Abstract
BackgroundAnthrax outbreaks in Tanzania have been reported from the human, livestock and wildlife sectors over several years, and is among the notifiable diseases. Despite frequent anthrax outbreaks, there is no comprehensive dataset indicating the magnitude and distribution of the disease in susceptible species. This study is a retrospective review of anthrax outbreaks from the human, livestock, and wildlife surveillance systems from 2006 to 2016. The objectives were to identify hotspot districts, describe anthrax epidemiology in the hotspot areas, evaluate the efficiency of the anthrax response systems and identify potential areas for further observational studies.MethodsWe prepared a spreadsheet template for a retrospective comprehensive record review at different surveillance levels in Tanzania. We captured data elements including demographic characteristics of different species, the name of health facility, and date of anthrax diagnosis. Also, we collected data on the date of specimen collection, species screened, type of laboratory test, laboratory results and the outcome recorded at the end of treatment in humans. After establishing the database, we produced maps in Quantum GIS software and transferred cleaned data to Stata software for supportive statistical analysis.ResultsAnthrax reported incidences over 4 years in humans were much higher in the Arusha region (7.88/100,000) followed by Kilimanjaro region (6.64/100,000) than other regions of Tanzania Mainland. The health facility based review from hotspot districts in parts of Arusha and Kilimanjaro regions from 2006 to 2016, identified 330 human anthrax cases from the selected health facilities in the two regions. Out of 161 livestock and 57 wildlife specimen tested, 103 and 18 respectively, were positive for anthrax.ConclusionThis study revealed that there is gross under-reporting in the existing surveillance systems which is an obstacle for estimating a true burden of anthrax in the hotspot districts. Repeated occurrences of anthrax in livestock, wildlife and humans in the same locations at the same time calls for the need to strengthen links and promote inter–disciplinary and multi-sectoral collaboration to enhance prevention and control measures under a One Health approach.
Highlights
Anthrax outbreaks in Tanzania have been reported from the human, livestock and wildlife sectors over several years, and is among the notifiable diseases
Anthrax in humans We found that the reported human anthrax incidence risk over 2013–16 per 100,000 population was much higher in Arusha region (7.88/100,000) followed by Kilimanjaro region (6.64/100,000) than any other regions of the Tanzania
The findings of this study are critical for consideration by respective authorities for setting up prevention and control measures of anthrax outbreaks in the human, livestock and wildlife sectors within Tanzania
Summary
Anthrax outbreaks in Tanzania have been reported from the human, livestock and wildlife sectors over several years, and is among the notifiable diseases. This study is a retrospective review of anthrax outbreaks from the human, livestock, and wildlife surveillance systems from 2006 to 2016. There is no evidence of person-to-person transmission of B. anthracis [4], and humans normally acquire the disease from direct contact with anthrax-infected animals or anthrax-contaminated animal products [4, 5]. Both domestic and wild animals serve as potential sources of infections in humans [6, 7]. Failure of the blood to clot, the absence of rigor mortis and the presence of splenomegaly are the most significant necropsy findings [6]
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