Browsing by Author "Cash-Goldwasser, Shama"

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    Prevalence and risk factors for human leptospirosis at a hospital serving a pastoralist community, Endulen, Tanzania
    (PLOS Neglected Tropical Diseases, 2023-12-20) MazeI, Michael; Shirima, Gabriel; Lukambagire, Abdul-Hamid; Bodenham, Rebecca; Rubach, Matthew; Cash-Goldwasser, Shama; Carugati, Manuela; Thomas, Kate; Sakasaka, Philoteus; Mkenda, Nestory; Allan, Kathryn; Kazwala, Rudovick; Mmbaga, Blandina; Buza, Joram; Maro, Venance; Galloway, Renee; Haydon, Daniel; T., John; Halliday, Jo
    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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    Prevalence and speciation of brucellosis in febrile patients from a pastoralist community of Tanzania.
    (Springer Nature Limited, 2020-04-27) Bodenham, Rebecca; Lukambagire, Abdul; Ashford, Roland; Buza, Joram; Cash-Goldwasser, Shama; Crump, John; Kazwala, Rudovick; Maro, Venance; McGiven, John; Mkenda, Nestory; Mmbaga, Blandina; Rubach, Matthew; Sakasaka, Philoteus; Shirima, Gabriel; Swai, Emanuel; Thomas, Kate; Whatmore, Adrian; Haydon, Daniel; Halliday, Jo
    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.