Brucellosis testing patterns at health facilities in Arusha region, northern Tanzania

Lukambagire, AbdulHamid S.; Shirima, Gabriel; Shayo, Damas Davis; Mathew, Coletha; Yapi, Richard B.; Mmbaga, Blandina T.; Kazwala, Rudovick; Halliday, Jo E. B.

doi:10.1371/journal.pone.0265612

Cited by 6 publications

(4 citation statements)

References 36 publications

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“…This requirement for diagnostic confirmation at the central level places unnecessary delays on case confirmation and the initiation of outbreak response and control measures; this delay could introduce inaccuracies to national epidemiological monitoring as well as burden of disease estimates. Therefore, our short-term recommendations reinforce training and education on reporting guidelines for clinicians, laboratories and local health officials to support efficiency of the passive surveillance system [ 36 , 37 ]. Efforts to bolster reporting compliance should acknowledge endemic and emerging zoonotic risks factors to local communities, particularly rural areas in Libya, due to increased exposure to livestock and wildlife and consumption of raw milk products [ 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Using One Health assessments to leverage endemic disease frameworks for emerging zoonotic disease threats in Libya

Miller,

Elmselati,

Fogarty

et al. 2023

PLOS Glob Public Health

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Continued emergence, re-emergence and spread of zoonotic diseases demonstrates the imperative need for multisectoral communication and joint coordination of disease detection and response. While there are existing international frameworks underpinning One Health capacity building for pandemic prevention and response, often guidance does not account for challenges faced by countries undergoing long-term conflict and sociopolitical instability. The purpose of this research was to identify Libya’s laboratory and surveillance networks and routes of inter- and multisectoral communication and coordination for priority zoonotic diseases. The One Health Systems Assessment for Priority Zoonoses (OH-SAPZ) tool is an established methodology that was adapted and applied to the Libyan context to support prioritization of zoonotic diseases, development of systems map schematics outlining networks of communication and coordination, and analysis of operations for targeted capacity building efforts. Five zoonotic diseases were selected to undergo assessment: highly pathogenic avian influenza, brucellosis, Rift Valley fever, leishmaniasis and rabies. Through decisive acknowledgement of Libya’s unique health setting, we mapped how patient and sample information is both communicated within and between the human, animal and environmental health sectors, spanning from local index case identification to international notification. Through our assessment we found strong communication within the public and animal health sectors, as well as existing multisectoral coordination on zoonotic disease response. However, local-level communication between the sectors is currently lacking. Due to the ongoing conflict, resources (financial and human) and access have been severely impacted, resulting in limited laboratory diagnostic capacity and discontinued disease prevention and control measures. We sought to identify opportunities to leverage existing operations for endemic diseases like brucellosis for emerging zoonotic threats, such as Rift Valley fever. Analysis of these operations and capabilities supports the development of targeted recommendations that address gaps and may be used as an implementation guide for future One Health capacity building efforts.

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Section: Discussionmentioning

confidence: 99%

Using One Health assessments to leverage endemic disease frameworks for emerging zoonotic disease threats in Libya

Miller,

Elmselati,

Fogarty

et al. 2023

PLOS Glob Public Health

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“…“Febrile antigen” kits for human brucellosis are marketed and widely used in low- and middle-income countries in Africa and Ibero-America and, as far as we have documented, in Pakistan. Studies in Kenya and Tanzania [ 155 , 160 , 161 , 162 , 163 , 164 ] have conclusively shown that these tests are a source of a very high proportion of false-positive results (over 95% in 800 febrile patients [ 160 ]), in all likelihood because of the smooth to rough dissociation issues [ 3 ]. Their use causes unnecessarily prolonged, expensive treatments and makes many records of human brucellosis prevalence unreliable, as found in Tanzania [ 162 ].…”

Section: One-health Challenges For Brucellosismentioning

confidence: 99%

“…Studies in Kenya and Tanzania [ 155 , 160 , 161 , 162 , 163 , 164 ] have conclusively shown that these tests are a source of a very high proportion of false-positive results (over 95% in 800 febrile patients [ 160 ]), in all likelihood because of the smooth to rough dissociation issues [ 3 ]. Their use causes unnecessarily prolonged, expensive treatments and makes many records of human brucellosis prevalence unreliable, as found in Tanzania [ 162 ]. Even worse, the disconnection of the epidemiological data and true brucellosis hides the effect of any control measures (hygiene, vaccination, and other issues), generating skepticism and mistrust of One Health recommendations among stakeholders, particularly farmers (see below).…”

Section: One-health Challenges For Brucellosismentioning

confidence: 99%

Brucellosis and One Health: Inherited and Future Challenges

et al. 2023

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One Health is the collaborative efforts of multiple disciplines to attain optimal health for people, animals and the environment, a concept that historically owes much to the study of brucellosis, including recent political and ethical considerations. Brucellosis One Health actors include Public Health and Veterinary Services, microbiologists, medical and veterinary practitioners and breeders. Brucellosis awareness, and the correct use of diagnostic, epidemiological and prophylactic tools is essential. In brucellosis, One Health implementation faces inherited and new challenges, some aggravated by global warming and the intensification of breeding to meet growing food demands. In endemic scenarios, disease awareness, stakeholder sensitization/engagement and the need to build breeder trust are unresolved issues, all made difficult by the protean characteristics of this zoonosis. Extended infrastructural weaknesses, often accentuated by geography and climate, are critically important. Capacity-building faces misconceptions derived from an uncritical adoption of control/eradication strategies applied in countries with suitable means, and requires additional reference laboratories in endemic areas. Challenges for One Health implementation includee the lack if research in species other than cattle and small ruminants, the need for a safer small ruminant vaccine, the need to fill in the infrastructure gap, the need for realistic capacity-building, the creation of reference laboratories in critical areas, and the stepwise implementation of measures not directly transposed from the so-called developed countries.

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“…8 The true burden of the disease in developing countries is underestimated due to poor surveillance systems 7 and lack of accurate diagnostic tools. 9 Early and accurate diagnosis is necessary to guide treatment in humans and establish control measures in animals.…”

Section: Introductionmentioning

confidence: 99%

Scent detection of Brucella abortus by African giant pouched rats (Cricetomys ansorgei).

Mwampashi

Cutright²,

Fast³

et al. 2023

Preprint

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Background Brucellosis is a contagious zoonosis caused by Brucella bacterium. While the disease has been eradicated in most developed countries, it remains endemic in sub–Saharan Africa where access to reliable diagnostics is limited. African giant pouched rats (Cricetomys ansorgei) have been trained to detect the scent of Mycobacterium tuberculosis to increase case detection in sub-Saharan Africa. Given the similar diagnostic challenges facing brucellosis and tuberculosis, we explored the feasibility of training African giant pouched rats to detect Brucella. Results After 3 months of training, rats reliably identified cultured Brucella, achieving an average sensitivity of 93.56% (SD = 0.650) and specificity of 97.65% (SD = 0.016). Rats readily generalized to novel, younger Brucella cultures that presumably generated a weaker volatile signal and correctly identified at least one out of three fecal samples spiked with Brucella culture during a final test of feasibility. Discussion To our knowledge, these experiments are the first to demonstrate Brucella emits a unique odor profile that scent detection animals can be trained to identify. Importantly, cultured E. colisamples were included throughout training and test to ensure the rats learned to specifically identify Brucella bacteria rather than any bacteria in comparison to bacteria-free culture medium. E. coli controls therefore served a crucial function in determining to what extent Brucella abortus emits a unique odor signature. Further research is needed to determine if a Brucella-specific volatile signature is present within clinical samples. If confirmed, the present results suggest trained rats could serve as a valuable, novel method for the detection of Brucellainfection.

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Brucellosis testing patterns at health facilities in Arusha region, northern Tanzania

Cited by 6 publications

References 36 publications

Using One Health assessments to leverage endemic disease frameworks for emerging zoonotic disease threats in Libya

Using One Health assessments to leverage endemic disease frameworks for emerging zoonotic disease threats in Libya

Brucellosis and One Health: Inherited and Future Challenges

Scent detection of Brucella abortus by African giant pouched rats (Cricetomys ansorgei).

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