both infections (X2=2.1; P=.045). Among the 30 patients with Plasmodium parasitaemia, 7 (23.3%) had fever, whereas 2 (12.5%) of 16 patients infected by S. typhi had fever. P. falciparum infection (X2=12.4, P<.001) and P. falciparum-S. typhi coinfection (X2=5.5, P=.019) were significantly associated with fever, while S. typhi infection alone was not. CONCLUSION: S. typhi and P. falciparum were considerably prevalent in the area. One-third of the P. falciparum-S. typhi coinfected individuals in Bondo had fever. P. falciparum infection was an important contributor to febrile illness in Bondo. In the presence of coinfections with P. falciparum and S. typhi, the use of malaria rapid diagnostic tests should be emphasised to reduce irrational use of medications.