Prevalence and risk factors for human leptospirosis at a hospital serving a pastoralist community, Endulen, Tanzania

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

Taenia multiceps in northern Tanzania: an important but preventable disease problem in pastoral and agropastoral farming systems

Coenurosis due to Taenia multiceps has emerged as a major concern to small ruminant-owning communities in northern Tanzania. Although a high incidence of disease has been reported, gaps still remain in our knowledge of the disease problem across different agro-ecological settings. The study aimed to determine the prevalence of coenurosis in small ruminants and taeniid infection in dogs and identify risk factors for infection. Questionnaire surveys, postmortem examination of small ruminants, and coproscopic examination of dog faeces were used to collect data on reported coenurosis cases and taeniid infections, respectively. The twelve-month period prevalence of coenurosis in small ruminants was 8.4% (95% CI 8.2–8.6). The prevalence of taeniid infection in dogs was 12.5% (95% CI 9.1–17.4). The village-level prevalence of coenurosis in sheep and goats was significantly correlated with taeniid infection prevalence in dogs (r = 0.51, p = 0.029). Multivariable analysis indicated that home slaughter was significantly associated with the livestock owner-reported neurological syndrome due to coenurosis in sheep and goats (OR = 13.3, 95% CI 4.2–42.0, p < 0.001) and the practice of offering discarded brains to dogs was significantly associated with taeniid infection prevalence in dogs (OR = 2.80, 95% CI 0.98–7.98, p = 0.05). Coenurosis is a major disease problem in livestock-keeping communities of northern Tanzania, but there is little awareness of transmission risks associated with home slaughter and dog feeding practices. There is a need for veterinary and animal health services to engage more actively with communities to increase awareness of the transmission cycle of T. multiceps and the preventive measures that can be taken to reduce the impact of disease in livestock-dependent communities

Iron Depletion, Iron Deficiency, and Iron Deficiency Anaemia Among Children Under 5 Years Old in Kilimanjaro, Northern Tanzania: A Hospital-Based Cross-Sectional Study

Background: Iron depletion results from reduced iron stores, and it is an early stage of disease progression before iron deficiency, which leads to iron deficiency anaemia (IDA). IDA is associated with delayed infant growth and development, diminished cognitive function, poor academic performance, decreased exercise tolerance, and impaired immune function.   This study aimed to determine the prevalence of iron depletion and IDA and factors associated with low ferritin levels among children under 5-years-old receiving care at Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania.   Methods: Under-5 children presenting at KCMC were successively enrolled and screened for iron depletion and IDA using complete blood count and serum ferritin levels. The generally accepted World Health Organization cut‑off levels for normal haemoglobin (Hb) and ferritin level were used. Iron depletion, iron deficiency, and IDA prevalences were estimated in relation to the combination measures of haemoglobin, mean corpuscular volume, and ferritin levels. Dietary and sociodemographic characteristic of the children were recorded after parents or caretakers provided informed consent. Data analysis was conducted using SPSS version 21.0.   Results: A total of 303 children aged 2 to 59 months were enrolled in the study. Anaemia was detected in169 (55.8%) children. Children aged 2 to 12 months had a higher prevalence of anaemia (n=101, 60.1%). The overall prevalences of iron depletion, iron deficiency with no anaemia, and IDA were 2.6% (n=8), 9.6% (n=29), and 28.1% (n=84), respectively. Low ferritin levels were detected in 124 (40.9%) children. Drinking more than 500 ml of cow's milk per day was associated with an increased risk of anaemia (adjusted odds ratio [AOR] 5.6; 95% confidence interval [CI], 2.6 to 12.1) relative to those not drinking cow's milk. Children whose families had meals that included beef more than 3 times per week were less likely to have low ferritin (AOR 0.6; 95% CI, 0.3 to 1.3), though the difference was not significant.   Conclusion: The IDA prevalence among children in the Kilimanjaro area was high, with more than 50% of infants being anaemic. Drinking cow's milk was associated with an increased risk of IDA. Future community-based research is recommended to elucidate more details about iron deficiency in the general population

Prevalence and risk factors for human leptospirosis in a pastoralist community, Endulen, Tanzania.

Excel file including all data fields included in the analyses presented in the paper, except for any fields where inclusion might compromise participant anonymity