Browsing by Author "Skjerve, E."

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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.
Association of long-term pesticide exposure and biologic parameters in female farm workers in Tanzania: A cross sectional study
(Toxics, 2016-09-29) Manyilizu, W. B.; Mdegela, R. H.; Kazwala, R. R.; Nonga, H. E.; Müller, M. B.; Lie, E.; Skjerve, E.; Lyche, J. L.
The study aimed to assess the association of long-term pesticide exposure (5 years) with hematological, serum biochemical parameters and acetylcholinesterase activity in farm workers. These pesticides included organophosphorus pesticides, carbamates, pyrethroids, dithiocarbamates, and other pesticides such as endosulfan. Applying a cross-sectional study design, 69 females from a pesticide-exposed farm population and 30 females from a district not using pesticides (reference group) were studied. The mean red cell corpuscular volume and hematocrit values were significantly lower (74.7 9.1 fl; 95% CI 72.5–76.9 and 32.0% 4.6%; 95% CI 30.9–33.1, respectively) in the exposed compared to the reference group, whereas mean corpuscular hemoglobin concentration and platelets were significantly higher (37.4 3.8 g/dL; 95% CI 36.5–38.3 and 374.1 95.3/L; 95% CI 351.2–396.9, respectively) in the exposed compared to the reference group. Mean serum glutamic oxaloacetate transaminase (20.7 8.9 U/L; 95% CI 18.5–22.9) and creatinine (83.9 6.6 mol/L; 95% CI 82.3–85.5) were significantly higher in the exposed compared to the reference group. A higher mean esterase activity (AChE 0.6 0.2 mM/min/mg protein; 95% CI 0.56–0.7; BChE 0.9 0.4 mM/min/mg protein; 95% CI 0.9–1.1) was noted in the exposed group. Regression models suggest that occupational exposure (p < 0.001) could be a predictor of esterase (AChE and BChE) activity and biochemical changes (= 0.4, 95% CI: 0.3–0.5; = 0.7, 95% CI: 0.6–0.9, respectively). Long-term pesticide exposure affects the hemato-biochemical and esterase responses, establishing the need for further studies.
Characterisation of mycobacteria isolated from slaughter cattle in pastoral regions of Uganda
(2007-10-25) Oloya, J.; Kazwala, R.; Lund, A.; Opuda-Asibo, J; Demelash, B.; Skjerve, E.; Johansen, T. B; Djønne, B.
Bovine tuberculosis is a zoonotic problem in pastoral cattle and communities in Uganda. Tuberculin tests in pastoral cattle had shown a high herd but low animal prevalence, with a high proportion of avian reactors. No work had been done to identify the mycobacterial species involved. The objective of the study was to isolate and characterise Mycobacterial species causing tuberculous lesions in slaughtered animals. Lesioned organs compatible with bovine tuberculosis in slaughtered cattle from pastoral areas in Uganda were collected and cultured to isolate mycobacteria. AccuProbe culture identification kits for the Mycobacterium tuberculosis complex, M. avium complex and M. avium were used to identify the isolates. Spoligotyping and Insertion Sequence (IS) 1311 and IS1245 Restriction Fragment Length Polymorphism analysis (RFLP) were used to further characterise the isolates. Results: Of the 61 lesioned organs and tissues cultured, 19 isolates were identified as M. bovis, 3 as M. avium subsp.hominissuis, 1 as M. intracellulare, 1 as a mixed culture of M. bovis and M. avium sp. and 1 as M. avium sp. and unidentified mycobacteria. Eleven other mycobacteria outside the tuberculosis and avium complex groups were also isolated. Ten new spoligopatterns grouped into three clusters were identified from M. bovis isolates. Two of the three M. avium subsp.hominissuis isolates showed similar patterns on the IS1311 RFLP but all were different on the IS1245 RFLP. Conclusion: The isolation of M. bovis confirms the ongoing infection with spoligotypes unique to Uganda. Isolation of environmental mycobacteria could explain the high avian or non specific tuberculin reactor patterns commonly observed in pastoral cattle and suggests their pathogenic or opportunistic role in the infection of cattle with disseminated bovine tuberculous lesions.
Ecological niche modeling as a tool for prediction of the potential geographic distribution of Bacillus anthracis spores in Tanzania
(International Society for Infectious Diseases, 2018-11-27) Mwakapeje, E.R.; Ndimuligo, S.A.; Mosomtai, G.; Nyakarahuka, L.; Nonga, H.E.; Mdegela, R.H.; Skjerve, E.; Ayebare, S.
Anthrax is caused by the spore-forming, Gram-positive bacterium Bacillus anthracis. The aim of this study was to predict the potential distribution of B. anthracis in Tanzania and produce epidemiological evidence for the management of anthrax outbreaks in the country. Methods: The Maxent algorithm was used to predict areas at risk of anthrax outbreaks based on the occurrence and environmental data in Arusha and Kilimanjaro regions; the model was later transferred to predict the entire country. Seventy percent of the occurrence data were used to train the model, while 30% were used for model evaluation. Results: Four regions of northern Tanzania are predicted to have a high risk for anthrax outbreaks, while the southern and western regions had low-risk areas. Soil type (56.5%), soil pH (23.7%), and isothermally (10.4%) were the most important variables for the model prediction, and the most significant soil types were solonetz, fluvisols, and lithosols. Conclusions: A strong risk level across districts of the Tanzania mainland was identified in this study. A total of 18 districts in Tanzania Mainland are predicted to be at very high risk of an anthrax outbreak occurrence. These findings are important for policymakers to effectively mount targeted control measures for anthrax outbreaks in Tanzania
Levels and patterns of persistent organic pollutants (POPs) in tilapia (Oreochromis sp.) from four different lakes in Tanzania: Geographical differences and implications for human health
(Elsevier, 2014-04-22) Lie, Elisabeth; Polder, A.; Müller, M. B.; Lyche, J. L.; Mdegela, R. H.; Nonga, H. E.; Mabiki, F.; Mbise, T. J.; Skaare, J. U.; Sandvik, M.; Skjerve, E.; Lie, E.
In Tanzania fish is one of the most important protein sources for the rapidly increasing population. Wild fish is threatened by overfishing and pollution from agriculture, industries, mining, household effluents and vector control. Tomonitor possible implications for public health, the geographical differences of the occurrence and levels of persistent organic pollutants (POPs) in tilapia fish (Oreochromis sp.) from four different Tanzanian lakes were investigated in 2011. Concentrations of organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), polybrominated diphenyls (PBDEs) and hexabromocyclododecane (HBCDD) were determined in pooled samples of tilapia muscle from Lake (L) Victoria, L. Tanganyika, L. Nyasa (also called L. Malawi) and L. Babati in Tanzania in 2011. Levels of Σ-DDTs (274 ng/g lipid weight (lw)) and sum of 7 indicator PCBs (Σ-7PCBs) (17 ng/g lw) were significantly higher in tilapia from L. Tanganyika compared to the other lakes. The highest levels of Σ-endosulfan (94 ng/g lw) were detected in tilapia from L. Victoria. Toxaphenes were detected in low levels in fish from L. Tanganyika and L. Babati. Results revealed a geographic difference in the use of DDT and endosulfan between L. Victoria and L. Tanganyika. Low ratios of DDE/DDT in tilapia from L. Tanganyika indicated an on-going use of DDT in the area. Median levels of ΣBDEs, including BDE-209, were highest in L. Victoria (19.4 ng/g lw) and BDE- 209 was present in 68% of the samples from this lake. The presence of BDE-209 indicates increasing influence of imported products from heavy industrialized countries. The measured POP levels in the studied tilapia were all below MRLs of EU or were lower than recommended levels, and thus the fish is considered as safe for human consumption. They may, however, pose a risk to the fish species and threaten biodiversity.
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.
Responses to tuberculin among Zebu cattle in the transhumance regions of Karamoja and Nakasongola district of Uganda
(Tropical Animal Health and Production, 2006-01-23) Oloya, J.; Opuda-Asibo, J.; Djønne, B.; Muma, J. B.; Matope, G.; Kazwala, R. R.; Skjerve, E.
Responses to tuberculin in Zebu cattle of the transhumant pastoral farming system in Karamoja region and Nakasongola district in the north-eastern and mid-central regions in Uganda, respectively, were investigated using a comparative intradermal tuberculin skin test. Of the 1864 cattle tested from 30 large units (superherds) in Karamoja and 7 herds in Nakasongola, a total of 28 animals from 19 herds (51.4%) tested positive. Inter-district tuberculin reactor prevalence variations seemed to be influenced by climate, with impact on both the management patterns and transmissibility of agent. High herd tuberculin reactor preva-lence (51.4%) was attributed to widespread contacts and mixing of animals between herds. Low individual animal tuberculin test positivity (mean=1.4%) was attributed to low transmissibility of the agent under the Karamoja climate, which is semi-arid, and to increased resistance due to non-specific response to environmental mycobacteria and natural selection, since there was no active control against bovine tuberculosis. Owing to similarities in management practices in Karamoja and widespread risk factors, it was difficult to identify which were more important, but variations in sources of drinking water pointed to provision of lake and borehole water during dry season as reducing the risk. Positive bovine tuberculin reactor prevalence and skin reactor status were related to age.
Risk factors for human cutaneous anthrax outbreaks in the hot-spot districts of Northern Tanzania: an unmatched case control study
(Royal Society Open Science, 2018-09-05) Mwakapeje, E.R.; Nonga, H.E.; Mdegela, R.H.; Skjerve, E.; Høgset, S.; Softic, A.; Mghamba, J.
Bacillus anthracis is an aerobic, Gram-positive and sporeforming bacterium, which causes anthrax in herbivores. Humans get infected after coming into contact with infected animals’ products. An unmatched case–control study was conducted to identify the importance of demographic, biological and/or behavioural factors associated with human cutaneous anthrax outbreaks in the hotspot areas of Northern Tanzania. A semi-structured questionnaire was administered to both cases and controls. The age range of participants was 1–80 years with a median age of 32 years. In the younger group (1–20 years), the odds of being infected were 25 times higher in the exposed group compared to the unexposed group (OR¼ 25, 95% CI ¼ 1.5–410). By contrast, the odds of exposure in the old group ( 20 years) were three times lower in the exposed group compared to the unexposed group (OR ¼ 3.2, 95% CI ¼ 1.28–8.00). Demographic characteristics, sleeping on animal’s skins, contacting with infected carcasses through skinning and butchering, and not having formal education were linked to exposure for anthrax infection. Hence, a One Health approach is inevitable for the prevention and control of anthrax outbreaks in the hotspot areas of Northern Tanzania.
Self-reported health effects among short and long-term pesticide sprayers in Arusha, Northern Tanzania: A cross sectional Study
(2015) Lyche, J.V.; Manyilizu, W. B.; Mdegela, R. H.; Manyilizu, W. B.; Mdegela, R. H.; Kazwala, R.; Müller, M.; Skjerve, E.
Background: The aim of the present study was to assess whether long-term exposure to pesticides is associated with adverse health effects in professional pesticide sprayers. Methods: The study was conducted in Lake Eyasi Basin and Ngarenanyuki in Arusha region, during the dry season in September-October 2013. In a cross-sectional study, 97 short-term exposed men with at most three months as professional sprayers were compared with 60 long-term exposed men with experience of at least five years as professional sprayers. The study participants were aged 18-30 years, drawn from the same source population and interviewed using semi structured questionnaire. The questions focused on spraying procedures and on present and recurrent medical history including presence of selected six known pesticide induced health conditions. Results: Organophosphates, carbamates, dithiocarbamates and pyrethroids were the most applied insecticides but also organochlorine fungicides and endosulfan were frequently applied. The majority of the sprayers reported unsafe pesticide use. Mean pesticide uses in litres, spray frequency per crop and per week were 637, and 1.3 respectively for about 270 days a year. Respiratory disease symptoms were the most frequently reported (46/157; 29.3%) followed by skin (27/157; 17.2%), and sight (24/157; 15.3%). When adjusted for age and other predictors, long-term exposed sprayers had significantly higher self-reported occurrences of peripheral neuropathy (OR=7.7, CI95%: 1.045-56.728, p=0.045) and respiratory disorders (OR=0.2, CI95%: 0.067-0.501, p=0.001) compared with short-term exposed. Furthermore, 10 sprayers, all long-term exposed reported poor libido and erection problems. Conclusions: These findings document lack of safety knowledge, safe pesticide management and the implementation of protective measures as well as suggesting that long-term exposure to pesticides increase the risk of experience disease conditions compared to short-term exposure.
Self-reported symptoms and pesticide use among farm workers in Arusha, northern Tanzania: A cross sectional study
(Toxics, 2017-09-27) Manyilizu, W. B.; Mdegela, R. H.; Helleve, A.; Skjerve, E.; Kazwala, R. R.; Nonga, H. E.; Müller, M. B.; Lie, E.; Lyche, J. L.
The objective of the study was to describe self-reported health symptoms, the use of personal protective gear and clothing and poor safety procedures when applying pesticides among farm workers. A total of 128 adult farm workers were interviewed using a structured questionnaire during the farming season. The commonly used pesticides included profenofos, mancozeb, chlorpyrifos, cypermethrin, deltamethrin, permethrin, lambda-cyhalothrin, endosulfan and carbosulfan. The majority (>90%) of farm workers used no personal protective clothing while handling pesticides. More than one-third of farm workers ate and drank without washing their hands following pesticide handling, while a smaller number smoked or chewed gum. Wearing special boots during pesticide application was found to reduce the risk of skin rash (OR = 0.2, 95% CI: 0.06–0.66), whereas smoking when applying pesticides increased the risk of chest pain occurrence (OR = 4.0, 95% CI: 1.14–15.43), as well as forgetfulness (OR = 4.0, 95% CI: 1.30–14.02). Chewing gum and eating when applying pesticides was associated with diarrhoea (OR = 11.0, 95% CI: 1.80–6.84 and OR = 7.0, 95% CI: 1.27–3.67 respectively). The increased self-reported prevalence of post-exposure adverse health effects among farm workers was associated with poor use of personal protective clothing and poor safety practices during pesticide use and handling. These data indicate the need for improved availability and use of protective equipment, and training in crop and pest management practices to prevent risky behavioursand for safer and sustainable vegetable production.