Comparison of the estimated incidence of acute leptospirosis in the Kilimanjaro Region of Tanzania between 2007-08 and 2012-14

Maze, M. J. et al. (2016) Comparison of the estimated incidence of acute leptospirosis in the Kilimanjaro Region of Tanzania between 2007-08 and 2012-14. PLoS Neglected Tropical Diseases, 10(12), e0005165. (doi:10.1371/journal.pntd.0005165) (PMID:27911902) (PMCID:PMC5135036)

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Abstract

Background: The sole report of annual leptospirosis incidence in continental Africa of 75–102 cases per 100,000 population is from a study performed in August 2007 through September 2008 in the Kilimanjaro Region of Tanzania. To evaluate the stability of this estimate over time, we estimated the incidence of acute leptospirosis in Kilimanjaro Region, northern Tanzania for the time period 2012–2014. Methodology and Principal Findings: Leptospirosis cases were identified among febrile patients at two sentinel hospitals in the Kilimanjaro Region. Leptospirosis was diagnosed by serum microscopic agglutination testing using a panel of 20 Leptospira serovars belonging to 17 separate serogroups. Serum was taken at enrolment and patients were asked to return 4–6 weeks later to provide convalescent serum. Confirmed cases required a 4-fold rise in titre and probable cases required a single titre of ≥800. Findings from a healthcare utilisation survey were used to estimate multipliers to adjust for cases not seen at sentinel hospitals. We identified 19 (1.7%) confirmed or probable cases among 1,115 patients who presented with a febrile illness. Of cases, the predominant reactive serogroups were Australis 8 (42.1%), Sejroe 3 (15.8%), Grippotyphosa 2 (10.5%), Icterohaemorrhagiae 2 (10.5%), Pyrogenes 2 (10.5%), Djasiman 1 (5.3%), Tarassovi 1 (5.3%). We estimated that the annual incidence of leptospirosis was 11–18 cases per 100,000 population. This was a significantly lower incidence than 2007–08 (p<0.001). Conclusions: We estimated a much lower incidence of acute leptospirosis than previously, with a notable absence of cases due to the previously predominant serogroup Mini. Our findings indicate a dynamic epidemiology of leptospirosis in this area and highlight the value of multi-year surveillance to understand leptospirosis epidemiology.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleaveland, Professor Sarah and Halliday, Dr Joanna and Allan, Dr Kathryn
Authors: Maze, M. J., Biggs, H. M., Rubach, M. P., Galloway, R. L., Cash-Goldwasser, S., Allan, K. J., Halliday, J. E.B., Hertz, J. t., Saganda, W., Lwezaula, B. F., Cleaveland, S., Mmbaga, B. T., Maro, V. P., and Crump, J. A.
College/School:College of Medical Veterinary and Life Sciences > Institute of Biodiversity Animal Health and Comparative Medicine
Journal Name:PLoS Neglected Tropical Diseases
Publisher:Public Library of Science
ISSN:1935-2727
ISSN (Online):1935-2735
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in PLoS Neglected Tropical Diseases 10(12):e0005165
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
568221Impact, ecology and social determinants of bacterial zoonoses in northern TanzaniaSarah CleavelandBiotechnology and Biological Sciences Research Council (BBSRC)BB/J010367/1RI BIODIVERSITY ANIMAL HEALTH & COMPMED
627871Social, economic and environmental drivers of zoonoses in Tanzania (SEEDZ)Sarah CleavelandBiotechnology and Biological Sciences Research Council (BBSRC)BB/L018926/1RI BIODIVERSITY ANIMAL HEALTH & COMPMED
628341Hazards associated with zoonotic enteric pathogens in emerging livestock meat pathways (HAZEL)Ruth ZadoksBiotechnology and Biological Sciences Research Council (BBSRC)BB/L017679/1RI BIODIVERSITY ANIMAL HEALTH & COMPMED
628321Molecular epidemology of brucellosis in northern TanzaniaDaniel HaydonBiotechnology and Biological Sciences Research Council (BBSRC)BB/L018845/1RI BIODIVERSITY ANIMAL HEALTH & COMPMED
573981Leptospirosis in Tanzania; a study of the role of rodents in an emerging public health problem.Sarah CleavelandWellcome Trust (WELLCOME)096400/Z/11/ZRI BIODIVERSITY ANIMAL HEALTH & COMPMED