Year: 2018
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Leptospirosis is a major cause of febrile illness in Africa but little is known about risk factors for human infection. We conducted a cross-sectional study to investigate risk factors for acute leptospirosis and Leptospira seropositivity among patients with fever attending referral hospitals in northern Tanzania. METHODS: We enrolled patients with fever from two referral hospitals in Moshi, Tanzania, 2012-2014, and performed Leptospira microscopic agglutination testing on acute and convalescent serum. Cases of acute leptospirosis were participants with a four-fold rise in antibody titers, or a single reciprocal titer ≥800. Seropositive participants required a single titer ≥100, and controls had titers <100 in both acute and convalescent samples. We administered a questionnaire to assess risk behaviors over the preceding 30 days. We created cumulative scales of exposure to livestock urine, rodents, and surface water, and calculated odds ratios (OR) for individual behaviors and for cumulative exposure variables. RESULTS: We identified 24 acute cases, 252 seropositive participants, and 592 controls. Rice farming (OR 14.6), cleaning cattle waste (OR 4.3), feeding cattle (OR 3.9), farm work (OR 3.3), and an increasing cattle urine exposure score (OR 1.2 per point) were associated with acute leptospirosis. CONCLUSIONS: In our population, exposure to cattle and rice farming were risk factors for acute leptospirosis. Although further data is needed, these results suggest that cattle may be an important source of human leptospirosis. Further investigation is needed to explore the potential for control of livestock Leptospira infection to reduce human disease.
Source: PLoS neglected tropical diseases
Authors: Michael J. Maze, Shama Cash-Goldwasser, Matthew P. Rubach, Holly M. Biggs, Renee L. Galloway, Katrina J. Sharples, Kathryn J. Allan, Jo E. B. Halliday, Sarah Cleaveland, Michael C. Shand, Charles Muiruri, Rudovick R. Kazwala, Wilbrod Saganda, Bingileki F. Lwezaula, Blandina T. Mmbaga, Venance P. Maro, John A. Crump
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,670
Awards: Viral Zoonoses and Severe Febrile Illness in Northern Tanzania, G1125710916, Social, Economic and Environmental Drivers of Zoonoses in Tanzania (SEEDZ), Hazards Associated with Zoonotic enteric pathogens in Emerging Livestock meat pathways (HAZEL), G1894086871, University of California Global Health Institute Program for Fellows and Scholars, Leptospirosis in Tanzania: the role of rodents and cattle in a neglected public health problem., The impact and social ecology of bacterial zoonoses in northern Tanzania, G3414247287, Vanderbilt-Emory-Cornell-Duke Consortium for Global Health Fellows (VECDor), International Clinical Trials Unit, The Impact and Society Ecology of Bacterial Zoonoses in Northern Tanzania: Under, G5522424963, Accelerating Precision Diagnostics – Bridging the Gap, Molecular epidemiology of brucellosis in northern Tanzania, International Vaccine Institute - to build additional evidence to understand where typhoid vaccine is needed in Africa and accelerate its delivery where needed, G767223094, Investigating Febrile Deaths in Tanzania (INDITe), Interdisciplinary Research Training Program in AIDS
OpenAlex ID: W2807235779