Leptospirosis outbreak in Tanzania: An alarming situation

Masunga, Daniel Stephen; Rai, Anushree; Abbass, Mortada; Uwishema, Olivier; Wellington, Jack; Uweis, Lama; Saleh, Rayyan El; Arab, Sara; Onyeaka, Chinyere Vivian Patrick; Onyeaka, Helen

doi:10.1016/j.amsu.2022.104347

Cited by 12 publications

(9 citation statements)

References 20 publications

(31 reference statements)

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“…In July 2022, Tanzania experienced re-emerging leptospirosis in the southern part (Lindi). Twenty confirmed cases and three deaths associated with symptoms of nasal bleeds, fever, headaches, and fatigue were reported [17]. Lack of diagnostic equipment and knowledge among healthcare workers on leptospirosis has led to misdiagnosis in favor of malaria due to the similarities in clinical symptoms [12,18].…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence of leptospirosis among hospitalized febrile patients in Unguja Island

et al. 2023

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Background: Leptospirosis is one of the neglected causes of febrile illness and death in developing countries, including Tanzania. The study aims to determine the seroprevalence of leptospirosis among hospitalized febrile patients in Unguja Island. Methods: A cross-sectional study was carried out in the three selected hospitals in Unguja Island between January and March 2022. A total of 402 participants with febrile illness were enrolled in the study, and blood samples were collected for sera preparation. Microscopic agglutination test (MAT) was used to detect antibodies against five Leptospira serovars, including Sokoine, Lora, Pomona, Grippotyphosa, and Hebdomadis. All sera samples reacted with MAT titers≥1:160 were counted as positive, MAT titers ranging from 1:20 to 1:80 were counted as exposed to Leptospira bacteria while the absence of agglutination was regarded as negative. The data was analyzed using SPSS version 26, 2019. Descriptive and logistic regression was performed, and p≤0.05 was considered statistically significant. Results: The mean age of study participants was 29.62 ±16.34, with a range of 0 days to 80 years. Most of them were females (64.2%) and unemployed (67.9%). The overall seroprevalence of leptospirosis was 7.7% (95% CI: 5.3-10.8). Females were 1.016 times higher likelihood to have leptospirosis (AOR = 1.016, 95% CI: 0.47-2.185, p = 0.968). Participants aged 18-35 were 2.093 times more likely to be infected with leptospirosis (AOR= 2.093, 95% CI: 0.835-5.250, p = 0.115). Participants who were unemployed (AOR = 1.169, 95% CI: 0.522-2.615, p = 0.704) revealed a significantly higher likelihood of being infected with leptospirosis. The predominant Leptospira serovars circulating among febrile patients were Sokoine 44 (10.9%), Lora 25 (6.2%), Grippotyphosa 20 (5.0%), Pomona 10 (2.5%), and Hebdomadis 9 (2.2%). Conclusion: Leptospirosis is a public health threat among febrile patients in Unguja Island; therefore, it’s important to be considered in the differential diagnosis of non-malaria febrile patients for early prevention and control strategies.

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Section: Introductionmentioning

confidence: 99%

Seroprevalence of leptospirosis among hospitalized febrile patients in Unguja Island

et al. 2023

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“…It enters intact mucus membrane or an abraded skin of human to cause systemic febrile illness in the population that work with animals or contaminated paddy field. Leptospirosis has worldwide distribution[ 10 11 12 13 14 15 16 17 18 19 20 21 22 23 ] and several reports have come out from India as well. [ 1 2 3 4 24 25 26 27 28 29 30 31 32 33 34 35 36 37 37 39 ] Primary infective stage/fever occur in monsoon season; however, ocular manifestation is late immune reaction.…”

Section: Discussionmentioning

confidence: 99%

Leptospiral uveitis- “Transition ‘from epidemic to endemic form” difficulties in laboratory confirmation

Rathinam,

Kohila,

Gowri

et al. 2023

Indian Journal of Ophthalmology

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Purpose: Leptospirosis is a waterborne zoonotic disease that primarily causes systemic illness, followed by uveitis. After heavy flooding in Madurai district, an epidemic outbreak of systemic and ocular leptospirosis occurred in 1994. Our data shows a transition to endemicity after each epidemic. Aim: The aim of this study is to report the clinical signs, epidemic outbreaks, and persistent endemicity of leptospiral uveitis, as well as the diagnostic dilemmas associated with it. Methods: A retrospective analysis of clinical signs was conducted using medical records of leptospiral uveitis patients over a period of 27 years (1994–2020) in a tertiary care eye hospital. The clinical workup of uveitis included a detailed clinical history, systemic, and ophthalmic examination. Microagglutination tests (MATs) was done at the Centers for Disease Control and Prevention (CDC) in Atlanta and later in our regional laboratory. Serum samples were collected from human systemic leptospirosis cases and a small group of animals in and around Madurai. Results: The first epidemic outbreak resulted in 200 seropositive patients. Subsequent epidemic outbreaks occurred in 1997, 1998, 2001, 2005, and 2012, with Madurai experiencing multiple outbreaks. However, the disease remained endemic, with 25–50 patients being observed per year in between the peaks. Ocular examination revealed acute non-granulomatous uveitis (94.9%), pan uveitis (59.8%), vitreous inflammatory reaction (55.4%), retinal vasculitis (29.5%), disc hyperemia (20.9%), and hypopyon. (16.2%). New serovars emerged every year, resulting in decreased sensitivity of the MAT. Over time, the MAT started to miss diagnoses. Conclusion: The persistent endemicity of leptospiral uveitis emphasizes the need for accessible diagnostic tests. The low performance of the MAT can be attributable to the use of an older panel. The incorporation of new isolates in the MAT by a national laboratory will improve the accuracy of diagnosis.

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“…Effective implementation of this policy will prevent polio cases due to OPV uses among children, since the current epidemiological alert is like to OPV [ 16 ]. As far as poliomyelitis epidemiological alert is concerned, countries and member states are advised to have outbreak response strategic plans in place so that to be prepared to respond in a timely fashion to the occurrence of an imported wild poliovirus (WPV) or vaccine-derived poliovirus case or the emergence of VDPV2 in their counties [ 17 ]. These recommendations can be applied in other countries especially the low and middle-income countries as a preparatory strategy to respond immediately to poliomyelitis cases in the future [ [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] ] [ [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] ] (See Fig.…”

Section: Recommendationsmentioning

confidence: 99%