Browsing by Author "Biggs, Holly M."

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    Epidemiology of Leptospirosis in Africa: A systematic review of a neglected zoonosis and a paradigm for ‘one health’ in Africa
    (PLOS, 2015-09) Allan, Kathryn J.; Biggs, Holly M.; Halliday, Jo E. B.; Kazwala, Rudovick R.; Maro, Venance P.; Cleaveland, Sarah; Crump, John A.
    Background Leptospirosis is an important but neglected bacterial zoonosis that has been largely overlooked in Africa. In this systematic review, we aimed to summarise and compare current knowledge of: (1) the geographic distribution, prevalence, incidence and diversity of acute human leptospirosis in Africa; and (2) the geographic distribution, host range, prevalence and diversity of Leptospira spp. infection in animal hosts in Africa. Methods Following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, we searched for studies that described (1) acute human leptospirosis and (2) pathogenic Leptospira spp. infection in animals. We performed a literature search using eight international and regional databases for English and non-English articles published between January 1930 to October 2014 that met out pre-defined inclusion criteria and strict case definitions. Results and Discussion We identified 97 studies that described acute human leptospirosis (n = 46) or animal Leptospira infection (n = 51) in 26 African countries. The prevalence of acute human leptospirosis ranged from 2 3% to 19 8% (n = 11) in hospital patients with febrile illness. Incidence estimates were largely restricted to the Indian Ocean islands (3 to 101 cases per 100,000 per year (n = 6)). Data from Tanzania indicate that human disease incidence is also high in mainland Africa (75 to 102 cases per 100,000 per year). Three major species (Leptospira borgpetersenii, L. interrogans and L. kirschneri) are predominant in reports from Africa and isolates from a diverse range of serogroups have been reported in human and animal infections …
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    Incidence estimates of acute Q fever and spotted fever group rickettsioses, Kilimanjaro, Tanzania, from 2007 to 2008 and from 2012 to 2014
    (The American Society of Tropical Medicine and Hygiene, 2022) Pisharody, Sruti; Rubach, Matthew P.; Carugati, Manuela; Nicholson, William L.; Perniciaro, Jamie L.; Biggs, Holly M.; Maze, Michael J.; Hertz, Julian T.; Halliday, Jo E. B.; Allan, Kathryn J.; Mmbaga, Blandina T.; Saganda, Wilbrod; Lwezaula, Bingileki F.; Kazwala, Rudovick R.; Cleaveland, Sarah; Maro, Venance P.; Crump, John A.
    Q fever and spotted fever group rickettsioses (SFGR) are common causes of severe febrile illness in north- ern Tanzania. Incidence estimates are needed to characterize the disease burden. Using hybrid surveillance—coupling case-finding at two referral hospitals and healthcare utilization data—we estimated the incidences of acute Q fever and SFGR in Moshi, Kilimanjaro, Tanzania, from 2007 to 2008 and from 2012 to 2014. Cases were defined as fever and a four-fold or greater increase in antibody titers of acute and convalescent paired sera according to the indirect immunoflu- orescence assay of Coxiella burnetii phase II antigen for acute Q fever and Rickettsia conorii (2007–2008) or Rickettsia africae (2012–2014) antigens for SFGR. Healthcare utilization data were used to adjust for underascertainment of cases by sentinel surveillance. For 2007 to 2008, among 589 febrile participants, 16 (4.7%) of 344 and 27 (8.8%) of 307 partici- pants with paired serology had Q fever and SFGR, respectively. Adjusted annual incidence estimates of Q fever and SFGR were 80 (uncertainty range, 20–454) and 147 (uncertainty range, 52–645) per 100,000 persons, respectively. For 2012 to 2014, among 1,114 febrile participants, 52 (8.1%) and 57 (8.9%) of 641 participants with paired serology had Q fever and SFGR, respectively. Adjusted annual incidence estimates of Q fever and SFGR were 56 (uncertainty range, 24–163) and 75 (uncertainty range, 34–176) per 100,000 persons, respectively. We found substantial incidences of acute Q fever and SFGR in northern Tanzania during both study periods. To our knowledge, these are the first incidence esti- mates of either disease in sub-Saharan Africa. Our findings suggest that control measures for these infections warrant consideration.