Browsing by Author "Kazwala, Rudovick Reuben"

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Brucellosis testing patterns at health facilities in Arusha region, northern Tanzania
(PLOS ONE, 2022) Lukambagire, AbdulHamid Settenda; Shirima, Gabriel Mkulima; Shayo, Damas Davis; Mathew, Coletha; Yapi, Richard B.; Kasanga, Christopher Julius; Mmbaga, Blandina Theophile; Kazwala, Rudovick Reuben; Halliday, Jo E. B.
Background Brucellosis is listed as one of six priority zoonoses in Tanzania’s One Health strategic plan which highlights gaps in data needed for the surveillance and estimation of human brucello- sis burdens. This study collected data on current testing practices and test results for human brucellosis in Arusha region, northern Tanzania. Methods Retrospective data were extracted from records at 24 health facilities in Arusha region for the period January 2012 to May 2018. Data were captured on: the test reagents used for brucellosis, procurement and testing protocols, the monthly number of patients tested for brucellosis and the monthly number testing positive. Generalised linear mixed models were used to evaluate relationships between health facility characteristics and the probability that brucellosis testing was conducted in a given month, and the proportion of individuals testing positive. Results Four febrile Brucella agglutination tests were used widely. The probability of testing for bru- cellosis in a given month was significantly associated with an interaction between year of testing and facility ownership. Test probability increased over time with more pronounced increases in privately owned as compared to government facilities. The proportion of individ- uals testing positive for brucellosis was significantly associated with facility type and district, with individuals tested in hospitals in Meru, Monduli and Ngorongoro districts more likely to test positive. Conclusions Febrile Brucella agglutination tests, known for their poor performance, were the mainstay of brucellosis testing at health facilities in northern Tanzania. The study indicates that historical data on human brucellosis in Arusha and other regions are likely to provide an inaccurate measure of true disease burden due to poor performance of the tests used and variation in testing practices. Measures to address these identified shortcomings could greatly improve quality of testing and surveillance data on brucellosis and ultimately inform prevention and control of this priority disease.
Drug susceptibility profiles and factors associated with non-tuberculous mycobacteria species circulating among patients diagnosed with pulmonary tuberculosis in Tanzania
(PLoS ONE, 2022) Maya, Togolani Godfrey; Komba, Erick Vitus; Mensah, Gloria Ivy; Mbelele, Peter Masunga; Mpagama, Stella George; Mfinanga, Sayoki Godfrey; Addo, Kennedy Kwasi; Kazwala, Rudovick Reuben
Background While most Non-tuberculous mycobacteria (NTM) are saprophytic, several species have been associated with human diseases, from localized infection to disseminated diseases. Pulmonary NTM infections lead to TB-like disease called NTM pulmonary disease (NTM- PD). Due to variation in treatment options among NTM species, it is necessary to identify the species and determine drug susceptibility profiles to inform the choice of appropriate regimen for the disease. Design A total of 188 culture-positive isolates from patients diagnosed with TB were screened for NTM at the Central Tuberculosis Reference Laboratory. All NTM were further speciated using GenoType® Mycobacterium—Common Mycobacterium and Additional species (GenoType® CM/AS) kit. Mycobacteria avium complex (MAC) and Mycobacteria absces- sus complex (MABC) which could not be identified with the test to species were subjected to GenoType® Mycobacteria NTM-DR for further speciation. Using the same test, identified MAC and MABC were genotyped to determine the drug susceptibility profile for each isolate to macrolide and aminoglycosides. Results Of all isolates identified as mycobacteria, 24 (13%) were NTM. Fifteen isolates could be identified to species level of which prevalent species was M. avium sub. intracellulare 4 (27%). A total of 10 isolates were MAC (n = 6) and MABC (n = 4) were subjected to Geno- Type® Mycobacteria NTM-DR for determination of macrolide and aminoglycoside suscepti- bility. Three of the four MABC had a mutation at the T28 position of the erm (41). All MAC were susceptible to both drugs. Conclusion In this study, MAC was the most frequently isolated NTM species followed by MABC. While all MAC and MABC identified, were susceptible to aminoglycosides, three MABC were resistant to the macrolides due to mutation at position 28 of the erm (41) gene. For this, it is important for clinicians need to rule out NTM, understand species and their drug susceptibil- ity for optimal case management.