Risk factors for human acute leptospirosis in northern Tanzania

Maze, Michael J.; Cash‐Goldwasser, Shama; Rubach, Matthew P.; Biggs, Holly M.; Galloway, Renee L.; Sharples, Katrina; Allan, Kathryn J.; Halliday, Jo E. B.; Cleaveland, Sarah; Shand, Mike; Muiruri, Charles; Kazwala, Rudovick; Saganda, Wilbrod; Lwezaula, Bingileki F.; Mmbaga, Blandina T; Maro, Venance P.; Crump, John A.

doi:10.1371/journal.pntd.0006372

Cited by 48 publications

(57 citation statements)

References 40 publications

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“…Serological data from human cases in Tanzania does exists [ 10 , 11 ] but the poor correlation between genotype and serogroup for Leptospira bacteria limits our ability to robustly link these data to attribute sources of Leptospira infection [ 7 , 68 ]. However, epidemiological studies have identified milking cattle, feeding and cleaning cattle and handling cattle waste as significant risk factors for human Leptospira infection in Moshi and neighbouring regions [ 69 , 70 ]. These findings suggest that cattle are indeed an important source of Leptospira infection for people in northern Tanzania and provide a strong rationale for further investigation linked human and cattle populations to better understand the relationship between human and bovine infection.…”

Section: Discussionmentioning

confidence: 99%

Assessment of animal hosts of pathogenic Leptospira in northern Tanzania

et al. 2018

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Leptospirosis is a zoonotic bacterial disease that affects more than one million people worldwide each year. Human infection is acquired through direct or indirect contact with the urine of an infected animal. A wide range of animals including rodents and livestock may shed Leptospira bacteria and act as a source of infection for people. In the Kilimanjaro Region of northern Tanzania, leptospirosis is an important cause of acute febrile illness, yet relatively little is known about animal hosts of Leptospira infection in this area. The roles of rodents and ruminant livestock in the epidemiology of leptospirosis were evaluated through two linked studies. A cross-sectional study of peri-domestic rodents performed in two districts with a high reported incidence of human leptospirosis found no evidence of Leptospira infection among rodent species trapped in and around randomly selected households. In contrast, pathogenic Leptospira infection was detected in 7.08% cattle (n = 452 [5.1–9.8%]), 1.20% goats (n = 167 [0.3–4.3%]) and 1.12% sheep (n = 89 [0.1–60.0%]) sampled in local slaughterhouses. Four Leptospira genotypes were detected in livestock. Two distinct clades of L. borgpetersenii were identified in cattle as well as a clade of novel secY sequences that showed only 95% identity to known Leptospira sequences. Identical L. kirschneri sequences were obtained from qPCR-positive kidney samples from cattle, sheep and goats. These results indicate that ruminant livestock are important hosts of Leptospira in northern Tanzania. Infected livestock may act as a source of Leptospira infection for people. Additional work is needed to understand the role of livestock in the maintenance and transmission of Leptospira infection in this region and to examine linkages between human and livestock infections.

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Section: Discussionmentioning

confidence: 99%

Assessment of animal hosts of pathogenic Leptospira in northern Tanzania

et al. 2018

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“…To detect the presence of Leptospira among febrile patients, we used plasma, serum, and urine collected from patients enrolled in two fever etiology studies that have been previously described. 2,13 Briefly, we enrolled adult and pediatric inpatients admitted with a fever at the KCMC and MRRH from September 2007 through August 2008 (study 1) and from February 2012 through May 2014 (study 2). A questionnaire was administered to each participant that included questions on the duration of illness and any antibacterial treatment received before presentation at the hospital.…”

Section: Methodsmentioning

confidence: 99%

“…Leptospirosis is a zoonotic disease, with an estimated annual incidence of up to approximately 100 cases per 100,000 people in Tanzania. 1 Previous studies in Tanzania have identified contact with cattle and working in rice fields as risk factors for acute human leptospirosis, 2,3 but further data are needed to understand transmission pathways and to confirm sources of Leptospira infection for people. Pathogenic Leptospira have been detected by culture or nucleic acid amplification methods in a number of animal hosts in Tanzania including cattle, goats, sheep, and rodents.…”

Section: Introductionmentioning

confidence: 99%

Molecular Detection and Typing of Pathogenic Leptospira in Febrile Patients and Phylogenetic Comparison with Leptospira Detected among Animals in Tanzania

Allan

Maze

Galloway

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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Molecular data are required to improve our understanding of the epidemiology of leptospirosis in Africa and to identify sources of human infection. We applied molecular methods to identify the infecting Leptospira species and genotypes among patients hospitalized with fever in Tanzania and compared these with Leptospira genotypes detected among animals in Tanzania to infer potential sources of human infection. We performed lipL32 real-time PCR to detect the presence of pathogenic Leptospira in acute-phase plasma, serum, and urine samples obtained from study participants with serologically confirmed leptospirosis and participants who had died with febrile illness. Leptospira blood culture was also performed. In positive specimens, we performed species-specific PCR and compared participant Leptospira secY sequences with Leptospira reference sequences and sequences previously obtained from animals in Tanzania. We detected Leptospira DNA in four (3.6%) of 111 participant blood samples. We detected Leptospira borgpetersenii (one participant, 25.0%), Leptospira interrogans (one participant, 25.0%), and Leptospira kirschneri (one participant, 25.0%) (one [25%] undetermined). Phylogenetic comparison of secY sequence from the L. borgpetersenii and L. kirschneri genotypes detected from participants was closely related to but distinct from genotypes detected among local livestock species. Our results indicate that a diverse range of Leptospira species is causing human infection. Although our analysis suggests a close relationship between Leptospira genotypes found in people and livestock, continued efforts are needed to obtain more Leptospira genetic material from human leptospirosis cases to help prioritize Leptospira species and genotypes for control.

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“…Rice farming, cleaning cattle waste, feeding cattle, farm work and increased exposure to cattle urine have been identified as risk factors for human leptospirosis in sub-Saharan Africa. 17…”

Section: Reservoir Source and Mode Of Transmissionmentioning

confidence: 99%

Fever, bacterial zoonoses, and One Health in sub-Saharan Africa

2019

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Although often underappreciated, a number of bacterial zoonoses are endemic in Africa. Of these, brucellosis, leptospirosis, Q fever, and rickettsioses are responsible for a substantial proportion of febrile illness among patients seeking hospital care. In this paper, we discuss the aetiology, epidemiology, clinical presentation, diagnosis, treatment and prevention of these bacterial zoonoses. To prevent and control bacterial zoonoses, strategies targeting both animals and humans are crucial. These may lead to better outcomes than strategies based exclusively on treatment of human infections. Such strategies are referred to as the 'One Health' approach; the collaborative effort of multiple disciplines to attain optimal health for people, animals and the environment.

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Risk factors for human acute leptospirosis in northern Tanzania

Cited by 48 publications

References 40 publications

Assessment of animal hosts of pathogenic Leptospira in northern Tanzania

Assessment of animal hosts of pathogenic Leptospira in northern Tanzania

Molecular Detection and Typing of Pathogenic Leptospira in Febrile Patients and Phylogenetic Comparison with Leptospira Detected among Animals in Tanzania

Fever, bacterial zoonoses, and One Health in sub-Saharan Africa

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