Browsing by Author "Lupindu, A. M."
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Item Bacteremia in critical care units at Bugando Medical Centre, Mwanza, Tanzania: the role of colonization and contaminated cots and mothers’ hands in cross-transmission of multidrug resistant Gram-negative bacteria(Antimicrobial Resistance and Infection Control, 2020) Silago, V.; Kovacs, D.; Msanga, D. R.; Seni, J.; Matthews, L.; Oravcová, K.; Zadoks, R. N.; Lupindu, A. M.; Hoza, A. S.; Mshana, S. E.Background: Multidrug resistance (MDR) is a major clinical problem in tertiary hospitals in Tanzania and jeopardizes the life of neonates in critical care units (CCUs). To better understand methods for prevention of MDR infections, this study aimed to determine, among other factors, the role of MDR-Gram-negative bacteria (GNB) contaminating neonatal cots and hands of mothers as possible role in transmission of bacteremia at Bugando Medical Centre (BMC), Mwanza, Tanzania. Methods: This cross-sectional, hospital-based study was conducted among neonates and their mothers in a neonatal intensive care unit and a neonatology unit at BMC from December 2018 to April 2019. Blood specimens (n = 200) were sub- cultured on 5% sheep blood agar (SBA) and MacConkey agar (MCA) plates. Other specimens (200 neonatal rectal swabs, 200 maternal hand swabs and 200 neonatal cot swabs) were directly inoculated on MCA plates supplemented with 2 μg/ml cefotaxime (MCA-C) for screening of GNB resistant to third generation cephalosporins, r-3GCs. Conventional biochemical tests, Kirby-Bauer technique and resistance to cefoxitin 30 μg were used for identification of bacteria, antibiotic susceptibility testing and detection of MDR-GNB and screening of potential Amp-C beta lactamase producing GNB, respectively. Results: The prevalence of culture confirmed bacteremia was 34.5% of which 85.5% were GNB. Fifty-five (93.2%) of GNB isolated from neonatal blood specimens were r-3GCs. On the other hand; 43% of neonates were colonized with GNB r- 3GCs, 32% of cots were contaminated with GNB r-3GCs and 18.5% of hands of neonates’ mothers were contaminated with GNB r-3GCs. The prevalences of MDR-GNB isolated from blood culture and GNB r-3GCs isolated from neonatal colonization, cots and mothers’ hands were 96.6, 100, 100 and 94.6%, respectively. Significantly, cyanosis (OR[95%CI]: 3.13[1.51–6.51], p = 0.002), jaundice (OR[95%CI]: 2.10[1.07–4.14], p = 0.031), number of invasive devices (OR[95%CI]: 2.52[1.08–5.85], p = 0.031) and contaminated cot (OR[95%CI]: 2.39[1.26–4.55], p = 0.008) were associated with bacteremia due to GNB. Use of tap water only (OR[95%CI]: 2.12[0.88–5.09], p = 0.040) was protective for bacteremia due to GNB. Conclusion: High prevalence of MDR-GNB bacteremia and intestinal colonization, and MDR-GNB contaminating cots and mothers’ hands was observed. Improved cots decontamination strategies is crucial to limit the spread of MDR- GNB. Further, clinical presentations and water use should be considered in administration of empirical therapy whilst awaiting culture results.Item Characterisation of commensal escherichia coli isolated from apparently healthy cattle and their attendants in Tanzania(PLOS ONE, 2016-12-15) Madoshi, B. P.; Kudirkiene, E; Mtambo, M. M. A.; Muhairwa, A. P.; Lupindu, A. M.; Olsen, J. E.While pathogenic types of Escherichia coli are well characterized, relatively little is known about the commensal E. coli flora. In the current study, antimicrobial resistance in commensal E. coli and distribution of ERIC-PCR genotypes among isolates of such bacteria from cattle and cattle attendants on cattle farms in Tanzania were investigated. Seventeen E. coli genomes representing different ERIC-PCR types of commensal E. coli were sequenced in order to determine their possible importance as a reservoir for both antimicrobial resistance genes and virulence factors. Both human and cattle isolates were highly resistant to tetracycline (40.8% and 33.1%), sulphamethazole-trimethoprim (49.0% and 8.8%) and ampicillin (44.9% and 21.3%). However, higher proportion of resistant E. coli and higher frequency of resistance to more than two antimicrobials was found in isolates from cattle attendants than isolates from cattle. Sixteen out of 66 ERIC-PCR genotypes were shared between the two hosts, and among these ones, seven types contained isolates from cattle and cattle attendants from the same farm, suggesting transfer of strains between hosts. Genome-wide analysis showed that the majority of the sequenced cattle isolates were assigned to phylogroups B1, while human isolates represented phylogroups A, C, D and E. In general, in silico resistome and virulence factor identification did not reveal differences between hosts or phylogroups, except for lpfA and iss found to be cattle and B1 phylogroup specific. The most frequent plasmids replicon genes found in strains from both hosts were of IncF type, which are commonly associated with carriage of antimicrobial and virulence genes. Commensal E. coli from cattle and attendants were found to share same genotypes and to carry antimicrobial resistance and virulence genes associated with both intra and extraintestinal E. coli pathotypes.Item Current manure management practices and hygiene aspects of urban and peri-urban livestock farming in Tanzania(Livestock Research for Rural Development,, 2012) Lupindu, A. M.; Ngowi, H. A.; Dalsgaard, A.; Olsen, J. E.; Msoffe, P. L. M.The recent expansion of urban and peri urban livestock farming has resulted in close contact between animals and humans, sometimes with adverse human health effects. A survey involving 119 cattle keeping households in urban and peri-urban settings of Morogoro, Tanzania revealed that manure management practices were different from traditional practices mainly due to lack of land. Manure was collected and conveyed by using tools by 94% of respondents, while others used water or bare hands. Seventy six percent of respondents collected manure from animal houses at least once a day, a feature that was associated with housing characteristics (p<0.05). Heaping was a common manure storage method although other cattle keepers directly spread manure on land. Manure was disposed of within residential area by 70% of respondents and this practice was associated with land area owned by or under control of the households (p<0.05). The current manure management practices did not protect either humans, animals or the environment against the risk of contamination with potential zoonotic pathogens and therefore there is a need for the formulation of guidelines on safe manure management practices.Item Ecological and Epidemiological Findings Associated with Zoonotic Rabies Outbreaks and Control in Moshi, Tanzania, 2017–2018(International Journal Environmental Research and Public Health, 2019-08-07) Killewo, Japhet; Mtui-Malamsha, N.; Sallu, R.; Mahiti, G. R.; Mohamed, H.; OleNeselle, M.; Rubegwa, B.; Swai, E. S.; Makungu, S.; Otieno, E. G.; Lupindu, A. M.; Komba, E.; Mdegela, R.; Assenga, J. A.; Bernard, J.; Marandu, W.; Warioba, J.; Makondo, Z.; Chang'a, J.; Mramba, F.; Hezron, N.; Killewo, J.; Kafeero, F.; Makonnen, Y. J.; Rivas, A. L.; Fasina, F. O.Approximately 1500 people die annually due to rabies in the United Republic of Tanzania. Moshi, in the Kilimanjaro Region, reported sporadic cases of human rabies between 2017 and 2018. In response and following a One Health approach, we implemented surveillance, monitoring, as well as a mass vaccinations of domestic pets concurrently in >150 villages, achieving a 74.5% vaccination coverage (n = 29, 885 dogs and cats) by September 2018. As of April 2019, no single human or animal case has been recorded. We have observed a disparity between awareness and knowledge levels of community members on rabies epidemiology. Self-adherence to protective rabies vaccination in animals was poor due to the challenges of costs and distances to vaccination centers, among others. Incidence of dog bites was high and only a fraction (65%) of dog bite victims (humans) received post-exposure prophylaxis. A high proportion of unvaccinated dogs and cats and the relative intense interactions with wild dog species at interfaces were the risk factors for seropositivity to rabies virus infection in dogs. A percentage of the previously vaccinated dogs remained unimmunized and some unvaccinated dogs were seropositive. Evidence of community engagement and multi-coordinated implementation of One Health in Moshi serves as an example of best practice in tackling zoonotic diseases using multi-level government e orts. The district-level establishment of the One Health rapid response team (OHRRT), implementation of a carefully structured routine vaccination campaign, improved health education, and the implementation of barriers between domestic animals and wildlife at the interfaces are necessary to reduce the burden of rabies in Moshi and communities with similar profiles.Item Epidemiology of Shiga toxin-producing Escherichia coli O157:H7 in Africa in review(Informa UK Limited, trading as Taylor & Francis Group, 2017-10-17) Lupindu, A. M.Shiga toxin-producing Escherichia coli (STEC) O157:H7 is responsible for intestinal and extra-intestinal disease syndromes in human. Isolation of the pathogen from animals, food, clinical samples and environment has been reported from all continents. A review of STEC O157:H7 in Africa from a structured literature search of the PubMed electronic database is presented. It describes the epidemiological status of the pathogen on the aspects of source, transmission, pathogenesis, disease syndromes, diagnosis, disease burden and the challenges in treatment and control strategies. About a quarter of African countries have reported isolation of STEC O157:H7 either from humans, animals, food or the environment. Different methods have been used in detection of the pathogen. Most reported human infections do not show temporal relationships with reports of isolation of the pathogen from other sources such as animals, water or food. Lack of a direct link between isolates from humans and other sources makes it difficult to point out incident specific determinants and direction of transmission. The aim of this review is to give an insight into the features of STEC O157:H7 infection in Africa and draw the attention of various stakeholders to the public health threat of the pathogen for possible interdisciplinary and multi-sectoral joint efforts in the control strategies.Item Evaluation of Bovine trypanosomosis intervention in Chunya District, Tanzania(Tanzania Veterinary Journal, 2015) Matogo, B. N.; Silayo, R. S.; Lupindu, A. M.A study was conducted in Chunya District, Tanzania during December 2013 to assess the impact of tsetse fly and trypanosomosis control programme based on use of targets and traps. The trypanosome prevalence was determined by microscopic examination of thick and thin blood smears from 229 cattle selected randomly from 33 households. Additionally a semi-structured questionnaire was administered to heads or representatives of selected households to collect information on cattle- keepers’ knowledge on clinical features, transmission and control of trypanosomosis. Descriptive analysis of the data was done to establish proportions of different attributes and association between variables. Of 229 animals examined, six (2.6%) were positive for trypanosomes indicating significant decrease from baseline level of 13.8% found in 2010 at the beginning of the programme. Two trypanosome species, Trypanosoma vivax and T. congolense were identified in blood samples and vectors collected from the study area were identified as Glossina spp, Tabanus spp and Haematopota spp. Questionnaire results showed that burning of grasses (30.3%), theft of targets and traps (3.0%) and lack of follow up from the programme authority (6.1%) were major constraints that faced the programme. The study has shown a decline in prevalence of trypanosomosis which suggests that the application of traps and screens had a significantr impact on the disease and this warrants a recommendation of extending the trap and screen application technology to other similar tsetse infested areas of Tanzania.Item Factors associated with acquisition of enteric episodes in cattle waste handlers in Morogoro, Tanzania(Research Gate, 2017) Madoshi, B. P.; Lupindu, A. M.; Mtambo, M. M. A.; Muhairwa, A. P.; Olsen, J. E.The study explored risk factors for acquiring enteric disease in animal waste handlers as occupational hazards. A qualitative survey of 124 of respondents from Morogoro peri-urban and urban areas was done. Eight four respondents had experienced enteric episodes as compared to forty who didn’t mention, and among those who mentioned the episodes, 55.95% had reported this to a health facility while 44.05% had consulted a nearby pharmacy or drug shop. Heaping in living plots was mostly practiced storage method within living plots (70.97 %). The percentage of handlers who were aware of risks for acquiring enteric pathogens from cattle after handling their wastes was 43.55%. There was limited awareness of government guideline on handling such wastes (3.23%) and washing hands without soap was found to be the most common health measures taken after handling animal wastes (70.16%). Statistically significant difference was observed in knowledge on occupational hazards (p = 0.001), zoonotic pathogens awareness (p=0.05), experience of participants (p=0.05) and protective gears (p = 0.022). The animal wastes handlers could be constantly exposed to risks associated with enteropathogens due to the lack of training on proper measures to handle animal wastes as occupational hazard, government interventions of formulating laws and by-laws which are user friendly. This could protect the attendants themselves against the zoonotic enteropathogens, the public in general and the environment.Item First Report on a Randomized Investigation of Antimicrobial Resistance in Fecal Indicator Bacteria from Livestock, Poultry, and Humans in Tanzania(Mary Ann Liebert, Inc., 2018-04-01) Katakweba, A. A. S.; Muhairwa, A. P.; Lupindu, A. M.; Damborg, P.; Rosenkrantz, J. T.; Minga, U. M.; Mtambo, M. A.; Olsen, J. E.This study provides an estimate of antimicrobial resistance in intestinal indicator bacteria from humans (n = 97) and food animals (n = 388) in Tanzania. More than 70% of all fecal samples contained tetracycline (TE), sulfamethoxazole (STX), and ampicillin (AMP)-resistant coliforms, while cefotaxime (CTX)-resistant coliforms were observed in 40% of all samples. The average Log10 colony forming units/g of CTX-resistant coliforms in samples from humans were 2.20. Of 390 Escherichia coli tested, 66.4% were resistant to TE, 54.9% to STX, 54.9% to streptomycin, and 36.4% to CTX. Isolates were commonly (65.1%) multiresistant. All CTX-resistant isolates contained blaCTX-M gene type. AMP- and vancomycin-resistant enterococci were rare, and the average concentrations in positive samples were low (log10 0.9 and 0.4, respectively). A low-to-moderate resistance (2.1–15%) was detected in 240 enterococci isolates to the drugs tested, except for rifampicin resistance (75.2% of isolates). The average number of sulII gene copies varied between Log10 5.37 and 5.68 with no significant difference between sample source, while cattle had significantly higher number of tetW genes than humans. These findings, based on randomly obtained samples, will be instrumental in designing antimicrobial resistance (AMR) intervention strategies for TanzaniaItem Isolation and characterization of Escherichia coli from animals, humans, and environment(INTECH- Open Science/ Open Minds, 2017-07) Lupindu, A. M.Working on a diverse species of bacteria that have hundreds of pathotypes representing hundreds of strains and many closely related family members is a challenge. Appropriate research design is required not only to achieve valid desired outcome but also to minimize the use of resources, including time to outcome and intervention. This chapter outlines basics of Escherichia coli isolation and characterization strategies that can assist in research designing that matches the set objectives. Types of samples to be collected, collection and storage strategies, and processing of samples are described. Different approaches to isolation, confirmation and concentration of various E. coli strains are summarized in this chapter. Characterization and typing of E. coli isolates by biochemical, serological, and molecular methods have been explained so that an appropriate choice is made to suite a specific E. coli strain/pathotype. Some clues on sample and isolate preservation for future use are outlined, and general precautions regarding E. coli handling are also presented to the researcher to avoid improper planning and execution of E. coli-related research. Given different options, the best E. coli research design, however, should try as much as possible to shorten the length of time to outcomes.Item Isolation of vancomycin-resistant Enterococcus from apparently healthy human animal attendants, cattle and cattle wastes in Tanzania(Wiley Online Library, 2018-03-07) Madoshi, B. P.; Mtambo, M. M. A.; Muhairwa, A. P.; Lupindu, A. M.; Olsen, J. E.AIM: The study aimed to isolate and characterize Enterococcus species from apparently healthy waste attendants, cattle and cattle waste in Tanzania. Emphasis was given to antimicrobial resistance and in particular occurrence of vancomycin (VA)-resistant enterococci. METHODS AND RESULTS: Faecal samples were collected from healthy cattle, cattle waste attendants and cattle house wastes, and isolation of Enterococcus species was performed using Slanetz Bartley agar. Isolates were characterized with regard to species, antimicrobial susceptibility and presence of VA resistance genes. Enterococcus faecalis was the most prevalent species from all sources of isolation (43·5%), followed by Enterococcus faecium (38·4%). Isolates of E. faecium showed a higher number of phenotypic antimicrobial resistance than isolates of E. faecalis. Fifty-eight isolates, which showed resistance or intermediate resistance to VA by disc diffusion test, were analysed for VA-resistant Enterococcus (VRE) by PCR. The vanA gene was detected in 14 isolates of E. faecium and 12 isolates of E. faecalis, while vanB was detected in three isolates. No isolates were found to carry vanC1-gene. CONCLUSION: VRE was detected in both human and cattle samples, despite no known use of antimicrobial agents that can select for VRE in livestock in Tanzania. Enterococcus faecalis was the most commonly isolated species from cattle and humans. SIGNIFICANCE AND IMPACT OF THE STUDY: The study provides information on the prevalence of VRE in human and nonhuman samples in Tanzania calling for further studies on the origin of VRE in such isolates, since no selection mechanism in Tanzania are known.Item Knowledge and attitude of pregnant women in rural Tanzania on prevention of Anaemia(African Journal of Reproductive Health, 2018-09) Margwe, J. A.; Lupindu, A. M.Anaemia during pregnancy is the leading cause of morbidity and mortality and poor birth outcomes worldwide. Despite control programmes, anaemia is far beyond the target of the fifth Millennium Development Goal. This study aimed at assessing the trend in anaemia and knowledge and attitude of pregnant women towards control measures in low income rural settings. A crosssectional study involving 354 pregnant women was conducted in Mbulu District, Tanzania. Socio-demographic and anaemia related information was gathered, and anaemia status determined. Descriptive statistics for socio-demographic and anaemia related data were computed. Knowledge and attitudes of pregnant women to anaemia were assessed using summated index and Likert scales respectively. Fisher‘s exact test was used to determine associations between variables. Multivariable logistic regression was run to quantify the risk factors for occurrence of anaemia. Prevalence of anaemia unadjusted and adjusted for altitude were 38.7% (95% CI: 0.34-0.44) and 46.3% (95% CI: 0.41-0.51) respectively. The overall score on the 11-point summated scale was 5.2, indicating low knowledge, while the overall score on Likert scale was 21.7 out of 40 points, indicating unfavorable attitude. High gravidity was a risk factor for anaemia during pregnancy (OR=13.09, 95% CI: 5.68 – 47.04 for 3-4 gravidity and OR=25.16, 95% CI: 12.46 – 37.23 for gravidity ≥ 5). There was upsurge of anaemia prevalence and low knowledge and unfavourable attitude were associated with anaemia (p-value<0.001). There is a need to set appropriate anaemia knowledge transfer and attitude change strategies in the community to have successful anaemia control program.Item Occurrence and characterization of Shiga toxin-producing Escherichia coli o157:h7 and other non-sorbitol–fermenting e. coli in cattle and humans in urban areas of Morogoro, Tanzania(Mary Ann Liebert, Inc., 2014) Lupindu, A. M.; Olsen, J. E.; Ngowi, H. A.; Msoffe, P. L. M.; Mtambo, M. M.; Scheutz, F.; Dalsgaard, A.Escherichia coli strains such as Shiga toxin–producing E. coli (STEC), enteropathogenic E. coli, enterotoxigenic, attaching, and effacing E. coli, and enteroinvasive E. coli cause diarrhea in humans. Although other serotypes exist, the most commonly reported STEC in outbreaks is O157:H7. A cross-sectional study was conducted to isolate and characterize non-sorbitol–fermenting (NSF) E. coli O157:H7 from urban and periurban livestock settings of Morogoro, Tanzania. Human stool, cattle feces, and soil and water samples were collected. Observations and questionnaire interview studies were used to gather information about cattle and manure management practices in the study area. E. coli were isolated on sorbitol MacConkey agar and characterized by conventional biochemical tests. Out of 1049 samples, 143 (13.7%) yielded NSF E. coli. Serological and antimicrobial tests and molecular typing were performed to NSF E. coli isolates. These procedures detected 10 (7%) pathogenic E. coli including STEC (n=7), enteropathogenic E. coli (EPEC) (n=2), and attaching and effacing E. coli (A/EEC) (n=1) strains. The STEC strains had the ability to produce VT1 and different VT2 toxin subtypes that caused cytopathic effects on Vero cells. The prevalence of STEC in cattle was 1.6%, out of which 0.9% was serotype O157:H7 and the overall prevalence of diarrheagenic E. coli in cattle was 2.2%. The serotypes O157:H7, O142:H34, O113:H21, O+:H-,O +:H16, and O25:H4 were identified. One ESBLproducing isolate showed the MLST type ST131. To our knowledge, this is the first finding in Tanzania of this recently emerged worldwide pandemic clonal group, causing widespread antimicrobial-resistant infections, and adds knowledge of the geographical distribution of ST131. Cattle manure was indiscriminately deposited within residential areas, and there was direct contact between humans and cattle feces during manure handling. Cattle and manure management practices expose humans, animals, and the environment to pathogenic E. coli and other manure-borne pathogens. Therefore, there is a need to improve manure management practices in urban and periurban areas to prevent pathogen spread and associated human health risks.Item Paralleling of diagnostic endeavor for control of mycobacterial infections and tuberculosis(IntechOpen, 2018-12-05) Lupindu, A. M.; Mbugi, E. V.; Nzalawahe, J.; Hoza, A. S.Mycobacterial infections and tuberculosis pose global public health threats. High tuberculosis morbidities and mortalities are due to the diagnosis problems among other causes. This chapter describes and compares diverse mycobacterial infections and tuberculosis diagnostic efforts and point-out the direction so as to inform areas of and motivate research toward early, rapid, and accurate diagnosis for effective TB control. We have grouped diagnostic approaches according to the type of sample taken for or organ targeted during diagnosis. The sputum-based methods include smear microscopy, culture, and rat sniffing. Interferon-γ (INF-γ) release assays, transcriptional blood signatures, and proteomic profiling use blood samples while colorimetric sensor array (CSA) and mass spectrometry use urine samples. Patho-physiological methods include tuberculin skin tests (TSTs) and radiography. Chromatography and acoustic wave detection can also be used to diagnose TB from breath. Comparative description of these methods is based on a time frame to diagnosis, accuracy, cost, and convenience. The trend shows that there is a move from time-consuming, slow and narrow-spectrum to quick and broad-spectrum TB diagnostic procedures. The sputum-based and patho-physiological approaches remain conformist while blood-based procedures lead research developments. Absence of single best approach calls for synergistic research combinations that form accurate, rapid, cheap, and convenient package at point-of-care centers.Item Paralleling of diagnostic endeavor for control of mycobacterial infections and tuberculosis(2018) Lupindu, A. M.; Mbugi, E. V.; Nzalawahe, J.; Hoza, A. S.Mycobacterial infections and tuberculosis pose global public health threats. High tuberculosis morbidities and mortalities are due to the diagnosis problems among other causes. This chapter describes and compares diverse mycobacterial infections and tuberculosis diagnostic efforts and point-out the direction so as to inform areas of and motivate research toward early, rapid, and accurate diagnosis for effective TB control. We have grouped diagnostic approaches according to the type of sample taken for or organ targeted during diagnosis. The sputum-based methods include smear microscopy, culture, and rat sniffing. Interferon-γ (INF-γ) release assays, transcriptional blood signatures, and proteomic profiling use blood samples while colorimetric sensor array (CSA) and mass spectrometry use urine samples. Patho-physiological methods include tuberculin skin tests (TSTs) and radiography. Chromatography and acoustic wave detection can also be used to diagnose TB from breath. Comparative description of these methods is based on a time frame to diagnosis, accuracy, cost, and convenience. The trend shows that there is a move from time-consuming, slow and narrow-spectrum to quick and broad-spectrum TB diagnostic procedures. The sputum-based and patho-physiological approaches remain conformist while blood-based procedures lead research developments. Absence of single best approach calls for synergistic research combinations that form accurate, rapid, cheap, and convenient package at point-of-care centers.Item Phages implications on Controlling antibiotic resistance and future biotechnology in Plants and Animals disease: a review(Tanzania Veterinary Journal, 2018) Motto, S. K.; Mwakaje, P.; Mgimba, M. C.; Alafi, Steven; Mita, S. J.; Magembe, E. J.; Sailen, A. M.; Mayenga, E. L.; Lupindu, A. M.Phages are bacterio-specific viruses. Involved in the origin of life and evolution, constituting a major part of the biosphere, they are promising as a sustainable, ecological and intrinsically cheap antibacterial. They have been proposed as alternatives to antibiotics for many antibiotic resistant bacterial strains. Phages can be used as biocontrol agents in agriculture and petroleum industry. Moreover phages are used as vehicles for vaccines both DNA and protein, for the detection of pathogenic bacterial strain, as display system for many proteins and antibodies. Bacteriophages are diverse group of viruses which are easily manipulated and therefore they have potential uses in biotechnology, research, and therapeutics. The aim of this review article is to enable the wide range of researchers, scientists, and biotechnologist who are putting phages into practice, to accelerate the progress and development in the field of biotechnology. Details given above give a glimpse of the large range of applications of phages in the field of biotechnology and medical science. There is the hope that phages could be useful to humans in many ways. By making a cock tail of phages it would become easy to treat a wide variety of bacterial infections that are otherwise resistant to the latest generations of antibiotics. Due to the rapid progress in the fields of biotechnology and molecular biology it is hoped that these entities (phages) which are present abundantly in the biosphere could answer many questions human beings are having.Item Prevalence of intestinal parasites in pig manure and the potential for zoonotic transmission in urban/peri-urban areas of Morogoro municipality, Tanzania(Livestock Research for Rural Development, 2017) Ngowi, H. A.; Mushi, P. E.; Lupindu, A. M.; Mtambo, M. M. A.; Muhairwa, A. P.Information on the prevalence and potential health consequences associated with the presence of parasites in livestock manures is lacking in many developing countries. In 2015, a cross-sectional study was conducted in 79 pig farms to estimate farm-level prevalence of helminth eggs using McMaster technique and protozoan parasite oocysts using the Modified Ziehl–Neelsen technique in Morogoro municipality, Tanzania. Farm-level representative samples of manure were collected from pig manure disposal sites in each farm. Pig farmers’ knowledge and practices related to pig husbandry and manure handling were assessed using a structured questionnaire. All pigs were reared indoors and their manures were handled in solid form. Farm-level prevalence of strongyle eggs was 7.6% (95% CI: 1.8, 13.4) and that of Ascaris spp. was 6.3% (95% CI: 0.9, 11.7). Prevalence of acid-fast protozoan oocysts was 6.3% (95% CI: 0.9, 11.7), includingIsospora spp., Cryptosporidium spp. and Eimeria spp. Approximately 27.8% (95% CI: 17.9, 37.7) of the samples had acid-fast objects that resembled microsporidia and other fungal spores. About 94.9% (95% CI: 90.0, 99.8) of the farmers reported to have experienced diseases in their pigs, commonly helminthosis. Only about 42.5% (95% CI: 31.3, 53.9) believed that pig manure could cause some human health problems. Approximately, 65.3% (54.3, 76.3) reported to clean their pig pens daily. About 61.1% (95% CI: 49.9, 72.3) reported to wear special clothing when removing pig manure. Handling of pig manure is associated with potential biological hazards with potential for zoonotic transmission in urban/peri-urban areas of Morogoro municipality, Tanzania. Further studies are needed to measure the actual risks associated with livestock manure handling and utilisation including parasite viability and characterization studies to guide implementation of appropriate bio-security and bio-safety measures in urban/peri-urban livestock farms.Item Public health aspect of manure management in urban and peri-urban livestock farming in developing countries(INTECH, 2017) Lupindu, A. M.Urban and peri-urban livestock farming has been expanding in recent decades due to high demand for animal proteins to feed the growing urban population. The increase in number of livestock and livestock keepers has led to increased manure production in a shrinking space. This chapter evaluates the risks of transmission of manure-borne pathogen between cattle, humans and the environment in urban and peri-urban areas. Cattle and manure management practices, government directives, the presence of zoonotic pathogens and risk of bacteria transmission were assessed by observations, interviews, bacteria isolation and characterization and statistical modeling. Cattle are kept under intensive and extensive systems. Different techniques are used to collect, convey, store and dispose manure, all of which lead to direct contact with humans. The prevalence of diarrheagenic Escherichia coli in cattle and water was 2.2% (95% CI: 0.99– 3.67) and 0.5% (95% CI: 0.025–2.44), respectively. There was transmission of bacteria between cattle, humans and the environment in 52% of clusters. Cattle and manure management practices expose humans, livestock and the environment to risk of infection or contamination. Holistic approach can be adopted in this scenario to attain one health status and improve urban and peri-urban livestock contribution to community livelihood simultaneously.Item Rabies trends and surveillance capabilities in Zambia(Tanzania Veterinary Journal, 2015) Kabaso, J.; Kimera, S. I.; Muma, J. B.; Lupindu, A. M.The main objective of this study was to assess the trends, distribution and positivity rate of rabies cases in Zambia. A retrospective study for the period of 10 years between 2004 and 2014, was conducted by using rabies case reports. The data were analyzed with descriptive statistics and geo- coded in Quantum Geographical Information System (QGIS) with the help of shape files. The geo- referenced data were then used to map the trend and spatial distribution of the disease on maps in a Geographical Information System (GIS) platform. The findings showed that 61.5% (462/751, 95% CI=57.9- 65.0) of the samples were positive. Canines accounted for 81.6% (95%, CI=77.7- 85) of the total positive samples followed by Bovines 9.1% (95%, CI= 6.7- 12.2). A mean monthly occurrence of canine rabies was 2.9. The average provincial positivity rate was 0.7. Positivity rates equal to or closer to one indicate poor surveillance; with rates equal to or closer to zero indicate good surveillance. One on one in-depth interview was conducted with one officer from each of these institutions i.e. The University of Zambia (UNZA), National Livestock and Epidemiological Information Center (NALEIC) and Central Veterinary Research Institute (CVRI) in order to familiarize with the current rabies surveillance systems in Zambia. The findings were that; sample submission is done by veterinarians and livestock officers and only UNZA and CVRI have capability for rabies diagnosis with NALEIC as a data storage institution. Rabies is endemic in Zambia and the dog is maintenance host for the disease in human and livestock populations. Therefore, controlling rabies in dogs indirectly overcomes the problem in human and livestock.Item Relationship between somatic cell count status and subsequent clinical mastitis in Dutch dairy cows(ELSEVIER, 2010) Van den Borne, H. B.; Vernooij, J. C.; Lupindu, A. M.; Van Schaik, G.; Frankena, K; Lam, T. J.High composite somatic cell counts (CSCC) in dairy cows may develop into clinical mastitis (CM), suggesting that prevention or intervention of high CSCC may prevent CM later in lactation. The objective of this study was to quantify the relationship between high CSCC in dairy cows and the first subsequent case of CM in the same lactation. Farmer-diagnosed cases of CM and test day CSCC measurements during 1 year of 13,917 cows in 196 randomly selected Dutch dairy herds were available for analysis. Cows were followed in 1 lactation from the first test day postpartum until CM, drying off, culling or end of study. Cox proportional hazards models with time-varying CSCC levels were used to estimate the effect of high CSCC (≥200,000cells/ml) on the time until the first case of CM. A shared frailty effect was included to adjust for clustering of cows within herds. The proportion of cows developing CM after a CSCC measurement was 11%. Primiparae with a high CSCC had a 4-fold higher hazard for subsequent CM than primiparae with a low CSCC; multiparae with a high CSCC had a 2-fold higher hazard than multiparae with a low CSCC. Additionally, multiparae with a low CSCC had a 2-fold higher hazard for CM occurrence than primiparae with a low CSCC. Increasing the threshold for high CSCC showed that the risk for CM increased. If the last CSCC before CM was low, CSCC information of 2 preceding test days was more predictive than CSCC information from only the last test day. When the last CSCC was high, CSCC information of 2 preceding test days did not have added predictive value. This study identified that approximately 25% of first subsequent CM cases after a CSCC measurement can potentially be prevented when cows are prevented to get high CSCC or when high CSCC cows are removed from the population. This corresponded with a decrease in the proportion of lactating cows with CM after a CSCC measurement from 11% to 7%.Item The role of nontuberculous mycobacteria in the diagnosis, management and quantifying risks of tuberculosis in Tanga, Tanzania(Tanzania Journal of Health Research, 2016) Hoza, A. S.; Lupindu, A. M.; Mfinanga, S. G. M.; Moser, I.; König, B.Background: The role of nontuberculous mycobacteria (NTM) in tuberculosis (TB) diagnosis is well documented in many developing settings. However, this has not been the case in many resource poor settings like Tanzania. This study aimed at understanding the role of NTM in the diagnosis and management of TB in resource poor settings of Tanzania. Methods: A cross-sectional study was conducted in Tanga, Tanzania. Patients with symptoms suggestive of TB self-referred to health care facilities were recruited. Two sputum samples were collected for standard direct smear microscopy. Culture was performed using BacT/Alert 3D system, LöwensteinJensen and Gottsacker slopes. Identification of Mycobacterium tuberculosis and NTM was done by using GenoType®MTBC and GenoType®CM/AS, respectively. Results: A total of 372 patients were involved in the study. Eighty-one (21.8%) patients were diagnosed as having M. tuberculosis by the isolation of the organism from cultures of sputum. Further analysis of culture showed that 8.1% (30/372) were NTM with 7/372 (1.9%) cases of NTM classified as pulmonary tuberculosis (PTB) patients. Ziehl Neelsen stain had a sensitivity of 68.8% and produced 10 false negative results. On the other hand, Fluorescence stain had a sensitivity of 85.7% and gave seven false negative samples when compared with culture results. Weight loss (p = 0.0001), fatigue (p = 0.003), fever (p = 0.038) and night sweats (p = 0.004), young population (18-40 years) (p = 0.0352), males (p = 0.0025) were important risk factors for TB. Four out of 30 NTM diagnosed by culture received first line anti-TB treatment suggesting that a good proportion of patients (4/65, 6.2%) were mistreated as TB patients. Conclusion: Inefficient screening of TB patients in resource poor settings and prevalent increase of NTM may contribute to over diagnosis of TB cases. The need to integrate NTM diagnosis in the routine management of TB is urgently needed for designing effective tuberculosis prevention and control strategies in the country.