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Epidemiological description of Marburg virus disease outbreak in Kagera region, Northwestern Tanzania.

ABSTRACT: In March 2023, a Marburg Virus Disease (MVD) outbreak was declared in Kagera region, Northwestern Tanzania. This was the first MVD outbreak in the country. We describe the epidemiological characteristics of MVD cases and contacts. The Ministry of Health activated an outbreak response team. Outbreak investigation methods were applied to cases identified through MVD standard case definitions and confirmed through reverse-transcriptase polymerase chain reaction (RT PCR). All identified case contacts were added into the contact listing form and followed up in-person daily for any signs or symptoms for 21 days. Data collected from various forms was managed and analyzed using Excel and QGIS software for mapping. A total of nine MVD cases were reported with eight laboratory-confirmed and one probable. Two of the reported cases were frontline healthcare workers and seven were family related members. Cases were children and adults between 1-59 years of age with a median age of 34 years. Six were males. Six cases died equivalent to a case fatality rate (CFR) of 66.7%. A total of 212 individuals were identified as contacts and two (2) became cases. The outbreak was localized in two geo-administrative wards (Maruku and Kanyangereko) of Bukoba District Council. Transmission during this outbreak occurred among family members and healthcare workers who provided care to the cases. The delay in detection aggravated the spread and possibly the consequent fatality but once confirmed the swift response stemmed further transmission containing the disease at the epicenter wards. The outbreak lasted for 72 days but as the origin is still unknown, further research is required to explore the source of this outbreak.

SUBMITTER: Mmbaga V

PROVIDER: S-EPMC11376503 | biostudies-literature | 2024

REPOSITORIES: biostudies-literature

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Epidemiological description of Marburg virus disease outbreak in Kagera region, Northwestern Tanzania.

Mmbaga Vida V Mrema George G Ngenzi Danstan D Magoge Welema W Mwakapasa Emmanuel E Jacob Frank F Matimba Hamza H Beyanga Medard M Samweli Angela A Kiremeji Michael M Kitambi Mary M Sylvanus Erasto E Kyungu Ernest E Manase Gerald G Hokororo Joseph J Kanyankole Christer C Rwabilimbo Martin M Kaniki Issessanda I Kauki George G Kelly Maria Ezekiely ME Mwengee William W Ayeni Gabriel G Msemwa Faraja F Saguti Grace G Mgomella George S GS Mukurasi Kokuhabwa K Mponela Marcelina M Kapyolo Eliakimu E Mcharo Jonathan J Mayige Mary M Gatei Wangeci W Conteh Ishata I Mala Peter P Swaminathan Mahesh M Horumpende Pius P Ruggajo Paschal P Magembe Grace G Yoti Zabulon Z Kwesi Elias E Nagu Tumaini T

PloS one 20240905 9

<h4>Introduction</h4>In March 2023, a Marburg Virus Disease (MVD) outbreak was declared in Kagera region, Northwestern Tanzania. This was the first MVD outbreak in the country. We describe the epidemiological characteristics of MVD cases and contacts.<h4>Methods</h4>The Ministry of Health activated an outbreak response team. Outbreak investigation methods were applied to cases identified through MVD standard case definitions and confirmed through reverse-transcriptase polymerase chain reaction ( ...[more]

PMID: 39236024

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Project description:IntroductionIn October 2017, a blood sample from a resident of Kween District, Eastern Uganda, tested positive for Marburg virus. Within 24 hour of confirmation, a rapid outbreak response was initiated. Here, we present results of epidemiological and laboratory investigations.MethodsA district task force was activated consisting of specialised teams to conduct case finding, case management and isolation, contact listing and follow up, sample collection and testing, and community engagement. An ecological investigation was also carried out to identify the potential source of infection. Virus isolation and Next Generation sequencing were performed to identify the strain of Marburg virus.ResultsSeventy individuals (34 MVD suspected cases and 36 close contacts of confirmed cases) were epidemiologically investigated, with blood samples tested for MVD. Only four cases met the MVD case definition; one was categorized as a probable case while the other three were confirmed cases. A total of 299 contacts were identified; during follow- up, two were confirmed as MVD. Of the four confirmed and probable MVD cases, three died, yielding a case fatality rate of 75%. All four cases belonged to a single family and 50% (2/4) of the MVD cases were female. All confirmed cases had clinical symptoms of fever, vomiting, abdominal pain and bleeding from body orifices. Viral sequences indicated that the Marburg virus strain responsible for this outbreak was closely related to virus strains previously shown to be circulating in Uganda.ConclusionThis outbreak of MVD occurred as a family cluster with no additional transmission outside of the four related cases. Rapid case detection, prompt laboratory testing at the Uganda National VHF Reference Laboratory and presence of pre-trained, well-prepared national and district rapid response teams facilitated the containment and control of this outbreak within one month, preventing nationwide and global transmission of the disease.

Project description:IntroductionThe Tanzania HIV Impact Survey (THIS) 2022-2023 showed that HIV prevalence among the general population stabilises but varies geographically across the country. Despite this, disproportionate burdens of HIV continue among specific subpopulations, such as fishermen. Fishermen are particularly vulnerable to HIV infection and have a low uptake of HIV prevention and treatment services. This study aimed to understand the prevalence of HIV infection, uptake of HIV/AIDs services, and associated risk factors of HIV Infection among fishermen residing along the shores of Lake Victoria in the Kagera region, Tanzania, in 2024.MethodsA cross-sectional study among fishermen was employed from February to April 2024, using convenient sampling of 10 beach management units (BMUs) to obtain a robust sample of fishermen aged ≥15 years in Kagera. Participants were randomly selected across BMUs. Information was collected using an interviewer-administered questionnaire, and HIV testing was offered on-site according to national testing guidelines. Multivariable logistic regression was used to determine factors associated with HIV infection, adjusted for potential confounders.ResultsA total of 774 fishermen with a median age of 31 years (interquartile range: 25-38 years) were recruited. The study found an HIV prevalence of 11.3% (95% CI: 9.2-13.8). HIV prevalence varied across selected districts: 12.7% in Muleba District, 10.1% in Bukoba Rural District, and 8.6% in Bukoba Urban District. The HIV prevalence was highest among fishermen aged 20-24 years (14.7% (95% CI: 9.7-21.5). The majority, 60.9% (95% CI: 57.4-64.2), had tested for HIV in the past 12 months. Of those living with HIV, 77.6% (95% CI: 67.3-85.9) self-reported using anti-retroviral therapy. In adjusted analysis, using alcohol before sex (aOR = 2.32, 95 CI: 1.42-3.80), not testing for HIV in the last 12 months (aOR = 4.69, 95% CI: 2.79-7.88), and not using condoms (aOR = 1.94, 95% CI: 1.13-3.27) were significantly associated with HIV infection among fishermen.ConclusionHIV prevalence among fishermen was nearly twice as high as in the general population in Kagera. HIV programming should be strengthened to reduce new HIV infections. Hotspot mapping to expand HIV prevention and treatment services is pivotal for controlling the HIV epidemic.

Project description:BackgroundThe Kagera region of north western Tanzania has a rich culture of traditional medicine use and practices. The dynamic inter-ethnic interactions of different people from the surrounding countries constitute a rich reservoir of herbal based healing practices. This study, the second in an ongoing series, reports on the medicinal plant species used in Katoro ward, Bukoba District, and tries to use the literature to establish proof of the therapeutic claims.MethodologyEthnomedical information was collected using semi-structured interviews in Kyamlaile and Kashaba villages of Katoro, and in roadside bushes on the way from Katoro to Bukoba through Kyaka. Data collected included the common/local names of the plants, parts used, the diseases treated, methods of preparation, dosage, frequency and duration of treatments. Information on toxicity and antidote were also collected. Literature was consulted to get corroborative information on similar ethnomedical claims and proven biological activities of the plants.ResultsThirty three (33) plant species for treatment of 13 different disease categories were documented. The most frequently treated diseases were those categorized as specific diseases/conditions (23.8% of all remedies) while eye diseases were the least treated using medicinal plants (1.5% of all remedies). Literature reports support 47% of the claims including proven anti-malarial, anti-microbial and anti-inflammatory activity or similar ethnomedical uses. Leaves were the most frequently used plant part (20 species) followed by roots (13 species) while making of decoctions, pounding, squeezing, making infusions, burning and grinding to powder were the most common methods used to prepare a majority of the therapies.ConclusionTherapeutic claims made on plants used in traditional medicine in Katoro ward of Bukoba district are well supported by literature, with 47% of the claims having already been reported. This study further enhances the validity of plants used in traditional medicine in this region as resources that can be relied on to provide effective, accessible and affordable basic healthcare to the local communities. The plants documented also have the potential of being used in drug development and on farm domestication initiatives.

Dataset Information

Epidemiological description of Marburg virus disease outbreak in Kagera region, Northwestern Tanzania.

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Epidemiological description of Marburg virus disease outbreak in Kagera region, Northwestern Tanzania.

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