Ssekawojwa, E

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Risk Factors for Brucella Sero-positivity in Cattle, Goats and Humans in Mbarara, Uganda Dr. Edward Ssekawojwa BVM, MVPM edsseka@yahoo.com   Workshop: An Integrated Approach to Controlling Brucellosis in Africa, Addis Ababa, 29-31 January 2013 Presentation Outline • Background • Methods and Materials • Results • Recommendations            Background • Mbarara District is one of the most important  livestock producing areas in Uganda. • Different livestock production systems are practiced in the same district. • Brucellosis is a major socio-economic threat            29th - 31st/01/2013 An Integrated Approach to Controlling Brucellosis in Africa 3 Livestock Production Systems 29th - 31st/01/2013 An Integrated Approach to Controlling Brucellosis in Africa 4 Pastoral Agro-pastoral Materials and Methods • Cross Sectional Survey: February to September 2005. • Multistage sampling technique for cattle and goats. • Serum collected from 1535 cattle and 812 goats from 98 farms. • 161 humans randomly selected from Brucella positive farms and 168 individuals attending HIV CTC in Kampala were included in the study. • Data on hypothesized risk factors was collected using standard structured questionnaires and individual animal data sheets.  29th - 31st/01/2013 An Integrated Approach to Controlling Brucellosis in Africa 5 • Sampled areas: – Pastoral areas – Nyabushozi County – Agro-pastoral – Ibanda and Kashaari Counties 29th - 31st/01/2013 An Integrated Approach to Controlling Brucellosis in Africa 6 • Cattle and goats sera were screened with Rose Bengal and confirmed with cELISA (all supplied by Veterinary Laboratory Agency, UK) • Human sera was tested using Plate Agglutination Test (RBT), Standard Tube Agglutination Test (STAT) and cELISA. • Raw data was stored in MS Access and analyzed with SPSS 12.0 for Windows and additional modeling done using SAS IML macro (SAS Institute Inc., version 6 1985) 29th - 31st/01/2013 An Integrated Approach to Controlling Brucellosis in Africa 7 Results  • Four percent (95% CI , 3.1% – 5.1%) and 7% (95% CI, 5.6% - 9.2%) of individual cattle and goats respectively were sero-positive. • Sero-positive cattle and goats were distributed in 21% (95%CI, 12.9% - 29.3%) and 20% (95%CI, 9.9% - 30%) cattle and goats herds respectively. • In cattle, environmental risk factors included; Pastoral Livestock Production System (p<0.001,OR = 18.5), herd size, Contact with wild life and water and / or pasture scarcity 29th - 31st/01/2013 An Integrated Approach to Controlling Brucellosis in Africa 8 • Host level risk factors for cattle included: – Age – Sex – Parity – Breed Abortion was strongly linked with Brucella sero-positivity   both in cattle (OR=5.9) and goats (OR= 5.5).  29th - 31st/01/2013 An Integrated Approach to Controlling Brucellosis in Africa 9 Human Results Distribution of hypothesized risk factors by District. ________________________________________________________________________ Variable  Levels  Kampala Mbarara Overall      %(n) %(n) %(n) Sex   Female  38.7(65) 36(58) 37.4(123)    Male  61.3(103) 64(103) 62.6(206) Consumption of  un-boiled milk Yes  16.7(28) 37.9(55) 26.5(83)    No  83.3(140) 62(90) 73.5(230)  Contact with animals  Yes  17.3(29) 93.2(150) 54.4(179)    No  82.7(139) 6.8(11) 45.6(150)  History of brucellosis- like symptoms 12months preceding study Yes  88.7(149) 71.4(115) 80.2(264)    No  8.9(15) 28.6(46) 18.5(61)  Human brucellosis awareness  Yes  21.4(36) 39.8(64) 30.4(100)    No  78.6(132) 60.2(97) 69.6(229)  29th - 31st/01/2013 10 Individual level seroprevalence based on RBT, STAT, cELISA and STAT+cELISA, by District Area      No Sampled Seroprevalence %, (n)       RBT    STAT    cELISA     STAT/cELISA Mbarara 161  18.0 (29)  7.5 (12)   9.3 (15)       13.0 (21)    Kampala 168  12.5 (21)   4.2 (7)     0.6 (1)           4.8 (8)   Total  329  15.2 (50)   5.8 (19)  4.9 (16)        8.8 (29) 29th - 31st/01/2013 An Integrated Approach to Controlling Brucellosis in Africa 11 • Consumption of un-boiled milk was singnificantly (p>0.001) associated with sero-posivitity in Mbarara District 29th - 31st/01/2013 An Integrated Approach to Controlling Brucellosis in Africa 12 Recommendations • Address the challenges  facing the pastoral production system; vis –a- viz herd sizes, rampant movements, contact with wildlife. • Discourage consumption of raw milk for humans – behavioral change? • Public awareness and sensitization • Urgent need for preventive measures: vaccination • One health approach to brucellosis control  29th - 31st/01/2013 An Integrated Approach to Controlling Brucellosis in Africa 13 Acknowledgement • My Supervisors; Prof Nasinyama G, Prof Opuda-Asibo J, Dr. Grimaud P. • Mbarara District Veterinary Officer, Dr. John Barigye and Staff. • Mbarara District Director of Health Services, Dr. Kaguna Amooti. • Dean, Faculty of Medicine, Mbarara University of Science and Technology, Dr. Jerome Kabakyenga. • Prof Kang’ethe Erasmus, Department of Public Health, Pharmacology and Toxicology, College of Agriculture and Veterinary Medicine, Nairobi University. • Dr. Hitimana, Mr. Mujulizi Tephy and staff of AIDS Informantion Center (AIC), Kampala. • Innovations @ Makerere, French Embassy in Uganda, Dairy Development Authority through FSP/ACSS   29th - 31st/01/2013 An Integrated Approach to Controlling Brucellosis in Africa 14 THANK YOU  FOR YOUR ATTENTION 29th - 31st/01/2013 An Integrated Approach to Controlling Brucellosis in Africa 15 

Risk factors for Brucella sero-positivity in cattle, goats and humans in Mbarara, Uganda

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Risk factors for Brucella sero-positivity in cattle, goats and humans in Mbarara, Uganda

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