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      Seropositivity of Brucella spp. and Leptospira spp. antibodies among abattoir workers and meat vendors in the city of Mwanza, Tanzania: A call for one health approach control strategies

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          Abstract

          Introduction

          Brucellosis and leptospirosis are among neglected tropical zoonotic diseases particularly in the resource limited countries. Despite being endemic in these countries, there is paucity of information on its magnitude. This study investigated seropositivity of Brucella spp. and Leptospira spp., and associated factors among abattoir workers and meat vendors in the city of Mwanza, Tanzania.

          Methodology

          A community based cross-sectional study was conducted in Mwanza city from May to July 2017. Socio-demographic and other relevant information were collected. Detection of Brucella spp. and Leptospira spp. antibodies were done using slide agglutination test and microscopic agglutination test, respectively. Data were analyzed using STATA version 13 Software.

          Findings

          A total of 250 participants (146 abattoir workers and 104 meat vendors) were enrolled with median age of 31 (IQR: 25–38) years. The overall, seropositivity of Brucella spp. antibodies was 48.4% (95% Cl: 42–54). Seropositivity of B. abortus was significantly higher than that of B. melitensis (46.0%, 95%Cl: 39–52 vs. 23.6%, 95% Cl: 18–28, P<0.001) while seropositivity of both species was 21.2% (95%Cl: 16–26). The seropositivity of Leptospira spp. was 10.0% (95% CI: 6–13) with predominance of Leptospira kirschneri serovar Sokoine which was detected in 7.2% of the participants. Being abattoir worker (OR: 2.19, 95% CI 1.06–4.54, p = 0.035) and long work duration (OR: 1.06, 95%CI: 1.01–1.11, p = 0.014) predicted presence of both B. abortus and B. melitensis antibodies. Only being married (p = 0.041) was significantly associated with seropositivity of Leptospira spp. Primary education was the only factor independently predicted presence of Brucella spp. antibodies among abattoir workers on sub-analysis of occupational exposure. None of factors were found to be associated with presence of Brucella spp. antibodies among meat vendors on sub-analysis.

          Conclusion

          Seropositivity of B. abortus antibodies among abattoir workers and meat vendors is high and seem to be a function of being abattoir worker, having worked for long duration in the abattoir and having primary education. In addition, a significant proportion of abattoir workers and meat vendors in the city was seropositive for Leptospira kirschneri serovar Sokoine. There is a need to consider ‘one health approach’ in devising appropriate strategies to control these diseases in the developing countries.

          Author summary

          Brucellosis and leptospirosis are among neglected diseases in many low-income countries affecting both animals and human populations. Despite being common, the information on their distribution are scarce. In a view of that, this study investigated the proportion of participants with positive antibody test specifically for the two diseases among slaughter house workers and meat sellers in Mwanza city. The study involved 250 participants aged between 25 and 38 years. Overall, 48.4% of participants were Brucella spp. seropositive. Proportion of participants who were positive for B. abortus specific antibodies was higher than that of B. melitensis while 21.2% of them found to have antibodies for both species studied. Furthermore, about 10% of the participants had Leptospira antibodies. Being abattoir worker, long work duration and having primary education were associated with the presence of Brucella antibodies while only being married was associated with the presence of Leptospira antibodies. The findings from this study emphasize the need for multisectoral approach in devising control strategies for these pathogens.

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          Most cited references26

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          Leptospirosis: a zoonotic disease of global importance.

          In the past decade, leptospirosis has emerged as a globally important infectious disease. It occurs in urban environments of industrialised and developing countries, as well as in rural regions worldwide. Mortality remains significant, related both to delays in diagnosis due to lack of infrastructure and adequate clinical suspicion, and to other poorly understood reasons that may include inherent pathogenicity of some leptospiral strains or genetically determined host immunopathological responses. Pulmonary haemorrhage is recognised increasingly as a major, often lethal, manifestation of leptospirosis, the pathogenesis of which remains unclear. The completion of the genome sequence of Leptospira interrogans serovar lai, and other continuing leptospiral genome sequencing projects, promise to guide future work on the disease. Mainstays of treatment are still tetracyclines and beta-lactam/cephalosporins. No vaccine is available. Prevention is largely dependent on sanitation measures that may be difficult to implement, especially in developing countries.
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            Improved microtechnique for the leptospiral microscopic agglutination test.

            A method for improving the original Galton microtechnique for detecting leptospiral antibodies has been developed. Simultaneous titrations were performed on 281 animal and human sera and 17 hyperimmune sera with the microscopic agglutination (MA) test and the improved microtechnique. Reproducibility of the improved microtechnique was determined independently on 65 animal sera by two laboratory sections. The results obtained by comparing positive test data from human and animal sera indicated that agreement between the original MA test and this new method exceeded 94%, whereas the original Galton microtechnique and the original MA test agreed in a maximum of 77% of the tests. This study indicates that the results obtained with the improved microtechnique are much more comparable to results obtained with the original MA test than are those obtained with the original Galton microtechnique.
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              Diagnosis of Leptospirosis: Comparison between Microscopic Agglutination Test, IgM-ELISA and IgM Rapid Immunochromatography Test

              Background Leptospirosis is diagnosed on clinical grounds, and confirmed by microscopic agglutination test (MAT). IgM-ELISA (Serion-Virion) and immunochromatography test (Leptocheck-WB) are two immunodiagnostic assays for leptospirosis. Their sensitivity, specificity and applicability in Sri Lanka have not been systematically evaluated. Methods Clinically diagnosed leptospirosis patients (n = 919) were recruited from three hospitals in the Western Province of Sri Lanka, during June 2012 to December 2013. MAT, IgM-ELISA and Leptocheck-WB were performed on all patient sera. MAT titer of ≥400 in single sample, four-fold rise or seroconversion ≥100 in paired samples were considered as positive for MAT. For diagnostic confirmation, MAT was performed during both acute and convalescent phases. Anti-leptospiral IgM ≥20 IU/ml and appearance of a band in the test window were considered as positive for IgM-ELISA and Leptocheck-WB test respectively. Patients with an alternative diagnosis (n = 31) were excluded. Data analysis was performed using two methods, i) considering MAT as reference standard and ii) using Bayesian latent class model analysis (BLCM) which considers each test as imperfect. Results MAT, IgM-ELISA and Leptocheck-WB positivity were 39.8%, 45.8% and 38.7% respectively during the acute phase. Acute-phase MAT had specificity and sensitivity of 95.7% and 55.3% respectively, when compared to overall MAT positivity. IgM-ELISA and Leptocheck-WB had similar diagnostic sensitivity when compared with acute-phase MAT as the gold standard, although IgM-ELISA showed higher specificity (84.5%) than Leptocheck-WB (73.3%). BLCM analysis showed that IgM-ELISA and Leptocheck-WB had similar sensitivities (86.0% and 87.4%), while acute-phase MAT had the lowest sensitivity (77.4%). However, acute-phase MAT had high specificity (97.6%), while IgM-ELISA and Leptocheck-WB showed similar but lower specificity (84.5% and 82.9%). Conclusions Both IgM-ELISA and Leptocheck-WB shows similar sensitivities and specificities. IgM-ELISA may be superior to MAT during the acute phase and suitable for early diagnosis of leptospirosis. Leptocheck-WB is suitable as a rapid immunodiagnostic screening test for resource limited settings.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Writing – original draft
                Role: ConceptualizationRole: Writing – review & editing
                Role: Data curation
                Role: Data curation
                Role: Methodology
                Role: Investigation
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS Negl Trop Dis
                PLoS Negl Trop Dis
                plos
                plosntds
                PLoS Neglected Tropical Diseases
                Public Library of Science (San Francisco, CA USA )
                1935-2727
                1935-2735
                25 June 2018
                June 2018
                : 12
                : 6
                : e0006600
                Affiliations
                [1 ] Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
                [2 ] Pest Management Centre (SPMC), Sokoine University of Agriculture, Morogoro, Tanzania
                [3 ] Department of Veterinary Pathology, Sokoine University of Agriculture, Morogoro, Tanzania
                University of California Davis, UNITED STATES
                Author notes

                The authors have declared that they have no competing interests.

                Author information
                http://orcid.org/0000-0003-2313-3079
                Article
                PNTD-D-18-00023
                10.1371/journal.pntd.0006600
                6034905
                29939991
                7f94084f-5bea-4e0e-8eae-a69725d79880
                © 2018 Mirambo et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 9 January 2018
                : 10 June 2018
                Page count
                Figures: 2, Tables: 4, Pages: 14
                Funding
                Funded by: The Catholic University of Health and Allied Sciences
                Award Recipient :
                Funded by: Sokoine University of Agriculture, Pest management centre
                Award Recipient :
                The authors received no specific funding for this work.
                Categories
                Research Article
                Biology and Life Sciences
                Organisms
                Bacteria
                Brucella
                Biology and Life Sciences
                Microbiology
                Medical Microbiology
                Microbial Pathogens
                Bacterial Pathogens
                Brucella
                Medicine and Health Sciences
                Pathology and Laboratory Medicine
                Pathogens
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                Bacterial Pathogens
                Brucella
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                2018-07-06
                All relevant data are within the paper and, due to the fact public availability would compromise patient privacy raw data, may be available on request from director of research and publication Prof. Domenica Morona, who can be contacted through email: dmorona@ 123456gmail.com .

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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