Browsing by Author "Halliday, J. E. B."

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Mobile phones as surveillance tools: Implementing and evaluating a large-scale intersectoral surveillance system for rabies in Tanzania
(PLOS Medicine, 2016-04-12) Mtema, Z.; Changalucha, J.; Cleaveland, S.; Elias, M.; Ferguson, M. H.; Halliday, J. E. B.; Haydon, D.T.; Jaswant, G.; Kazwala, R. R.; Killeen, G. F.; Lembo, T; Lushasi, K.; Malishee, A. D.; Mancy, R.; Maziku, M.; Mbunda, E. M.; Mchau, G. J. M.; Murray-Smith, R.; Rysava, K.; Said, K.; Sambo, M.; Shayo, E.; Sikana, L.; Townsend, S. E.; Urassa, H.; Hampson, K.
Surveillance is critical to manage preventative health services and control infectious diseases. Integrated surveillance involving public health, veterinary, and environmental sectors is urgently needed to effectively manage zoonoses and vector-borne diseases. However, most surveillance in low-income countries is paper-based, provides negligible timely feedback, is poorly incentivised, and results in delays, limited reporting, inaccurate data, and costly processing. • The potential of mobile technologies for improving health system surveillance has been demonstrated through small-scale pilots, but large-scale evaluations under programmatic implementation remain rare. • An intersectoral mobile-phone–based system was developed and implemented for rabies surveillance across southern Tanzania. Since 2011, the system has facilitated near realtime reporting of animal bites and human and animal vaccine use (almost 30,000 reports) by over 300 frontline health and veterinary workers across a catchment area of 150,000 km2 with >10 million inhabitants, improving data quality, timeliness, and completeness while reducing costs. • The surveillance system infrastructure is a platform that can be further developed to improve services and deliver health interventions; for example, generating automated personalized text messages (SMS) to alert patients to their vaccination schedules improved their compliance with regimens. Other interventions targeting patients and health workers can now be implemented easily. • The system has become an integrated, popular, and valuable tool across sectors, used routinely throughout southern Tanzania to evaluate the impacts of rabies control and prevention activities and to improve their management, directly informed by the experiences of frontline users. • We discuss challenges encountered during development and deployment, how we overcame these, and our recommendations for scaling up mobile-phone–based health (mHealth) interventions in low-income countries.
Risk Factors for Human Brucellosis in Northern Tanzania.
(The American Society of Tropical Medicine and Hygiene., 2018) Cash-Goldwasser, S.; Maze, M. J.; Rubach, M. P.; Biggs, H. M.; Stoddard, R. A.; Sharples, K. J.; Halliday, J. E. B.; Cleaveland, S.; Shand, M. C.; Mmbaga, B. T.; Muiruri, C.; Saganda, W.; Lwezaula, B. F.; Kazwala, R. R.; Maro, V. P.; Crump, J. A.
Little is known about the epidemiology of human brucellosis in sub-Saharan Africa. This hampers prevention and control efforts at the individual and population levels. To evaluate risk factors for brucellosis in northern Tanzania, we conducted a study of patients presenting with fever to two hospitals in Moshi, Tanzania. Serum taken at enrollment and at 4-6 week follow-up was tested by Brucella microagglutination test. Among participants with a clinically compatible illness, confirmed brucellosis cases were defined as having a ≥ 4-fold rise in agglutination titer between paired sera or a blood culture positive for Brucella spp., and probable brucellosis cases were defined as having a single reciprocal titer ≥ 160. Controls had reciprocal titers < 20 in paired sera. We collected demographic and clinical information and administered a risk factor questionnaire. Of 562 participants in the analysis, 50 (8.9%) had confirmed or probable brucellosis. Multivariable analysis showed that risk factors for brucellosis included assisting goat or sheep births (Odds ratio [OR] 5.9, 95% confidence interval [CI] 1.4, 24.6) and having contact with cattle (OR 1.2, 95% CI 1.0, 1.4). Consuming boiled or pasteurized dairy products was protective against brucellosis (OR 0.12, 95% CI 0.02, 0.93). No participants received a clinical diagnosis of brucellosis from their healthcare providers. The under-recognition of brucellosis by healthcare workers could be addressed with clinician education and better access to brucellosis diagnostic tests. Interventions focused on protecting livestock keepers, especially those who assist goat or sheep births, are needed.
Serological and molecular evidence of brucella species in the rapidly growing pig sector in Kenya
(BMC Veterinary Research, 2020) Akoko, J; Pelle, R; Kivali, V; Schelling, E; Shirima, G; Mathew, C; Kyallo, V; Bonfoh, B; Kazwala, R; Ouma, C; Machuka, E. M.; Fèvre, E. M.; Falzon, L. C.; Lukambagire, A. S.; Halliday, J. E. B.
Background: Brucellosis is an emerging yet neglected zoonosis that has been reported in Kenya. Epidemiological data on brucellosis in ruminants is readily accessible; however, reports on brucellosis in pigs remain limited. This study sought to detect Brucella infection in pig serum by both serological and molecular techniques. Serum from 700 pigs randomly collected at a centralized abattoir in Nairobi region, Kenya were screened in parallel, using both Rose Bengal Test (RBT) and competitive Enzyme-Linked Immuno-sorbent Assay (cELISA) for antibodies against Brucella spp. All sera positive by RBT and 16 randomly selected negative samples were further tested using conventional PCR targeting bcsp31 gene and real-time PCR (RT-PCR) assays targeting IS711 and bcsp31 genes. Results: A prevalence of 0.57% (n = 4/700) was estimated using RBT; none of these samples was positive on cELISA. All RBT positive sera were also positive by both PCRs, while two sero-negative samples also tested positive on RTPCR (n = 6/20). Brucella abortus was detected in four out of the six PCR positive samples through a real-time multiplex PCR. Conclusion: The detection of antibodies against Brucella spp. and DNA in serum from slaughterhouse pigs confirm the presence of Brucella in pigs. Therefore, investigation of the epidemiology and role of pigs in the transmission of brucellosis in Kenya is needed. Further targeted studies would be useful to systematically quantify and identify the spp. of Brucella in pigs.