Browsing by Author "Rubach, Matthew"

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Complete genome sequence of Brucella abortus isolated from a human blood culture sample in Tanzania
(American society for microbiology, 2024-01-30) Mbwambo, Gershom; Zwetselaar, Marco; Sonda, Tolbert; Lukambagire, AbdulHamid; Njau, Judith; Wadugu, Boaz; Ignass, Ignass; Amani, Nelson; Hugho, Ephrasia; Rubach, Matthew; Sakasaka, Philoteus; Oisso, Rose; Mkenda, Nestory; Shirima, Gabriel; Ashford, Roland; Haydon, Daniel; Maro, Venance; Kazwala, Rudovick; Kumburu, Happiness; Mmbaga, Blandina; Halliday, Jo E.
Brucella abortus causes infections in humans and livestock. Bacterial isolates are challenging to obtain, and very little is known about the genomic epidemiology of this species in Africa. Here, we report the complete genome sequence of a Brucella abortus isolate cultured from a febrile human in northern Tanzania
Inter-epidemic Rift Valley fever virus infection incidence and risks for zoonotic spillover in northern Tanzania
(PLOS, 2022-10-28) Ngonzi, Amos; Glanville, William; Nyarobi, James; Kibona, Tito; Halliday, Jo; Thomas, Kate; Allan, Kathryn; Johnson, Paul; Davis, Alicia; Lankester, Felix; Claxton, John; Rosta, Melinda; Carter, Ryan; Jong, Rosanne; Rubach, Matthew; Crump, John; Mmbaga, Blandina; Nyasebwa, Obed; Swai, Emanuel; Willett, Brian; Cleaveland, Sarah
Rift Valley fever virus (RVFV) is a mosquito-borne pathogen that has caused epidemics involving people and animals across Africa and the Arabian Peninsula. A number of studies have found evidence for the circulation of RVFV among livestock between these epidemics but the population-level incidence of infection during this inter-epidemic period (IEP) is rarely reported. General force of infection (FOI) models were applied to age-adjusted cross-sectional serological data to reconstruct the annual FOI and population-level incidence of RVFV infection among cattle, goats, and sheep in northern Tanzania from 2009 through 2015, a period without reported Rift Valley fever (RVF) cases in people or animals. To evaluate the potential for zoonotic RVFV spillover during this period, the relationship between village-level livestock RVFV FOI and human RVFV seropositivity was quantified using multi-level logistic regression. The predicted average annual incidence was 72 (95% Credible Interval [CrI] 63, 81) RVFV infections per 10,000 animals and 96 (95% CrI 81, 113), 79 (95% CrI 62, 98), and 39 (95% CrI 28, 52) per 10,000 cattle, sheep, and goats, respectively. There was variation in transmission intensity between study villages, with the highest estimated village-level FOI 2.49% (95% CrI 1.89, 3.23) and the lowest 0.12% (95% CrI 0.02, 0.43). The human RVFV seroprevalence was 8.2% (95% Confidence Interval 6.2, 10.9). Human seropositivity was strongly associated with the village-level FOI in livestock, with the odds of seropositivity in an individual person increasing by around 1.2 times (95% CrI 1.1, 1.3) for each additional annual RVFV seroconversion per 1,000 animals. A history of raw milk consumption was also positively associated with human seropositivity. RVFV has circulated at apparently low levels among livestock in northern Tanzania in the period since the last reported epidemic. Although our data do not allow us to confirm human RVFV infections during the IEP, a strong association between human seropositivity and the FOI in cattle, goats, and sheep supports the hypothesis that RVFV circulation among livestock during the IEP poses a risk for undetected zoonotic spillover in northern Tanzania. We provide further evidence for the likely role of raw milk consumption in RVFV transmission from animals to people.
One Health contributions towards more effective and equitable approaches to health in low- and middle-income countries
(Published by the Royal Society, 2017) Cleaveland, Sarah; Sharp, Jo; Abela-Ridder, Bernadette; Allan, Kathryn; Buza, Joram; Crump, John; Davis, Adrian; Del Rio Vilas, Victor; de Glanville, William; Kazwala, Rudovick; Kibona, Tito; Lankester, Felix; Lugelo, Ahmed; Mmbaga, Blandina; Rubach, Matthew; Swai, Senyael; Waldman, Linda; Haydon, Daniel; Hampson, Katie; Halliday, Jo
Emerging zoonoses with pandemic potential are a stated priority for the global health security agenda, but endemic zoonoses also have a major societal impact in low-resource settings. Although many endemic zoonoses can be treated, timely diagnosis and appropriate clinical management of human cases is often challenging. Preventive ‘One Health’ interventions, e.g. interventions in animal populations that generate human health benefits, may provide a useful approach to overcoming some of these challenges. Effective strategies, such as animal vaccination, already exist for the prevention, control and elimination of many endemic zoonoses, including rabies, and several livestock zoonoses (e.g. brucellosis, leptospirosis, Q fever) that are important causes of human febrile illness and livestock productivity losses in low- and middle-income countries. We make the case that, for these diseases, One Health interventions have the potential to be more effective and generate more equitable benefits for human health and livelihoods, particularly in rural areas, than approaches that rely exclusively on treatment of human cases.We hypothesize that applying One Health interventions to tackle these health challenges will help to build trust, community engagement and cross-sectoral collaboration, which will in turn strengthen the capacity of fragile health systems to respond to the threat of emerging zoonoses and other future health challenges. One Health interventions thus have the potential to align the ongoing needs of disadvantaged communities with the concerns of the broader global community, providing a pragmatic and equitable approach to meeting the global goals for sustainable development and supporting the global health security agenda. This article is part of the themed issue ‘One Health for a changing world: zoonoses, ecosystems and human well-being’.
Performance characteristics and costs of serological tests for brucellosis in a pastoralist community of northern Tanzania
(Springer Nature Limited, 2021-03-09) Lukambagire, AbdulHamid; Mendes, Ângelo; Bodenham, Rebecca; McGiven, John; Mkenda, Nestory; Mathew, Coletha; Rubach, Matthew; Sakasaka, Philoteus; Shayo, Davis; Maro, Venance; Shirima, Gabriel; Kasanga, Christopher; Kazwala, Rudovick; Halliday, Jo; Mmbaga, Blandina
The control of brucellosis across sub-Saharan Africa is hampered by the lack of standardized testing and the use of tests with poor performance. This study evaluated the performance and costs of serological assays for human brucellosis in a pastoralist community in northern Tanzania. Serum collected from 218 febrile hospital patients was used to evaluate the performance of seven index tests, selected based on international recommendation or current use. We evaluated the Rose Bengal test (RBT) using two protocols, four commercial agglutination tests and a competitive enzyme-linked immunosorbent assay (cELISA). The sensitivity, specificity, positive predictive value, negative predictive value, Youden’s index, diagnostic accuracy, and per-sample cost of each index test were estimated. The diagnostic accuracy estimates ranged from 95.9 to 97.7% for the RBT, 55.0 to 72.0% for the commercial plate tests, and 89.4% for the cELISA. The per-sample cost range was $0.69–$0.79 for the RBT, $1.03–$1.14 for the commercial plate tests, and $2.51 for the cELISA. The widely used commercial plate tests performed poorly and cost more than the RBT. These findings provide evidence for the public health value of discontinuing the use of commercial agglutination tests for human brucellosis in Tanzania.
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.
Prevalence and risk factors for Q fever, spotted fever group rickettsioses, and typhus group rickettsioses in a pastoralist community of northern Tanzania, 2016–2017
(John Wiley & Sons Ltd., 2024-01-12) Moorthy, Ganga; Rubach, Matthew; Maze, Michael; .Refuerzo, Regina; Shirima, Gabriel; Lukambagire, AbdulHamid; Bodenham, Rebecca; Goldwasser, Shama; Thomas, Kate; Sakasaka, Philoteus; Mkenda, Nestory; Bowhay, Thomas; Perniciaro, Jamie; Nicholson, William; Kersh, Gilbert; Kazwala, Rudovick; Mmbaga, Blandina; . Buza, Joram; Maro, Venance; Haydon, Daniel; Crump, John; Halliday, Jo
Background: In northern Tanzania, Q fever, spotted fever group (SFG) rickettsioses, and typhus group (TG) rickettsioses are common causes of febrile illness. We sought to describe the prevalence and risk factors for these zoonoses in a pastoralist community. Methods: Febrile patients ≥2 years old presenting to Endulen Hospital in the Ngorongoro Conservation Area were enrolled from August 2016 through October 2017. Acute andconvalescent blood samples were collected, and a questionnaire was administered. Sera were tested by immunofluorescent antibody (IFA) IgG assays using Coxiella burnetii (Phase II), Rickettsia africae, and Rickettsia typhi antigens. Serologic evidence of exposure was defined by an IFA titre ≥1:64; probable cases by an acute IFA titre ≥1:128; and confirmed cases by a ≥4-fold rise in titre between samples. Risk factors for exposure and acute case status were evaluated. Results: Of 228 participants, 99 (43.4%) were male and the median (interquartile range) age was 27 (16–41) years. Among these, 117 (51.3%) had C. burnetii exposure, 74 (32.5%) had probable Q fever, 176 (77.2%) had SFG Rickettsia exposure, 134 (58.8%) had probable SFG rickettsioses, 11 (4.8%) had TG Rickettsia exposure, and 4 (1.8%) had probable TG rickettsioses. Of 146 participants with paired sera, 1 (0.5%) had confirmed Q fever, 8 (5.5%) had confirmed SFG rickettsioses, and none had confirmed TG rickettsioses. Livestock slaughter was associated with acute Q fever (adjusted odds ratio [OR] 2.54, 95% confidence interval [CI] 1.38–4.76) and sheep slaughter with SFG rickettsioses case (OR 4.63, 95% CI 1.08–23.50). Discussion: Acute Q fever and SFG rickettsioses were detected in participants with febrile illness. Exposures to C. burnetii and to SFG Rickettsia were highly prevalent, and interactions with livestock were associated with increased odds of illness with both path- ogens. Further characterisation of the burden and risks for these diseases is warranted.
Prevalence and risk factors for Q fever, spotted fever grouprickettsioses, and typhus group rickettsioses in a pastoralistcommunity of northern Tanzania, 2016–2017
(Tropical Medicine & International Health, 2024-02-01) Moorthy, Ganga; Rubach, Matthew; Maze, Michael; Shirima, Gabriel
Background: In northern Tanzania, Q fever, spotted fever group (SFG) rickettsioses, and typhus group (TG) rickettsioses are common causes of febrile illness. We sought to describe the prevalence and risk factors for these zoonoses in a pastoralist community. Methods: Febrile patients ≥2 years old presenting to Endulen Hospital in the Ngorongoro Conservation Area were enrolled from August 2016 through October 2017. Acute and convalescent blood samples were collected, and a questionnaire was administered. Sera were tested by immunofluorescent antibody (IFA) IgG assays using Coxiella burnetii (Phase II), Rickettsia africae, and Rickettsia typhi antigens. Serologic evidence of exposure was defined by an IFA titre ≥1:64; probable cases by an acute IFA titre ≥1:128; and confirmed cases by a ≥4-fold rise in titre between samples. Risk factors for exposure and acute case status were evaluated. Results: Of 228 participants, 99 (43.4%) were male and the median (interquartile range) age was 27 (16–41) years. Among these, 117 (51.3%) had C. burnetii exposure, 74 (32.5%) had probable Q fever, 176 (77.2%) had SFG Rickettsia exposure, 134 (58.8%) had probable SFG rickettsioses, 11 (4.8%) had TG Rickettsia exposure, and 4 (1.8%) had probable TG rickettsioses. Of 146 participants with paired sera, 1 (0.5%) had confirmed Q fever, 8 (5.5%) had confirmed SFG rickettsioses, and none had confirmed TG rickettsioses. Livestock slaughter was associated with acute Q fever (adjusted odds ratio [OR] 2.54, 95% confidence interval [CI] 1.38–4.76) and sheep slaughter with SFG rickettsioses case (OR 4.63, 95% CI 1.08–23.50). Discussion: Acute Q fever and SFG rickettsioses were detected in participants with febrile illness. Exposures to C. burnetii and to SFG Rickettsia were highly prevalent, and interactions with livestock were associated with increased odds of illness with both path- ogens. Further characterisation of the burden and risks for these diseases is warranted.
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.