Comparison of the Estimated Incidence of Acute Leptospirosis in the Kilimanjaro Region of Tanzania between 2007-08 and 2012-14.
<h4>Background</h4>The sole report of annual leptospirosis incidence in continental Africa of 75-102 cases per 100,000 population is from a study performed in August 2007 through September 2008 in the Kilimanjaro Region of Tanzania. To evaluate the stability of this estimate over time, w...
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Public Library of Science (PLoS)
2016-12-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0005165&type=printable |
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| author | Michael J Maze Holly M Biggs Matthew P Rubach Renee L Galloway Shama Cash-Goldwasser Kathryn J Allan Jo E B Halliday Julian T Hertz Wilbrod Saganda Bingileki F Lwezaula Sarah Cleaveland Blandina T Mmbaga Venance P Maro John A Crump |
| author_facet | Michael J Maze Holly M Biggs Matthew P Rubach Renee L Galloway Shama Cash-Goldwasser Kathryn J Allan Jo E B Halliday Julian T Hertz Wilbrod Saganda Bingileki F Lwezaula Sarah Cleaveland Blandina T Mmbaga Venance P Maro John A Crump |
| author_sort | Michael J Maze |
| collection | DOAJ |
| description | <h4>Background</h4>The sole report of annual leptospirosis incidence in continental Africa of 75-102 cases per 100,000 population is from a study performed in August 2007 through September 2008 in the Kilimanjaro Region of Tanzania. To evaluate the stability of this estimate over time, we estimated the incidence of acute leptospirosis in Kilimanjaro Region, northern Tanzania for the time period 2012-2014.<h4>Methodology and principal findings</h4>Leptospirosis cases were identified among febrile patients at two sentinel hospitals in the Kilimanjaro Region. Leptospirosis was diagnosed by serum microscopic agglutination testing using a panel of 20 Leptospira serovars belonging to 17 separate serogroups. Serum was taken at enrolment and patients were asked to return 4-6 weeks later to provide convalescent serum. Confirmed cases required a 4-fold rise in titre and probable cases required a single titre of ≥800. Findings from a healthcare utilisation survey were used to estimate multipliers to adjust for cases not seen at sentinel hospitals. We identified 19 (1.7%) confirmed or probable cases among 1,115 patients who presented with a febrile illness. Of cases, the predominant reactive serogroups were Australis 8 (42.1%), Sejroe 3 (15.8%), Grippotyphosa 2 (10.5%), Icterohaemorrhagiae 2 (10.5%), Pyrogenes 2 (10.5%), Djasiman 1 (5.3%), Tarassovi 1 (5.3%). We estimated that the annual incidence of leptospirosis was 11-18 cases per 100,000 population. This was a significantly lower incidence than 2007-08 (p<0.001).<h4>Conclusions</h4>We estimated a much lower incidence of acute leptospirosis than previously, with a notable absence of cases due to the previously predominant serogroup Mini. Our findings indicate a dynamic epidemiology of leptospirosis in this area and highlight the value of multi-year surveillance to understand leptospirosis epidemiology. |
| format | Article |
| id | doaj-art-28fb60e5919c43e6b9a671303897e554 |
| institution | Kabale University |
| issn | 1935-2727 1935-2735 |
| language | English |
| publishDate | 2016-12-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj-art-28fb60e5919c43e6b9a671303897e5542025-08-20T03:26:43ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352016-12-011012e000516510.1371/journal.pntd.0005165Comparison of the Estimated Incidence of Acute Leptospirosis in the Kilimanjaro Region of Tanzania between 2007-08 and 2012-14.Michael J MazeHolly M BiggsMatthew P RubachRenee L GallowayShama Cash-GoldwasserKathryn J AllanJo E B HallidayJulian T HertzWilbrod SagandaBingileki F LwezaulaSarah CleavelandBlandina T MmbagaVenance P MaroJohn A Crump<h4>Background</h4>The sole report of annual leptospirosis incidence in continental Africa of 75-102 cases per 100,000 population is from a study performed in August 2007 through September 2008 in the Kilimanjaro Region of Tanzania. To evaluate the stability of this estimate over time, we estimated the incidence of acute leptospirosis in Kilimanjaro Region, northern Tanzania for the time period 2012-2014.<h4>Methodology and principal findings</h4>Leptospirosis cases were identified among febrile patients at two sentinel hospitals in the Kilimanjaro Region. Leptospirosis was diagnosed by serum microscopic agglutination testing using a panel of 20 Leptospira serovars belonging to 17 separate serogroups. Serum was taken at enrolment and patients were asked to return 4-6 weeks later to provide convalescent serum. Confirmed cases required a 4-fold rise in titre and probable cases required a single titre of ≥800. Findings from a healthcare utilisation survey were used to estimate multipliers to adjust for cases not seen at sentinel hospitals. We identified 19 (1.7%) confirmed or probable cases among 1,115 patients who presented with a febrile illness. Of cases, the predominant reactive serogroups were Australis 8 (42.1%), Sejroe 3 (15.8%), Grippotyphosa 2 (10.5%), Icterohaemorrhagiae 2 (10.5%), Pyrogenes 2 (10.5%), Djasiman 1 (5.3%), Tarassovi 1 (5.3%). We estimated that the annual incidence of leptospirosis was 11-18 cases per 100,000 population. This was a significantly lower incidence than 2007-08 (p<0.001).<h4>Conclusions</h4>We estimated a much lower incidence of acute leptospirosis than previously, with a notable absence of cases due to the previously predominant serogroup Mini. Our findings indicate a dynamic epidemiology of leptospirosis in this area and highlight the value of multi-year surveillance to understand leptospirosis epidemiology.https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0005165&type=printable |
| spellingShingle | Michael J Maze Holly M Biggs Matthew P Rubach Renee L Galloway Shama Cash-Goldwasser Kathryn J Allan Jo E B Halliday Julian T Hertz Wilbrod Saganda Bingileki F Lwezaula Sarah Cleaveland Blandina T Mmbaga Venance P Maro John A Crump Comparison of the Estimated Incidence of Acute Leptospirosis in the Kilimanjaro Region of Tanzania between 2007-08 and 2012-14. PLoS Neglected Tropical Diseases |
| title | Comparison of the Estimated Incidence of Acute Leptospirosis in the Kilimanjaro Region of Tanzania between 2007-08 and 2012-14. |
| title_full | Comparison of the Estimated Incidence of Acute Leptospirosis in the Kilimanjaro Region of Tanzania between 2007-08 and 2012-14. |
| title_fullStr | Comparison of the Estimated Incidence of Acute Leptospirosis in the Kilimanjaro Region of Tanzania between 2007-08 and 2012-14. |
| title_full_unstemmed | Comparison of the Estimated Incidence of Acute Leptospirosis in the Kilimanjaro Region of Tanzania between 2007-08 and 2012-14. |
| title_short | Comparison of the Estimated Incidence of Acute Leptospirosis in the Kilimanjaro Region of Tanzania between 2007-08 and 2012-14. |
| title_sort | comparison of the estimated incidence of acute leptospirosis in the kilimanjaro region of tanzania between 2007 08 and 2012 14 |
| url | https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0005165&type=printable |
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