Background: Anthrax continues to be a disease of public health importance in Zimbabwe, with sporadic outbreaks reported annually in many parts of the country. A human anthrax outbreak occurred in wards 22 and 23 of Makoni District from mid-June 2013 to end of January 2014, following cattle deaths in the wards. Laboratory tests confirmed anthrax as the cause for the cattle deaths. This study aims to investigate the clinical characteristics, distribution of anthrax cases (places, person and time), risk factors for contracting the disease, environmental assessment, district preparedness and response, and outbreak prevention and control measures.Methods: We conducted an outbreak investigation using a mixed-methods design. A 1:1 case-control study was used to assess risk factors for contracting anthrax. The controls were frequency matched to cases by sex. Data were collected using a structured interviewer-administered questionnaire. Environmental assessment, district preparedness and response, and outbreak prevention and control measures were assessed using a checklist, observations, and key informant interviews. Multivariable unconditional logic regression analysis was performed to identify independent risk factors associated with contracting anthrax.Results: We interviewed 37 of the 64 cases, along with 37 controls. All the cases had cutaneous anthrax, with the hand being the most common site of the eschar (43%). Most of the cases (89%) were managed according to the national guidelines. Multivariable analysis demonstrated that meat sourced from other villages [vs butchery, OR = 15.21, 95% CI (2.32-99.81)], skinning [OR = 4.32, 95% CI (1.25-14.94)], and belonging to religions that permit eating meat from cattle killed due to unknown causes or butchered after unobserved death [OR = 6.12, 95% CI (1.28-29.37)] were associated with contracting anthrax. The poor availability of resources in the district caused a delayed response to the outbreak.Conclusion: The described anthrax outbreak was caused due to contact with infected cattle meat. Although the outbreak was eventually controlled through cattle vaccination and health education and awareness campaigns, the response of the district office was initially delayed and insufficient. The district should strengthen its emergency preparedness and response capacity, revive zoonotic committees, conduct awareness campaigns and improve surveillance, especially during outbreak seasons.
Background : The first official clinical case of human anthrax case was made at Makoni District Medical Office on the 19 th of December 2013. This followed cattle deaths which were confirmed in the laboratory to be due to anthrax. We report the clinical characteristics, distribution of anthrax cases (place and time), risk factors for contracting the disease, environmental assessment, district preparedness and response and outbreak prevention and control measures. Methods: We conducted an outbreak investigation with the design of a 1:1 unmatched case-control study. Data were collected using a structured questionnaire. Environmental assessment, district preparedness and response and outbreak prevention and control measures were assessed using checklists through observations and key informant interviews. Data were analyzed using Stata-16. Bivariate analysis was performed to identify risk factors for contracting anthrax. Results: Thirty-seven cases (37) and 37 controls were interviewed. All the cases had cutaneous anthrax with commonest site of eschar being the hand (43%). Most of the cases (89%) were managed according to national guidelines. Eating meat from a from a cattle slaughtered due unknown illness or died alone [OR = 7.00 , 95%CI(2.06-23.82], skinning [OR = 5.04, 95%CI(1.77-14.36)], cutting meat [OR = 5.32, 95%CI(1.91-14.77)], cooking meat [OR = 3.42, 95%CI(1.32-8.91.)], source of from other villagers [vs butchery, OR = 14.85, 95%CI(2.79-79.06)], cuts during cutting meat or skinning cattle [OR = 3.50, 95% CI(1.18-10.51)], belonging to a religion which permits eating meat from a from a cattle slaughtered due unknown illness or died alone [OR = 6.29, 95%CI(1.85-21.39)] were associated with contracting anthrax. Having heard of anthrax before was protective against contracting anthrax [OR = 0.35, 95%CI (0.13-0.93)]. The district was ill-equipped and delay to respond to the outbreak. Conclusion: The anthrax outbreak resulted from contact with and consumption of infected cattle meat. The district delayed and was not prepared to control the outbreak. However, the outbreak was controlled through cattle vaccination; health education and awareness campaigns. The district should strengthen its emergence preparedness and response capacity, revive zoonotic committees, conduct awareness campaign during the high-risk period and improve the surveillance of anthrax during high risk periods.
Introduction during a Global Fund sub-sub recipients (SSRs) and implementing partners (IPs) review meeting for quarter 14 held in September 2013, several reports on mismanagement of vehicles were reported. We were then prompted to assess the transport management systems for the SSRs and IPs. Methods we conducted a descriptive cross-sectional study. The study participants were managers, drivers and other personnel involved in transport management. We also assessed the conditions of the vehicles. Data were collected using a questionnaire and checklist. Results we interviewed ten participants, seven from the IPs and three from the SSRs. Understanding and knowledge on the contents of the Memorandum of Understanding (MOU) which accompanied the vehicles were low. Six out of the ten organisations had operational vehicle policies but had shallow content. Eighteen (18) vehicles were assessed, 16 runners and two non-runners. Fifteen (15/18) of the vehicles did not have valid Zimbabwe National Authority for Road Administration (ZINARA) license discs. Only one (1/18) vehicle had a valid Zimbabwe Broadcasting Cooperation (ZBC) license disc. Of the 18 vehicles, 12 were insured with comprehensive insurance cover. Seven (7/18) of the vehicles were once involved in an accident. All the vehicles were serviced on a quarterly basis. Six (6/18) vehicles had both records of monthly service expenses and fuel returns. All the vehicles had logbooks, but only 8/18 of them were carbonated. Some sections of logbooks were incomplete. Conclusion the transport management systems for the IPs and SSRs were below standard. We recommended the training and capacity building of IPs and SSRs in transport management.
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