BackgroundBrucellosis is a zoonosis of veterinary, public health and economic significance in most developing countries. Human brucellosis is a severely debilitating disease that requires prolonged treatment with a combination of antibiotics. The disease can result in permanent and disabling sequel, and results in considerable medical expenses in addition to loss of income due to loss of working hours. A study was conducted in Northern Tanzania to determine the risk factors for transmission of brucellosis to humans in Tanzania.MethodsThis was a matched case-control study. Any patient with a positive result by a competitive ELISA (c-ELISA) test for brucellosis, and presenting to selected hospitals with at least two clinical features suggestive of brucellosis such as headache, recurrent or continuous fever, sweating, joint pain, joint swelling, general body malaise or backache, was defined as a case. For every case in a district, a corresponding control was traced and matched by sex using multistage cluster sampling. Other criteria for inclusion as a control included a negative c-ELISA test result and that the matched individual would present to hospital if falls sick.ResultsMultivariable analysis showed that brucellosis was associated with assisted parturition during abortion in cattle, sheep or goat. It was shown that individuals living in close proximity to other households had a higher risk of brucellosis. People who were of Christian religion were found to have a higher risk of brucellosis compared to other religions. The study concludes that assisting an aborting animal, proximity to neighborhoods, and Christianity were associated with brucellosis infection. There was no association between human brucellosis and Human Immunodeficiency Virus (HIV) serostatus. Protecting humans against contact with fluids and tissues during assisted parturition of livestock may be an important means of reducing the risk of transferring brucellosis from livestock to humans. These can be achieved through health education to the communities where brucellosis is common.

Background: Many factors have been mentioned as contributing to under-diagnosis and underreporting of zoonotic diseases particularly in the sub-Sahara African region. These include poor disease surveillance coverage, poor diagnostic capacity, the geographical distribution of those most affected and lack of clear strategies to address the plight of zoonotic diseases. The current study investigates the knowledge of medical practitioners of zoonotic diseases as a potential contributing factor to their under-diagnosis and hence under-reporting.

Background: Delay in Tuberculosis (TB) case detection may worsen the disease and increase TB transmission. It is also a challenge to the National TB and Leprosy control Program (NTLP).

Tuberculosis is a major public health problem in developing countries, 1 where sputum smear microscopy is the most common technique for diagnosing the disease. This method has limitations, the most serious being inaccuracy, when large numbers of sputum samples are analyzed.2 Hence, alternative diagnostic tools are badly needed. In recent years, researchers have explored the possibility of using trained giant African pouched rats ( Cricetomys gambianus ), to screen sputum samples rapidly and accurately. A recent study 3 reported that 18 of 20 pouched rats could detect the presence of Mycobacterium tuberculosis in sputum samples at least as well as, and more quickly than, trained microscopists using the standard Ziehl Neelsen (ZN) method. 3In 2009, the rats analyzed sputum samples collected from five Direct Observation Treatment Short-Course (DOTS) centers in Dar es Salaam, Tanzania.4 Sputum samples were used to prepare microscope slides that were stained by the ZN method and evaluated under light microscopes by technicians at the DOTS centers. Sputum remaining after smears were prepared was frozen and the samples were sent to Anti-Persoonsmijnen Ontmijnende Product Ontwikkeling (APOPO) for subsequent analysis by the rats. Thus, the rats were used in a context that approximated second-line tuberculosis (TB) screening. This work describes their performance in that capacity.Ethical clearance to conduct the reported research was obtained from the Tanzanian National Institute for Medical Research. The manner in which rats were maintained, trained, and used in evaluating sputum samples is detailed elsewhere. 3,5 In brief, they were rewarded with a mouthful of banana for pausing at sputum samples known to contain M. tuberculosis but not for pausing at other sputum samples. Through such training, they learned to pause reliably only at samples that were positive for TB. In simulated second-line screening the rats worked in a 10-hole stainless steel cage 205 cm long, 55 cm wide, and 55 cm high, shown elsewhere.3 Sputum samples obtained from the DOTS centers and autoclaved to kill infectious microorganisms were presented in small pots located immediately below the holes. The status of samples with respect to microscopy was known and the rats were rewarded with food when they kept their nose in a hole above a TB-positive sample for at least 5 seconds, which defines an indicator response. Indicator responses to samples deemed by microscopists to be TB-negative were of particular interest, because such responses may indicate detection of TB-positive cases initially missed by the DOTS centers.Ten rats evaluated every sample. Any sample reported as TB-negative by a DOTS center but TB-positive by two or more rats was evaluated by a second ZN microscopic analysis performed by a technician in our laboratory. Those cases found positive in this analysis were designated as new case detections. They were reported to the appropriate DOTS Centers for follow-up testing and, if appropriate, treatment.In 2009, 23,101 sputum samples from 10,...

Setting. Tanzania. Objective. To compare microscopy as conducted in direct observation of treatment, short course centers to pouched rats as detectors of Mycobacterium tuberculosis. Design. Ten pouched rats were trained to detect tuberculosis in sputum using operant conditioning techniques. The rats evaluated 910 samples previously evaluated by smear microscopy. All samples were also evaluated through culturing and multiplex polymerase chain reaction was performed on culture growths to classify the bacteria. Results. The patientwise sensitivity of microscopy was 58.0%, and the patient-wise specificity was 97.3%. Used as a group of 10 with a cutoff (defined as the number of rat indications to classify a sample as positive for Mycobacterium tuberculosis) of 1, the rats increased new case detection by 46.8% relative to microscopy alone. The average samplewise sensitivity of the individual rats was 68.4% (range 61.1–73.8%), and the mean specificity was 87.3% (range 84.7–90.3%). Conclusion. These results suggest that pouched rats are a valuable adjunct to, and may be a viable substitute for, sputum smear microscopy as a tuberculosis diagnostic in resource-poor countries.