Circulating Brucella species in wild animals of the Serengeti ecosystem, Tanzania.

BACKGROUND: Brucellosis is a bacterial zoonosis of public health and economic importance worldwide. It affects a number of domestic animals, wild animals and humans. Human brucellosis originates from either livestock or wildlife. The species of Brucella circulating in wild animals in Tanzania is largely unknown due to insufficient surveillance. This study was carried out to identify Brucella species found in selected wildlife hosts in the Serengeti ecosystem. METHODOLOGY: The study used a total of 189 archived samples that were obtained from cross-sectional studies previously conducted between 2000 and 2017 in the Serengeti ecosystem in Tanzania. Whole blood, serum and amniotic fluid collected from buffalos, lions, wildebeest, impala, zebra and hyena were available for DNA extraction. Multiplex polymerase chain reaction for B. abortus, B. melitensis, B. ovis and B. suis (AMOS PCR) and quantitative real-time PCR (qPCR) targeting the bcsp31 and IS711 genes for Brucella genus detection and the IS711 targets alkB for B. abortus and BMEI1162 for B. melitensis were used to detect Brucella strains. RESULTS: Out of the 189 samples tested, 12 (6.35 %) and 22 (11.6 %) were positive to AMOS-PCR and qPCR, respectively. Most of the positive samples were from lions (52.6 %) and buffaloes (19.6 %). Other animals that were positive included: wildebeest (13.6 %), impala (13.6 %), zebra (4.5 %) and hyena (4.5 %). Out of 22 positive samples, 16 (66.7 %) were identified as B. abortus and the other six samples did not amplify for neither B. abortus nor B. melitensis. CONCLUSIONS: The detection of Brucella DNA in archived wild animal samples shows testing potential of samples collected from this population. The zoonotic species B. abortus and B. melitensis detected in wild animals have previously been reported in livestock and humans in the region. The findings suggest that, due to the contact network, some of the identified wild animal hosts in this study could be reservoirs for infections in domestic animals and humans within the Serengeti ecosystem while others are likely dead-end hosts. One Health control strategies and continuous surveillance programs in other wildlife reserved areas should be implemented to help predicting transmission in livestock and humans in the region.

Female and male-controlled livestock holdings impact pastoralist food security and women's dietary diversity.

BACKGROUND: Food insecurity is a global problem that requires a One Health approach. As many households in low- and middle-income nations rely on crops and livestock that they produce to meet their household's needs, food security and nutrition are closely linked to the health of animals and the environment. Resources controlled by women are more often allocated to uses that benefit the entire household, such as food, health, and educating children, than men's resources. However, studies of gender control of resources among pastoralist societies are scant. We examined the effect of female and male control of livestock resources on food security and women's dietary diversity among households from one agro-pastoralist and two pastoralist tribes in Iringa Region in south-central Tanzania. METHODS: We conducted surveys with 196 households, which included questions on food availability and food consumption among women, livestock holdings, gender control of livestock and livestock product income, and household demographics, as well as open-ended questions on the use of income. Food availability and food consumption responses were used to construct food security and women's dietary diversity indexes, respectively. We conducted mixed effects logistic regression to analyze how household food security and dietary diversity were associated with livestock and other household variables. We also examined qualitative responses for use of income controlled by women and how the household obtained income when needed. RESULTS: Female-controlled livestock generally supported better household nutrition outcomes. Greater chicken holdings increased the probability of being food secure in pastoralist households but decreased it in agro-pastoralist households, while increasing the probability of having medium-high dietary diversity among all tribes. Male-controlled livestock holdings were not related to food security status. Women used income to supplement food supplies and livestock they controlled as a primary response to unanticipated household needs. CONCLUSIONS: Our results show that female-control of livestock is significantly related to household food security and dietary diversity in pastoralists and agro-pastoralists in rural Tanzania. Importantly, the relationship between food security and dietary diversity differs among tribes for both male and female-controlled livestock, which suggests that blanket policies regarding management of livestock holdings may have unintended consequences. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s42522-020-00032-5.

Trends in extrapulmonary TB cases at three teaching hospitals in Ghana, 2008-2017.

SETTING: Three teaching hospitals in Ghana. OBJECTIVE: To elucidate trends in demographics, clinical characteristics and treatment outcomes in extrapulmonary TB (EPTB) patients. DESIGN: This was a retrospective study involving the review and comparison of EPTB and pulmonary TB (PTB) data from 1 January 2008 to 31 December 2017 in TB registers and treatment cards. RESULTS: Of 15,392 TB cases, 4607 (30%) were EPTB, including 4477/4607 (97%) new cases. There were 2,679/4607 (58%) males and the age range was 0.3 to 96 years. Pleural TB (1021/4607, 22%) was the most common. Treatment success rates for EPTB and PTB were respectively 72% and 84%. HIV positivity was high among patients with disseminated/miliary TB (429/779, 55%) and TB meningitis (242/526, 46%). To note, disseminated/miliary TB (χ2 = 33.53, P < 0.0001) increased, whereas TB meningitis (χ2 = 19.43, P < 0.0001) decreased over the 10-year period. Mortality among EPTB patients was associated with increasing age (⩾25 years), disseminated/miliary TB, TB meningitis and HIV positivity. CONCLUSIONS: There is male preponderance for both EPTB and PTB in Ghana. Increasing age, disseminated/ miliary TB, TB meningitis and HIV are risk factors for mortality among EPTB patients. This emphasises the need for public education on the risk factors for EPTB and preventive strategies.

CONTEXTE: Trois centres hospitalières universitaires au Ghana. OBJECTIF: Elucider les tendances démographiques, les caractéristiques cliniques et les résultats du traitement de patients atteints de TB extrapulmonaire (EPTB) au Ghana. SCHEMA: Ceci est une étude rétrospective de revue et de comparaison des données de EPTB et de TB pulmonaire (PTB) du 1e janvier 2008 au 31 décembre 2017 dans les registres de TB et les cartes de traitement. RESULTATS: Sur 15 392 cas de TB, 4607 (30%) étaient des EPTB dont 4477/4607 (97%) étaient de nouveaux cas. Les hommes représentaient 2679/4607 (58%) et leur âge allait de 0,3 à 96 ans. Une TB pleurale 1021/4607 (22%) était la plus fréquente. Le taux de réussite du traitement de la EPTB et de la PTB a été de 72% et 84%, respectivement. La positivité au VIH était élevée parmi les patients atteints de TB disséminée/miliaire (429/779 ; 55%) et de méningite tuberculeuse (242/526 ; 46%). Il est significatif que la TB disséminée/miliaire (χ2 = 33,53 ; P < 0,0001) a augmenté tandis que la méningite TB (χ2 = 19,43, P < 0,0001) a diminué au long de la période de 10 ans. La mortalité des patients EPTB a été associée à un âge croissant (≥25 ans), une forme disséminée/miliaire, à une méningite TB et à la positivité au VIH. CONCLUSIONS: Il y a une prépondérance masculine à la fois de la EPTB et de la PTB au Ghana. Un âge croissant, une forme disséminée/ miliaire, une méningite TB et le VIH sont des facteurs de risque de mortalité pour les patients EPTB. Ceci met l'accent sur le besoin d'éducation du public relative aux facteurs de risque et aux stratégies de prévention.

One Health contributions towards more effective and equitable approaches to health in low- and middle-income countries.

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'.

Clinical implication of novel drug resistance-conferring mutations in resistant tuberculosis.

Evolving novel and/or unfamiliar mutations are revolutionizing the pathways of antibiotic resistance of clinical tuberculosis. The accumulation and interaction of these poorly characterized mutations augment the complexity of resistant pathogenic strains and raise public health concerns. This article reviews our current understanding of the genetic changes that characterize drug resistance in tuberculosis and highlights the imperative for further investigations focusing on the effects of an individual mutation and interacting mutations with detailed strain epidemiology, particularly as these pertain to technology-limited countries with high tuberculosis incidence rates. Concomitantly, there is a need for the development, testing, and uptake of new tools for studying the effects of these mutations in drug resistance and fitness cost of the pathogen. Such genetic data are critical for effective localized and global tuberculosis control interventions and for accurate epidemiological predictions.

Isolation and Potential for Transmission of Mycobacterium bovis at Human-livestock-wildlife Interface of the Serengeti Ecosystem, Northern Tanzania.

Mycobacterium bovis, the causative agent of bovine tuberculosis (bTB), is a multihost pathogen of public health and veterinary importance. We characterized the M. bovis isolated at the human-livestock-wildlife interface of the Serengeti ecosystem to determine the epidemiology and risk of cross-species transmission between interacting hosts species. DNA was extracted from mycobacterial cultures obtained from sputum samples of 472 tuberculosis (TB) suspected patients and tissue samples from 606 livestock and wild animal species. M. bovis isolates were characterized using spoligotyping and Mycobacterial Interspersed Repetitive Units-Variable Tandem Repeats (MIRU-VNTR) on 24 loci. Only 5 M. bovis were isolated from the cultured samples. Spoligotyping results revealed that three M. bovis isolates from two buffaloes (Syncerus caffer) and 1 African civet (Civettictis civetta) belonged to SB0133 spoligotype. The two novel strains (AR1 and AR2) assigned as spoligotype SB2290 and SB2289, respectively, were identified from indigenous cattle (Bos indicus). No M. bovis was detected from patients with clinical signs consistent with TB. Of the 606 animal tissue specimens and sputa of 472 TB-suspected patients 43 (7.09%) and 12 (2.9%), respectively, yielded non-tuberculous mycobacteria (NTM), of which 20 isolates were M. intracellulare. No M. avium was identified. M. bovis isolates from wildlife had 45.2% and 96.8% spoligotype pattern agreement with AR1 and AR2 strains, respectively. This finding indicates that bTB infections in wild animals and cattle were epidemiologically related. Of the 24 MIRU-VNTR loci, QUB 11b showed the highest discrimination among the M. bovis strains. The novel strains obtained in this study have not been previously reported in the area, but no clear evidence for recent cross-species transmission of M. bovis was found between human, livestock and wild animals.

A field vaccine trial in Tanzania demonstrates partial protection against malignant catarrhal fever in cattle.

Malignant catarrhal fever (MCF) is a fatal lymphoproliferative disease of cattle that, in East Africa, results from transmission of the causative virus, alcelaphine herpesvirus 1 (AlHV-1), from wildebeest. A vaccine field trial involving an attenuated AlHV-1 virus vaccine was performed over two wildebeest calving seasons on the Simanjiro Plain of northern Tanzania. Each of the two phases of the field trial consisted of groups of 50 vaccinated and unvaccinated cattle, which were subsequently exposed to AlHV-1 challenge by herding toward wildebeest. Vaccination resulted in the induction of virus-specific and virus-neutralizing antibodies. Some cattle in the unvaccinated groups also developed virus-specific antibody responses but only after the start of the challenge phase of the trial. PCR of DNA from blood samples detected AlHV-1 infection in both groups of cattle but the frequency of infection was significantly lower in the vaccinated groups. Some infected animals showed clinical signs suggestive of MCF but few animals went on to develop fatal MCF, with similar numbers in vaccinated and unvaccinated groups. This study demonstrated a baseline level of MCF-seropositivity among cattle in northern Tanzania of 1% and showed that AlHV-1 virus-neutralizing antibodies could be induced in Tanzanian zebu shorthorn cross cattle by our attenuated vaccine, a correlate of protection in previous experimental trials. The vaccine reduced infection rates by 56% in cattle exposed to wildebeest but protection from fatal MCF could not be determined due to the low number of fatal cases.

Tuberculosis infection in wildlife from the Ruaha ecosystem Tanzania: implications for wildlife, domestic animals, and human health.

Mycobacterium bovis, a pathogen of conservation, livestock, and public health concern, was detected in eight species of wildlife inhabiting protected areas bordering endemic livestock grazing lands. We tested tissues from 179 opportunistically sampled hunter-killed, depredation, road-killed, and live-captured wild animals, representing 30 species, in and adjacent to Ruaha National Park in south-central Tanzania. Tissue culture and PCR were used to detect 12 (8.1%) M. bovis-infected animals and 15 (10.1%) animals infected with non-tuberculosis complex mycobacteria. Kirk's dik-dik, vervet monkey, and yellow baboon were confirmed infected for the first time. The M. bovis spoligotype isolated from infected wildlife was identical to local livestock, providing evidence for livestock-wildlife pathogen transmission. Thus we advocate an ecosystem-based approach for bovine tuberculosis management that improves critical ecological functions in protected areas and grazing lands, reduces focal population density build-up along the edges of protected areas, and minimizes ecological stressors that increase animals' susceptibility to bovine tuberculosis.

Zoonotic tuberculosis and brucellosis in Africa: neglected zoonoses or minor public-health issues? The outcomes of a multi-disciplinary workshop.

Late in 2007, veterinary, medical and anthropological professionals from Europe and Africa met in a 2-day workshop in Pretoria, South Africa, to evaluate the burden, surveillance and control of zoonotic tuberculosis and brucellosis in sub-Saharan Africa. Keynote presentations reviewed the burden of these diseases on human and livestock health, the existing diagnostic tools, and the available control methods. These presentations were followed by group discussions and the formulation of recommendations. The presence of Mycobacterium bovis and Brucella spp. in livestock was considered to be a serious threat to public health, since livestock and animal products are the only source of such infections in human beings. The impact of these pathogens on human health appears to be relatively marginal, however, when compared with Mycobacterium tuberculosis infections and drug resistance, HIV and malaria. Appropriate diagnostic tools are needed to improve the detection of M. bovis and Brucella spp. in humans. In livestock, the 'test-and-slaughter' approach and the pasteurization of milk, which have been used successfully in industrialized countries, might not be the optimal control tools in Africa. Control strategies should fit the needs and perceptions of local communities. Improved intersectoral and international collaboration in surveillance, diagnosis and control, and in the education of medical and veterinary personnel, are advocated.

African pouched rats for the detection of pulmonary tuberculosis in sputum samples.

SETTING: Resource-limited settings in sub-Saharan African countries. OBJECTIVE: To utilise African giant pouched rats (Cricetomys gambianus) for the diagnosis of tuberculosis (TB) in human sputum. DESIGN: A specially designed cage with 10 sniffing holes and cassette-carrier was used. The sputum samples were put in the sample cassette, containing 10 samples in line, placed under matching sniffing holes. Rats were trained to sniff each consecutive sample, and indicate TB positives by fixing their nose for 5 seconds at the sniffing hole. This behaviour was maintained by food reinforcement upon correct indications. A total of 3416 samples were used. RESULTS: Of the 20 trained rats, 18 were able to discriminate positive from negative sputum samples, with average daily sensitivities ranging from 72% to 100%, and average daily false-positives ranging from 0.7% to 8.1%. The use of multiple rats significantly increased sensitivity and negative predictive value. CONCLUSION: Utilising trained sniffer rats for TB detection is a potentially faster screening method and is at least as sensitive as smear microscopy. This method could therefore be suitable for active case finding, especially where large numbers of samples are to be analysed in resource-limited settings, to complement existing diagnostic techniques.

Hydatidosis of slaughtered animals in Ngorongoro district of Arusha region, Tanzania.

A study on the prevalence of hydatidosis in cattle, goats and sheep was carried out in Ngorongoro district of Arusha region, Tanzania. A 4-years data records from four slaughter slabs were retrieved and analysed. In addition, meat inspection was done in the same slaughter slabs for nine months and 64 households were interviewed to assess the community awareness on hydatidosis. Results showed the overall prevalence of hydatidosis to be 47.9%. Species prevalence of 48.7%, 34.7% and 63.8% in cattle, goats and sheep respectively was recorded. Of 174 cysts examined in cattle, 37 (21.3%) were fertile, 126 (72.4%) were sterile and 11 (6.3%) were calcified. Out of 215 goats and 67 sheep cysts examined, 52 (24.7%) and 26 (38.8%) were fertile, 138 (64.2%) and 38 (56.7%) were sterile, 24 (11.2%) and 3 (4.5%) were calcified respectively. The higher percentage of fertile hydatid cysts in sheep and goats coupled with the practice of backyard slaughter of sheep and goats suggests that, these animals could be important intermediate hosts for the maintenance of the domestic life cycle of E. granulosus in the locality. Questionnaire survey revealed that 17.2% of the respondents were aware of hydatidosis but non of them were knowledgeable on its transmission. Up to 84.4% of the respondents had domestic ruminants and donkeys, while 89.1% had dogs. Of the households with dogs, only 19.3% had their dogs dewormed at least once in life time. Most of the households (87.7%) had their dogs managed freely and 77.2% of the respondents reported school children to be the closest friends of dogs in the family. The prevalence of E. granulosus infection in wildlife and the possible relationship of the domestic cycle to the sylvatic cycle operating in the same area are unknown and need to be studied.

Mycobacteria causing human cervical lymphadenitis in pastoral communities in the Karamoja region of Uganda.

Mycobacteria from lymph node biopsies of patients with cervical lymphadenitis reporting for tuberculosis treatment in Matany and Moroto Hospitals in the transhumant areas of Karamoja, Uganda were isolated and characterized. The AccuProbe culture identification kits for Mycobacterium tuberculosis complex (MTC), M. avium complex (MAC) and M. avium were used to identify the isolates. Spoligotyping, IS901 PCR and IS1311 and IS1245 restriction fragment length polymorphism (RFLP) were used to characterize the isolates. Of the 43 biopsies, ten M. avium, seven M. tuberculosis, three M. bovis, and two M. intracellulare were isolated. Two isolates could not be identified with AccuProbe and from 19 samples no mycobacteria could be isolated. Three isolates with the Beijing spoligotype were identified from the seven M. tuberculosis isolates. The spoligopatterns of the M. bovis isolates had previously been detected in cattle in Uganda. Isolation of members of the MAC group reflects the complex interaction between the transhumant communities, water sources and their cattle. None of the M. avium isolates harboured IS901, and all showed several bands on IS1311 and IS1245 RFLP, in accordance with M. avium subsp. hominissuis. Composite dendrograms of IS1311 and IS1245 RFLP showed that the isolates were similar and identical patterns were found. The isolation of M. bovis confirms the human infection with zoonotic mycobacteria in areas where consumption of raw milk and meat is routine. Isolation of environmental mycobacteria also confirms their increasing role in human disease and the occupational risk of infection in the transhumant ecosystem in the absence of safe drinking water and environmental contamination.

Characterisation of mycobacteria isolated from slaughter cattle in pastoral regions of Uganda.

BACKGROUND: Bovine tuberculosis is a zoonotic problem in pastoral cattle and communities in Uganda. Tuberculin tests in pastoral cattle had shown a high herd but low animal prevalence, with a high proportion of avian reactors. No work had been done to identify the mycobacterial species involved. The objective of the study was to isolate and characterise Mycobacterial species causing tuberculous lesions in slaughtered animals. Lesioned organs compatible with bovine tuberculosis in slaughtered cattle from pastoral areas in Uganda were collected and cultured to isolate mycobacteria. AccuProbe culture identification kits for the Mycobacterium tuberculosis complex, M. avium complex and M. avium were used to identify the isolates. Spoligotyping and Insertion Sequence (IS) 1311 and IS1245 Restriction Fragment Length Polymorphism analysis (RFLP) were used to further characterise the isolates. RESULTS: Of the 61 lesioned organs and tissues cultured, 19 isolates were identified as M. bovis, 3 as M. avium subsp.hominissuis, 1 as M. intracellulare, 1 as a mixed culture of M. bovis and M. avium sp. and 1 as M. avium sp. and unidentified mycobacteria. Eleven other mycobacteria outside the tuberculosis and avium complex groups were also isolated. Ten new spoligopatterns grouped into three clusters were identified from M. bovis isolates. Two of the three M. avium subsp.hominissuis isolates showed similar patterns on the IS1311 RFLP but all were different on the IS1245 RFLP. CONCLUSION: The isolation of M. bovis confirms the ongoing infection with spoligotypes unique to Uganda. Isolation of environmental mycobacteria could explain the high avian or non specific tuberculin reactor patterns commonly observed in pastoral cattle and suggests their pathogenic or opportunistic role in the infection of cattle with disseminated bovine tuberculous lesions.

Risk factors for herd-level bovine-tuberculosis seropositivity in transhumant cattle in Uganda.

We investigated the prevalence and risk factors to positive herd-level tuberculin reactivity between October 2003 to May 2004 to bovine tuberculosis (BTB) in the four transhumant districts of Uganda: three districts (Karamoja region) of nomadic transhumance cattle rearing (30 superherds and 1522 cattle), and one district (Nakasongola) of fixed-transhumance (7 herds and 342 cattle). We used the comparative intradermal skin-test, sampled 50 animals per superherd/herd, and considered herd positive if there was at least one reactor. Of the 30 superherds under nomadic transhumance, 60% (95% CI 41.4, 79) were tuberculin-test positive; of the 7 fixed herds, 14.3% (95% CI -20.7, 49.2) were tuberculin test positive. The true herd prevalence was estimated at 46.6%. Many risk factors were collinear. The final multivariable logistic-regression model included: recent introductions from market (OR=3.4; 95% CI 1.1, 10.3), drinking water form mud holes during dry season (OR=49; 95% CI 9.1, 262), and the presence of monkeys (OR=0.08; 95% CI 0.0, 0.6) or warthogs (OR=0.1; 95% CI 0.0, 0.3). No association was found between herd size or number of herd contacts with reactors; it was probably masked by the effect of high between-herd interactions. Provision of water from mud holes in dry river beds and introductions of new animals are risk factors that might be targeted to control BTB in transhumance areas.

Responses to tuberculin among Zebu cattle in the transhumance regions of Karamoja and Nakasongola district of Uganda.

Responses to tuberculin in Zebu cattle of the transhumant pastoral farming system in Karamoja region and Nakasongola district in the north-eastern and mid-central regions in Uganda, respectively, were investigated using a comparative intradermal tuberculin skin test. Of the 1864 cattle tested from 30 large units (superherds) in Karamoja and 7 herds in Nakasongola, a total of 28 animals from 19 herds (51.4%) tested positive. Inter-district tuberculin reactor prevalence variations seemed to be influenced by climate, with impact on both the management patterns and transmissibility of agent. High herd tuberculin reactor prevalence (51.4%) was attributed to widespread contacts and mixing of animals between herds. Low individual animal tuberculin test positivity (mean = 1.4%) was attributed to low transmissibility of the agent under the Karamoja climate, which is semi-arid, and to increased resistance due to non-specific response to environmental mycobacteria and natural selection, since there was no active control against bovine tuberculosis. Owing to similarities in management practices in Karamoja and widespread risk factors, it was difficult to identify which were more important, but variations in sources of drinking water pointed to provision of lake and borehole water during dry season as reducing the risk. Positive bovine tuberculin reactor prevalence and skin reactor status were related to age.

Prevalence of thermophilic campylobacter infections in humans, chickens and crows in Morogoro, Tanzania.

Prevalence of thermophilic Campylobacter infections in humans, chickens and crows was determined in a cross-sectional study that was carried out in urban and rural areas of Morogoro region, Tanzania during the period of January 2003 to December 2004. A total of 632 human stool samples, 536 cloacal swabs from local and broiler chickens and 22 intestinal contents from crows were screened for presence of thermophilic campylobacters using Skirrow's protocol. Representative Campylobacter jejuni isolates from human and chicken samples were also analysed by polymerase chain reaction (PCR) as a definitive identification method. The overall prevalence of thermophilic campylobacters was 9.3% (95% CI: 7.2-11.9), 69.8% (95% CI: 65.7-73.6) and 72.7% (95% CI: 49.8-89.3) in humans, chickens and crows respectively. In humans, 59 thermophilic campylobacters were isolated of which 96.6% were C. jejuni and 3.4%Campylobacter coli. There was a significantly (P<0.001) higher prevalence in young individuals (16%) than in adults (7%). Of 341 isolates from chickens, 91.2% were C. jejuni and 8.8% were C. coli. A significantly (P<0.05) higher infection rate was observed in rural local chicken (76%) than in broilers (60%). In crows, of 16 isolates, 93.8% were C. jejuni and 6.2% were C. coli. Definitive identification of C. jejuni by PCR revealed positive results in 74.1% of 243 analysed isolates. Findings in this study indicate high prevalence of thermophilic campylobacters in humans, chickens and crows in Morogoro, and a higher infection rate of C. jejuni than that of C. coli in different animal species. Age of humans and location of chickens were identified as risk factors for thermophilic Campylobacter infections. Positive isolates to biochemical tests that indicated negative results on PCR indicates the additional value of PCR for definitive diagnosis of C. jejuni.

The molecular epidemiology of Mycobacterium bovis infections in Tanzania.

A molecular epidemiological study to determine the zoonotic importance of bovine tuberculosis was carried out in Tanzania. Specimens from human cases of tuberculosis as well as from slaughtered cattle were collected from regions with a high proportion of extrapulmonary tuberculosis. In order to determine the similarity of strains from the two sources, molecular typing techniques, namely RFLP and spoligotyping, were used to determine the genetic profile of the strains involved. The results of pTBN12 typing of M. bovis from cattle and man has shown a rather heterogeneous population of this species spread all over Tanzania, assuming that the present sample is representative. There were 13 different pTBN12 RFLP types encountered. The genetic relatedness between the pTBN12 RFLP patterns indicated a high degree of relatedness (86%) between the dominant pTBN12 genotypes existing in Tanzania. There were 13 different spoligotypes found in this study, whose genetic relatedness was also high (79%). DNA profiles were also confirmed by IS986 RFLP, which revealed that strains have 1-13 copies of IS986. Geographically, there was overlap between pTBN12 RFLP and spoligotypes amongst strains isolated from various parts of Tanzania. The diversity of the RFLP and spoligotype patterns observed in Tanzania probably reflects the extensive internal movements of cattle belonging to pastoralists. The evidence of overlap between DNA fingerprints of M. bovis from cattle and man has once more highlighted a need for synergy of veterinary and medical policies in the control of tuberculosis in Tanzania and probably in other developing countries.

Tuberculosis in Tanzanian wildlife.

Bovine tuberculosis, caused by Mycobacterium bovis, is a pathogen of growing concern in free-ranging wildlife in Africa, but little is known about the disease in Tanzanian wildlife. Here, we report the infection status of Mycobacterium bovis in a range of wildlife species sampled from protected areas in northern Tanzania. M. bovis was isolated from 11.1% (2/18) migratory wildebeest (Connochaetes taurinus) and 11.1% (1/9) topi (Damaliscus lunatus) sampled systematically in 2000 during a meat cropping program in the Serengeti ecosystem, and from one wildebeest and one lesser kudu (Tragelaphus imberbis) killed by sport hunters adjacent to Tarangire National Park. A tuberculosis antibody enzyme immunoassay (EIA) was used to screen serum samples collected from 184 Serengeti lions (Panthera leo) and 19 lions from Ngorongoro Crater sampled between 1985 and 2000. Samples from 212 ungulates collected throughout the protected area network between 1998 and 2001 also were tested by EIA. Serological assays detected antibodies to M. bovis in 4% of Serengeti lions; one positive lion was sampled in 1984. Antibodies were detected in one of 17 (6%) buffalo (Syncerus caffer) in Tarangire and one of 41 (2%) wildebeest in the Serengeti. This study confirms for the first time the presence of bovine tuberculosis in wildlife of northern Tanzania, but further investigation is required to assess the impact on wildlife populations and the role of different wildlife species in maintenance and transmission.

Patient knowledge, practices and challenges to health care system in early diagnosis of mycobacterial adenitis.

OBJECTIVE: To assess diagnostic delay, knowledge and practices related to tuberculosis among patients with mycobacterial adenitis. DESIGN: A cross sectional study involving comparison analysis of high-risk groups. SETTING: Seven hospitals in rural and semi-rural districts of Arusha. SUBJECTS: Four hundred and twenty six clinically diagnosed adenitis patients. INTERVENTIONS: Biopsy specimens were processed for culture, histology, and sera for HIV testing. A questionnaire was used to assess knowledge, practice, and diagnostic time. MAIN OUTCOME MEASURES: Tribal comparisons were made using proportions and means. RESULTS: About 90% (387/423) of patients first visited medical facilities within a mean time of 10.1(SD, 15.7) weeks after becoming aware of their illness, and a diagnosis was made at a mean of 27 (SD, 25) weeks. Non-Iraqw patients, especially the Datoga, practised drinking raw milk (35.2% 43/122), eating raw animal products (18.8% 24/128) and living in houses with poor ventilation (33.6% 44/131), more than Iraqw patients. Of the investigations done, 14.5% (60/415) were culture positive, 11.3% (16/142) were HIV positive, and 73.6% (128/174) had histological features consistent with tuberculosis. The knowledge of TB spread by air droplets was poorer in Iraqw (74.1%, 203/274) than in non-lraqw (61.1%, 77/126) patients. About 35.0% (45/129) of non-lraqw and 27.3% (79/289) of Iraqw patients were not aware that TB could be transmitted from animals to humans. CONCLUSIONS: The health system diagnostic delay is about twice the patient delay. The knowledge and practices related to both human and bovine TB transmission were poor in all patients, especially in the patients from nomadic tribes.

Brucellosis in Arusha and Manyara Regions; Tanzania: A Challenge to Public Health

Setting: Karatu; Ngorongoro; Babati; Mbulu and Hanang districts in Arusha and Manyara regions; Tanzania. Methodology: A retrospective study was conducted in Karatu; Ngorongoro; Babati; Hanang and Mbulu districts in Arusha and Manyara regions between July and September 2002. Review of Hospital records and interview with district medical officers; hospital Incharge and clinicians were conducted.Results: Out 170;345 patients who attended hospitals in Babati; Dareda; Karatu; Hydom; Katesh; Wasso; Endulen and Mbulu hospitals in the year 2001; 619(0.36) were diagnosed as having brucellosis. It was found out that women suffer from brucellosis more than males. Out of 619 cases of brucellosis reported in the year 2001; 432 (69.8) were females and 187(30.2) were males. Most of the patients were of the age between 16-35 (46.3) i.e. after school age compared to the middle aged 36-50 (30.4). Few cases were found in the pre school age (7 years); school age (7-15) and old age (50 years) Conclusion There is a need to carry out a study that will establish the burden caused by brucellosis in the area. This should also include investigating the relationship between infection in animals and that in humans. There is also a need to investigate the burden of the disease to the community as well and not only to those who attend hospitals. Factors that favor acquisition of brucellosis to animals and subsequent transmission to humans must be explored and pointed out clearly so that the communities can be made aware of and hence minimize the chances for transmission of brucellosis