Browsing by Author "Kakulu, Remidius"

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Characterization of population connectivity for enhanced cross-border surveillance of yellow fever at Mutukula and Namanga borders in Tanzania
(Elsevier, 2024-12) Kakulu, Remidius; Msuya, Mwanahamis; Makora, Said; Lucas, Athanas; Kapinga, Josephine; Mwangoka, Nisalile; Mehta, Kanan; McIntyre, Elvira; Boos, Alexandra; Lamb, Gabriella; Mponela, Marcelina; Gatei, Wangeci; Merrill, Rebecca; Ward, Sarah; Seleman, Amour; Massa, Khalid; Kimaro, Esther; Mpolya, Emmanuel
Objectives Yellow fever (YF) remains a public health threat in Sub-Saharan Africa and South America, with an estimated 200,000 cases and 30,000 deaths annually. Although the World Health Organization considers Tanzania to be at low risk for YF because no YF cases have been reported, the country remains at alert to importation of the virus due to ecological factors and high connectivity to high-risk YF areas in other countries. This study aimed to identify points of interest with connectivity to high-risk YF areas to guide preparedness efforts in Tanzania. Methods Using the Population Connectivity Across Borders (PopCAB) toolkit, the Nelson Mandela African Institution of Science and Technology (Department of Health and Biomedical Sciences), in collaboration with the Tanzania Ministry of Health and the Centers for Disease Control and Prevention, implemented 12 focus group discussions with participatory mapping in two high-risk borders of Mutukula and Namanga. Results Participants identified 147 and 90 points of interest with connectivity to YF risk areas in Kenya and Uganda, respectively. The identified locations are important for trade, fishing, pastoralism, tourism, health-seeking, agriculture, mining, religious activities, education, and cross-border marriages. Conclusions The Tanzania Ministry of Health used the results to update cross-border surveillance and risk communication strategies and vaccination guidelines to prevent the importation of YF into Tanzania.
Effectiveness of Point of Entry Health Screening Measures among Travelers in the Detection and Containment of the International Spread of COVID-19: A Review of the Evidence
(MDPI, 2024-03-28) Kakulu, Remidius; Kimaro, Esther; Mpolya, Emmanuel
COVID-19 remains a communicable disease with the capacity to cause substantial damage to health and health systems. Enhanced health screening at points of entry (POEs) is a public health measure implemented to support early detection, prevention and response to communicable diseases, such as COVID-19. The purpose of this study was to review the available evidence on the effectiveness of POE health screening in the detection and containment of the COVID-19 pandemic. This study was registered under PROSPERO and followed PRISMA guidelines in which the literature between 2019 and 2022 was retrieved from Scopus, PubMed, Web of Science, Global Health, CINAHL, Embase, Google Scholar and international organizations. A total of 33,744 articles were screened for eligibility, from which 43 met the inclusion criteria. The modeling studies predicted POE screening able to detect COVID-19 in a range of 8.8% to 99.6%, while observational studies indicated a detection rate of 2% to 77.9%, including variants of concern depending on the screening method employed. The literature also indicated these measures can delay onset of the epidemic by 7 to 32 days. Based on our review findings, if POE screening measures are implemented in combination with other public health interventions such as rapid tests, they may help detect and reduce the spread of COVID-19.
Seroprevalence and molecular analysis of yellow fever virus in mosquitoes at Namanga and Mutukula borders in Tanzania
(Elsevier, 2025-01-01) Kakulu, Remidius; Kapinga, Josephine; Rugarabamu, Sima; Kemibala, Elison; Beyanga, Medard; Mbelele, Peter; Massa, Khalid; Kimaro, Esther; Mpolya, Emmanuel
Objectives Yellow fever (YF) is a major public health concern, particularly in Africa and South America. This study aimed to detect YF in human and mosquito samples to understand transmission dynamics in the Tanzania–Uganda and Tanzania–Kenya cross-border areas. Methods Blood samples were collected from individuals aged ≥9 months for serological testing. Mosquitoes were captured and tested for YF virus RNA. Logistic regression models were used to predict seroprevalence and associated risk factors. Results The overall YF seroprevalence was 12.5%, with higher rates among older individuals (7.0%) and female participants (immunoglobulin [Ig] G 4.4%, IgM 6.0%). Notably, YF virus RNA was detected in three out of 46 pools of 192 mosquitoes. The odds of testing positive for YF IgG were lower among those with primary education compared with college education (AOR = 0.27, CI: 0.08-0.88) and increased with those experiencing muscle pain (AOR = 4.5, CI: 1.08-18.78) while the odds of testing positive to YF IgM increased with being female (AOR = 4.7, CI: 1.5-14.7), traveling to YF endemic areas (AOR = 5.2, CI: 1.35-44.75), exposure to Aedes mosquitoes (AOR = 3.7, CI: 1.27-10.84) and exhibiting bruising (AOR = 13.5, CI: 1.23-145.72) Conclusions Although Tanzania has not experienced YF outbreaks, evidence of YF exposure at the studied borders highlights the need for strengthening cross-border surveillance, vector control, and vaccination efforts. Further research is needed to evaluate the country's overall YF risks