Brucellosis testing patterns at health facilities in Arusha region, northern Tanzania

Brucellosis is listed as one of six priority zoonoses in Tanzania's One Health strategic plan which highlights gaps in data needed for the surveillance and estimation of human brucellosis burdens. This study collected data on current testing practices and test results for human brucellosis in A...

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Bibliographic Details
Published in:	PloS one 2022-03, Vol.17 (3), p.e0265612-e0265612
Main Authors:	Lukambagire, AbdulHamid Settenda, Shirima, Gabriel Mkulima, Shayo, Damas Davis, Mathew, Coletha, Yapi, Richard B, Kasanga, Christopher Julius, Mmbaga, Blandina Theophile, Kazwala, Rudovick Reuben, Halliday, Jo E B
Format:	Article
Language:	eng
Subjects:	Agglutination Agglutination tests Analysis Animals Biology and Life Sciences Brucella Brucellosis Brucellosis - diagnosis Brucellosis - epidemiology Care and treatment Clinics Data collection Diagnosis Disease Disease control Health care facilities Health Facilities Health planning Health services Historical account Hospital facilities Hospitals Humans Information management Information systems Medicine and Health Sciences Methods People and Places Reagents Retrospective Studies Risk factors Strategic planning (Business) Tanzania Tanzania - epidemiology Test procedures Uganda Veterinary colleges Veterinary medicine Zoonoses
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Summary:	Brucellosis is listed as one of six priority zoonoses in Tanzania's One Health strategic plan which highlights gaps in data needed for the surveillance and estimation of human brucellosis burdens. This study collected data on current testing practices and test results for human brucellosis in Arusha region, northern Tanzania. Retrospective data were extracted from records at 24 health facilities in Arusha region for the period January 2012 to May 2018. Data were captured on: the test reagents used for brucellosis, procurement and testing protocols, the monthly number of patients tested for brucellosis and the monthly number testing positive. Generalised linear mixed models were used to evaluate relationships between health facility characteristics and the probability that brucellosis testing was conducted in a given month, and the proportion of individuals testing positive. Four febrile Brucella agglutination tests were used widely. The probability of testing for brucellosis in a given month was significantly associated with an interaction between year of testing and facility ownership. Test probability increased over time with more pronounced increases in privately owned as compared to government facilities. The proportion of individuals testing positive for brucellosis was significantly associated with facility type and district, with individuals tested in hospitals in Meru, Monduli and Ngorongoro districts more likely to test positive. Febrile Brucella agglutination tests, known for their poor performance, were the mainstay of brucellosis testing at health facilities in northern Tanzania. The study indicates that historical data on human brucellosis in Arusha and other regions are likely to provide an inaccurate measure of true disease burden due to poor performance of the tests used and variation in testing practices. Measures to address these identified shortcomings could greatly improve quality of testing and surveillance data on brucellosis and ultimately inform prevention and control of this priority disease.
ISSN:	1932-6203 1932-6203