Browsing by Author "Mwakapeje, E. R."

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Anthrax outbreaks in the humans - livestock and wildlife interface areas of Northern Tanzania: A retrospective record review 2006–2016
(BMC, 2018-02-15) Mwakapeje, E. R.; Høgset, S.; Fyumagwa, R.; Nonga, H. E.; Mdegela, R. H.; Skjerve, E.
Background: Anthrax outbreaks in Tanzania have been reported from the human, livestock and wildlife sectors over several years, and is among the notifiable diseases. Despite frequent anthrax outbreaks, there is no comprehensive dataset indicating the magnitude and distribution of the disease in susceptible species. This study is a retrospective review of anthrax outbreaks from the human, livestock, and wildlife surveillance systems from 2006 to 2016. The objectives were to identify hotspot districts, describe anthrax epidemiology in the hotspot areas, evaluate the efficiency of the anthrax response systems and identify potential areas for further observational studies. Methods: We prepared a spreadsheet template for a retrospective comprehensive record review at different surveillance levels in Tanzania. We captured data elements including demographic characteristics of different species, the name of health facility, and date of anthrax diagnosis. Also, we collected data on the date of specimen collection, species screened, type of laboratory test, laboratory results and the outcome recorded at the end of treatment in humans. After establishing the database, we produced maps in Quantum GIS software and transferred cleaned data to Stata software for supportive statistical analysis. Results: Anthrax reported incidences over 4 years in humans were much higher in the Arusha region (7.88/100,000) followed by Kilimanjaro region (6.64/100,000) than other regions of Tanzania Mainland. The health facility based review from hotspot districts in parts of Arusha and Kilimanjaro regions from 2006 to 2016, identified 330 human anthrax cases from the selected health facilities in the two regions. Out of 161 livestock and 57 wildlife specimen tested, 103 and 18 respectively, were positive for anthrax. Conclusion: This study revealed that there is gross under-reporting in the existing surveillance systems which is an obstacle for estimating a true burden of anthrax in the hotspot districts. Repeated occurrences of anthrax in livestock, wildlife and humans in the same locations at the same time calls for the need to strengthen links and promote inter–disciplinary and multi-sectoral collaboration to enhance prevention and control measures under a One Health approach.
Prevention, detection, and response to anthrax outbreak in Northern Tanzania using one health approach: A case study of Selela ward in Monduli district
(International Journal of One Health, 2017-11-04) Mwakapeje, E. R.; Assenga, J. A.; Kunda, J. S.; Mjingo, E. E.; Makondo, Z. E.; Nonga, H. E.; Mdegela, R. H.; Skjerve, E.
Background: Anthrax is an infectious fatal zoonotic disease caused by Bacillus anthracis. Anthrax outbreak was confirmed in samples of wild animals following rumors of the outbreak in wild animals, livestock, and humans in Selela ward, Monduli district of Northern Tanzania. Therefore, a multi-sectorial team was deployed for outbreak response in the affected areas. Objectives: The aim of the response was to manage the outbreak in a One Health approach and specifically: (i) To determine the magnitude of anthrax outbreak in humans, livestock, and wild animals in Selela ward, (ii) to assess the outbreak local response capacity, (iii) to establish mechanisms for safe disposal of animal carcasses in the affected areas, and (iv) to mount effective control and preventive strategies using One Health approach in the affected areas. Materials and Methods: This was a cross-sectional field survey using: (i) Active searching of suspected human cases at health facilities and community level, (ii) physical counting and disposal of wild animal carcasses in the affected area, (iii) collection of specimens from suspected human cases and animal carcasses for laboratory analysis, and (iv) meetings with local animal and human health staff, political, and traditional leaders at local levels. We analyzed data by STATA software, and a map was created using Quantum GIS software. Results: A total of 21 humans were suspected, and most of them (62%) being from Selela ward. The outbreak caused deaths of 10 cattle, 26 goats, and three sheep, and 131 wild animal carcasses were discarded the majority of them being wildebeest (83%). Based on laboratory results, three blood smears tested positive for anthrax using Giemsa staining while two wildebeest samples tested positive and five human blood samples tested negative for anthrax using quantitative polymerase chain reaction techniques. Clinical forms of anthrax were also observed in humans and livestock which suggest that wild animals may contribute as reservoir of anthrax which can easily be transmitted to humans and livestock. Conclusion: The rapid outbreak response by multi-sectoral teams using a One Health approach managed to contain the outbreak. The teams were composed of animal and human health experts from national to village levels to control the outbreak. The study testifies the importance of multi-sectoral approach using One Health approach in outbreak preparedness and response.
Trends of human brucellosis in pastoralist communities based on hospital records during 2013–2016 in Ngorongoro District, Tanzania
(African Journal Online, 2016-12-05) Nonga, H. E.; Mwakapeje, E. R.
Brucellosis is among the neglected zoonotic disease which mostly affects the pastoral and agro-pastoral communities because they are exposed to many risk factors for the infection. A four-year (2013–2016) retrospective study was carried out to determine the sero-prevalence of human brucellosis in patients at Wasso and Endulen hospitals in Ngorongoro district, Tanzania. Hospitalization records were reviewed and serological positive cases of brucellosis were classified according to: year recorded, hospital facility, areas of residence, age, sex and season of the year. A total of 794 (5.8%) brucellosis cases from 111 villages/areas were diagnosed out of 13642 patients admitted at Wasso and Endulen hospitals. Most of brucellosis cases (35.5%, n=282) and (34.8%, n=276) were recorded in 2014 and 2015 respectively. Wasso hospital had more cases (6.9%) compared to Endulen (3.5%) and the difference was statistically significant (P= 0.0000001). More Brucella positive cases (P=0.0006681) were observed in females than males. Similarly, adult individuals suffered more (P=0.00000001) than young ones. Most of the cases (P=0.00000001) were observed during the rainy seasons. Brucellosis is prevalent in Ngorongoro district which affects mostly women and adults, and therefore, an important public health problem. These findings merit for more extensive epidemiological investigations of brucellosis in pastoral and agro-pastoral communities in Tanzania.