Browsing by Author "Jubara, Ambrose Samuel"

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    The Epidemiology of Zoonotic Brucellosis in Bahr el Ghazal Region of South Sudan
    (Frontiers in Public Health, 2019) Madut, Nuol Aywel; Muleme, James; Kankya, Clovice; Nasinyama, George William; Bwalya Muma, John; Godfroid, Jacques; Jubara, Ambrose Samuel; Muwonge, Adrian
    In this study, we focused on three zoonotic brucellosis risk groups; abattoir workers, febrile cases at Wau hospital and cattle herders, in Bahr el Ghazal region, South Sudan. Competitive c-ELISA was used to detect anti-Brucella antibodies in 725 individuals between December 2015 andMay 2016. In addition, questionnairemetadata, focus group discussions and key informant interviews were used to characterize the epidemiology of zoonotic brucellosis in this region. Results: Overall, we estimate 27.2%(95%CI = 23.9–30.6) brucellosis sero-prevalence; 32.1% (95% CI = 26.2–38.4), 23.0% (95% CI = 19.1–27.4) and 34.6% (95% CI = 24.4–46.3) among abattoir workers, febrile cases, and herders, respectively. Marital status (Single, OR= 0.58, 95%CI: 0.36–0.91, P =0.02) and ethnicity (Kerash OR = 6.01, 95%CI: 1.97–21.10, P = 0.003 and Balanda, OR = 3.78, 95%CI: 1.42–12.02, P = 0.01) were associated with brucellosis. While gender and ethnicity were important factors for general awareness of zoonotic diseases. Highly ranked occupations at risk included veterinarian, butchers and milk handlers. We also identified covariate patterns for clinical diagnostics and public health interventions. Conclusion: We report the highest sero-prevalence of zoonotic brucellosis in three risk groups in the East African region. All this is not only occurring in a population with limited awareness that brucellosis is a zoonotic disease but also where one in nine health workers tested was sero-positive. We identified social demographic associations with brucellosis, however, the qualitative analysis suggests these are more complex and nuanced. Therefore, future studies could benefit from the use of the mixed methods approach to add extensiveness and depth to our understanding of zoonotic disease drivers, in order to implement mitigating measures such as cattle vaccination.
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    The sero-prevalence of brucellosis in cattle and their herders in Bahr el Ghazal region, South Sudan
    (PLOS Neglected Tropical Diseases, 2018) Madut, Nuol Aywel; Muwonge, Adrian; Nasinyama, George William; Bwalya Muma, John; Godfroid, Jacques; Jubara, Ambrose Samuel; Muleme, James; Kankya, Clovice
    Brucellosis is a worldwide recognized bacterial zoonotic disease. There is currently no information on bovine brucellosis sero-prevalence in South Sudan regardless of the economic, social and public health impact on populations. Therefore, for the first time in 33 years, we report the sero-prevalence of brucellosis in cattle and their herders. Furthermore, we characterize the drivers associated with the disease at the human-animal interface in Bahr el Ghazal region, South Sudan. Methods A total of 893 and 87 animal and human sera respectively were examined between December 2015 and May 2016. Rose Bengal Plate Test (RBPT) and Competitive Enzyme Linked Immuno Sorbent Assay (c-ELISA) were used in parallel to detect anti-Brucella antibodies. Questionnaires were administered to collect relevant metadata used for the association analysis in R version 3.2.3. Odds Ratio (OR) and Confidence Intervals (CI) were determined. Results Overall bovine brucellosis prevalence was 31% (95%CI = 28.0±34.2), with the highest 63% (95%CI = 53±70) and lowest 10% (95%CI = 4.5±20.1) prevalence estimates in Wau and Gogrial states respectively. The bovine sero-prevalence was approximately equally distributed among the male 30.4% (26.9±34.2) and the females 32.5% (26.8±38.7). Poor body condition (OR = 0.22; 95%CI = 0.07±0.54) and larger herd sizes (OR = 0.05; 95%CI = 0.008±0.173) were protective factors for brucellosis, while the opposite was true for the second (OR = 1.70; 95%CI = 1.08±2.67) and third (OR = 2.5; 95%CI = 1.46±4.47) lactation stage. The overall brucellosis sero-prevalence in herders was estimated at 33.3% (23.9± 44.3). Conclusion We report a high prevalence of anti-Brucella antibodies in cattle and their herders in Bahr el Ghazal, indicating an enzootic status in the cattle population being an important source of infection for humans. This represents a genuine public health challenge. Therefore, there is need to raise awareness and build capacity and infrastructure in this fragile state to underwrite future public health strategies for brucellosis.