Comparison of rose bengal plate test, serum agglutination test, and indirect enzyme-linked immunosorbent assay in brucellosis detection for human and goat samples

Background: In Uganda, detection of brucellosis in goats and humans is more frequently done using rose bengal plate test (RBPT) in comparison to other serological tests such as serum agglutination test (SAT) and indirect enzyme-linked immunosorbent assay (i-ELISA). Aim: This study aimed at estimating the degree of agreement, specificity and sensitivity of RBPT, SAT, and ELISA in brucellosis detection in human and goat samples. Materials and Methods: An analytical study was conducted involving parallel testing of 425 goat samples and 177 human samples to compare RBPT, SAT, and i-ELISA tests of brucellosis detection. Results: A seroprevalence of 14.82% in animals and 11.86% in humans was detected using RBPT, 7.06% in goats and 5.09% in humans using SAT, and 6.35% in humans and 4.52% in animals using i-ELISA. The degree of agreement between the three tests in humans and animals was compared using Fleiss' kappa statistics where a moderate agreement (MA) was obtained for both with kappa value 0.57 in animals and 0.51 in humans and p<0.001. Kappa values in animals were 0.52 (MA) for RBPT and i-ELISA, 0.61 (MA) for RBPT and SAT, and 0.82 substantial agreement (SA) for SAT and i-ELISA. The kappa values in humans were 0.52 (MA) for RBPT and i-ELISA, 0.57 (MA) for RBPT and SAT, and 0.82 (SA) for SAT and i-ELISA, respectively. The study revealed a significant agreement in the tests for all the three tests, but there was SA between SAT and i-ELISA in both animal and human samples. Sensitivity and specificity of RBT and SAT were estimated using i-ELISA as a gold standard as follows, in goats RBPT: 100 and 91% and SAT: 100 and 99%, respectively, and in humans RBPT: 100 and 92% and SAT: 88 and 99%, respectively. Conclusion: It appears that RBPT is good as a screening test, whereas SAT and i-ELISA are good for diagnosis purposes or confirmatory test

Electroencephalographic features of convulsive epilepsy in Africa: A multicentre study of prevalence, pattern and associated factors

Objective: We investigated the prevalence and pattern of electroencephalographic (EEG) features of epilepsy and the associated factors in Africans with active convulsive epilepsy (ACE). Methods: We characterized electroencephalographic features and determined associated factors in a sample of people with ACE in five African sites. Mixed-effects modified Poisson regression model was used to determine factors associated with abnormal EEGs. Results: Recordings were performed on 1426 people of whom 751 (53%) had abnormal EEGs, being an adjusted prevalence of 2.7 (95% confidence interval (95% CI), 2.5–2.9) per 1000. 52% of the abnormal EEG had focal features (75% with temporal lobe involvement). The frequency and pattern of changes differed with site. Abnormal EEGs were associated with adverse perinatal events (risk ratio (RR) = 1.19 (95% CI, 1.07–1.33)), cognitive impairments (RR = 1.50 (95% CI, 1.30–1.73)), use of anti-epileptic drugs (RR = 1.25 (95% CI, 1.05–1.49)), focal seizures (RR = 1.09 (95% CI, 1.00–1.19)) and seizure frequency (RR = 1.18 (95% CI, 1.10–1.26) for daily seizures; RR = 1.22 (95% CI, 1.10–1.35) for weekly seizures and RR = 1.15 (95% CI, 1.03–1.28) for monthly seizures)). Conclusions: EEG abnormalities are common in Africans with epilepsy and are associated with preventable risk factors. Significance: EEG is helpful in identifying focal epilepsy in Africa, where timing of focal aetiologies is problematic and there is a lack of neuroimaging services

Prevalence and factors associated with convulsive status epilepticus in Africans with epilepsy

Objective: We conducted a community survey to estimate the prevalence and describe the features, risk factors, and consequences of convulsive status epilepticus (CSE) among people with active convulsive epilepsy (ACE) identified in a multisite survey in Africa. Methods: We obtained clinical histories of CSE and neurologic examination data among 1,196 people with ACE identified from a population of 379,166 people in 3 sites: Agincourt, South Africa; Iganga-Mayuge, Uganda; and Kilifi, Kenya. We performed serologic assessment for the presence of antibodies to parasitic infections and HIV and determined adherence to antiepileptic drugs. Consequences of CSE were assessed using a questionnaire. Logistic regression was used to identify risk factors. Results: The adjusted prevalence of CSE in ACE among the general population across the 3 sites was 2.3 per 1,000, and differed with site (p \u3c 0.0001). Over half (55%) of CSE occurred in febrile illnesses and focal seizures were present in 61%. Risk factors for CSE in ACE were neurologic impairments, acute encephalopathy, previous hospitalization, and presence of antibody titers to falciparum malaria and HIV; these differed across sites. Burns (15%), lack of education (49%), being single (77%), and unemployment (78%) were common in CSE; these differed across the 3 sites. Nine percent with and 10% without CSE died. Conclusions: CSE is common in people with ACE in Africa; most occurs with febrile illnesses, is untreated, and has focal features suggesting preventable risk factors. Effective prevention and the management of infections and neurologic impairments may reduce the burden of CSE in ACE

Clinical features, proximate causes, and consequences of active convulsive epilepsy in Africa

Purpose: Epilepsy is common in sub-Saharan Africa (SSA), but the clinical features and consequences are poorly characterized. Most studies are hospital-based, and few studies have compared different ecological sites in SSA. We described active convulsive epilepsy (ACE) identified in cross-sectional community-based surveys in SSA, to understand the proximate causes, features, and consequences. Methods: We performed a detailed clinical and neurophysiologic description of ACE cases identified from a community survey of 584,586 people using medical history, neurologic examination, and electroencephalography (EEG) data from five sites in Africa: South Africa; Tanzania; Uganda; Kenya; and Ghana. The cases were examined by clinicians to discover risk factors, clinical features, and consequences of epilepsy. We used logistic regression to determine the epilepsy factors associated with medical comorbidities. Key Findings: Half (51%) of the 2,170 people with ACE were children and 69% of seizures began in childhood. Focal features (EEG, seizure types, and neurologic deficits) were present in 58% of ACE cases, and these varied significantly with site. Status epilepticus occurred in 25% of people with ACE. Only 36% received antiepileptic drugs (phenobarbital was the most common drug [95%]), and the proportion varied significantly with the site. Proximate causes of ACE were adverse perinatal events (11%) for onset of seizures before 18 years; and acute encephalopathy (10%) and head injury prior to seizure onset (3%). Important comorbidities were malnutrition (15%), cognitive impairment (23%), and neurologic deficits (15%). The consequences of ACE were burns (16%), head injuries (postseizure) (1%), lack of education (43%), and being unmarried (67%) or unemployed (57%) in adults, all significantly more common than in those without epilepsy. Significance: There were significant differences in the comorbidities across sites. Focal features are common in ACE, suggesting identifiable and preventable causes. Malnutrition and cognitive and neurologic deficits are common in people with ACE and should be integrated into the management of epilepsy in this region. Consequences of epilepsy such as burns, lack of education, poor marriage prospects, and unemployment need to be addressed

A retrospective analysis of antimicrobial resistance in pathogenic Escherichia coli and Salmonella spp. isolates from poultry in Uganda

There are increasing reports of antimicrobial treatment failures for bacterial diseases of poultry in Uganda. The paucity of data on antimicrobial resistance (AMR) of pathogenic bacteria in Uganda is a major setback to AMR control. This study investigated the occurrence of fowl typhoid, colibacillosis, and AMR in associated pathogens from 2012 to 2018. Laboratory records from the Central Diagnostic Laboratory (CDL), a National Veterinary Diagnostic Facility located at Makerere University, were reviewed. Archived isolates of the causative bacteria for the two diseases were also evaluated for AMR. The frequencies of the two disease conditions, their clinical and necropsy presentations and the demographic data of the diagnostic samples were summarized from the records. Archived bacterial isolates were revived before antimicrobial susceptibility testing. This was done on Mueller Hinton agar using the disk diffusion method, against 16 antimicrobials of medical and veterinary importance according to the Clinical Laboratory Standards Institute guidelines. A total of 697 poultry cases were presented for bacteriological investigations in the review period. Colibacillosis and salmonellosis had prevalence rates of 39.7% (277/697) and 16.2% (113/697), respectively. A total of 63 and 92 isolates of Escherichia coli and Salmonella spp., respectively, were archived but 43 (68.3%) E. coli and 47 (51.1%) Salmonella spp. isolates were recovered and evaluated for AMR. Multidrug resistance was more frequent in E. coli (38; 88.4%) than salmonellae (25; 53.2%), (p < 0.001). The high prevalence of colibacillosis, salmonellosis and the AMR of associated pathogens warrants immediate institution of appropriate disease control measures

Occurrence of Selected Bacterial Antibiotic Resistance Genes in Soils of Animal Farms in Uganda

The antibiotic resistance genes (ARG) of bacteria can be found in diverse environments such as the gut of mammals, soil, air, and water. In this research, we examined soils (for ARG) from 27 animal farms in Uganda (Mbarara, Wakiso and Mpigi districts) rearing poultry, pigs, dairy, or beef animals. Among these 27 places, there were antibiotic-free farms and those, which routinely used antibiotics to control diseases. DNA was extracted from soil samples using a commercial kit. A polymerase chain reaction (PCR) was performed to detect baScterial genes of resistance to sulphonamide (3 genes), beta lactam (1 gene), and Tetracycline (8 genes) antibiotics. The highest number of soils contaminated with these genes were from Mpigi district, whereas in Mbarara we found contamination of farm soils to a lesser extent. In all districts, the ARG were detected in farm soils regardless of the evidence of antibiotic usage; however, ARG were predominant in severe antibiotic consuming farms than the less consuming ones. Sulphonamide resistance genes were predominant in most district samples. In particular, the sul2 (Sulphonamide) and tetW (Tetracycline) genes were the most prevalent in all samples, suggesting that fecal disposal or use of animal manure could drive the accumulation of ARG in these soils, making it a deadly reservoir, especially in areas with vast consumption of antibiotics

Characteristics of Gorilla-Specific Lactobacillus Isolated from Captive and Wild Gorillas

Lactic acid bacteria (LAB) reside in a wide range of mammals, such as autochthonous intestinal bacteria. In this paper, we present the phenotypic and phylogenetic characteristics of gorilla-specific LAB. Lactobacillus gorillae&mdash;previously isolated from the wild and captive western lowland gorillas (Gorilla gorilla gorilla)&mdash;were successfully isolated from wild mountain gorillas (Gorilla gorilla beringei) in addition to other captive and wild western lowland gorillas. The strains from wild gorillas could ferment D-xylose, arbutine, cellobiose, and trehalose better than those from captive gorillas. By contrast, tolerance to NaCl was higher in isolates from captive gorillas than in those from wild gorillas. This tendency may have been induced by regular foods in zoos, which contain sufficient amount of salts but less amount of indigestible fiber and plant secondary metabolites compared to foods in the wild. All strains of L. gorillae showed inhibitory activities to enteric pathogenic bacteria; however, the activity was significantly higher for strains from wild gorillas than for those from captive gorillas. This may have been induced by the captive condition with routine veterinary intervention. Since L. gorillae can grow in the gastrointestinal tract of gorillas in captivity, the strains from wild mountain gorillas are potential probiotics for gorillas under captive conditions

Isolation and Characterization of Antimicrobial-Resistant Escherichia coli from Retail Meats from Roadside Butcheries in Uganda

Retail meats are one of the main routes for spreading antimicrobial-resistant bacteria (ARB) from livestock to humans through the food chain. In African countries, retail meats are often sold at roadside butcheries without chilling or refrigeration. Retail meats in those butcheries are suspected to be contaminated by ARB, but it was not clear. In this study, we tested for the presence of antimicrobial-resistantEscherichia colifrom retail meats (n = 64) from roadside butcheries in Kampala, Uganda. The meat surfaces were swabbed and inoculated on PetriFilm SEC agar to isolateE. coli. We successfully isolatedE. colifrom 90.6% of these retail meat samples. We identified the phylogenetic type, antimicrobial susceptibility, and antimicrobial resistance genes prevalence between retail meat isolates (n = 89). Phylogenetic type B1 was identified from 70.8% of the retail meat isolates, suggesting that the isolates originated primarily from fecal contamination during meat processing. Tetracycline (TET)-resistant isolates withtetAand/ortetBgene(s) were the most frequently detected (28.1%), followed by ampicillin (AMP) resistance genes withbla(TEM)(15.7%,) and sulfamethoxazole-trimethoprim (SXT) resistance genes withsul2(15.7%). No extended-spectrum beta-lactamase-producing isolates were detected. A conjugation assay showed that resistance to AMP, TET, and SXT could be simultaneously transferred to recipients. These findings suggest that antimicrobial-resistantE. colican easily be transferred from farms to tables from retail meats obtained from roadside butcheries