Maze, Michael JShirima, Gabriel MLukambagire, Abdul-Hamid SBodenham, Rebecca FRubach, Matthew PCash-Goldwasser, ShamaCarugati, ManuelaThomas, Kate MSakasaka, PhiloteusMkenda, NestoryAllan, Kathryn JKazwala, Rudovick RMmbaga, Blandina TBuza, Joram JMaro, Venance PGalloway, Renee LHaydon, Daniel TCrump, John AHalliday, Jo EBXue, Feng2024-01-232024-01-232023-121935-27271935-2735https://hdl.handle.net/10161/29806<h4>Background</h4>Leptospirosis is suspected to be a major cause of illness in rural Tanzania associated with close contact with livestock. We sought to determine leptospirosis prevalence, identify infecting Leptospira serogroups, and investigate risk factors for leptospirosis in a rural area of Tanzania where pastoralist animal husbandry practices and sustained livestock contact are common.<h4>Methods</h4>We enrolled participants at Endulen Hospital, Tanzania. Patients with a history of fever within 72 hours, or a tympanic temperature of ≥38.0°C were eligible. Serum samples were collected at presentation and 4-6 weeks later. Sera were tested using microscopic agglutination testing with 20 Leptospira serovars from 17 serogroups. Acute leptospirosis cases were defined by a ≥four-fold rise in antibody titre between acute and convalescent serum samples or a reciprocal titre ≥400 in either sample. Leptospira seropositivity was defined by a single reciprocal antibody titre ≥100 in either sample. We defined the predominant reactive serogroup as that with the highest titre. We explored risk factors for acute leptospirosis and Leptospira seropositivity using logistic regression modelling.<h4>Results</h4>Of 229 participants, 99 (43.2%) were male and the median (range) age was 27 (0, 78) years. Participation in at least one animal husbandry practice was reported by 160 (69.9%). We identified 18 (7.9%) cases of acute leptospirosis, with Djasiman 8 (44.4%) and Australis 7 (38.9%) the most common predominant reactive serogroups. Overall, 69 (31.1%) participants were Leptospira seropositive and the most common predominant reactive serogroups were Icterohaemorrhagiae (n = 21, 30.0%), Djasiman (n = 19, 27.1%), and Australis (n = 17, 24.3%). Milking cattle (OR 6.27, 95% CI 2.24-7.52) was a risk factor for acute leptospirosis, and milking goats (OR 2.35, 95% CI 1.07-5.16) was a risk factor for Leptospira seropositivity.<h4>Conclusions</h4>We identified leptospirosis in approximately one in twelve patients attending hospital with fever from this rural community. Interventions that reduce risks associated with milking livestock may reduce human infections.HumansMaleAnimalsCattleFemaleTanzaniaPrevalenceLeptospirosisLeptospiraGoatsRisk FactorsSerogroupFeverLivestockSeroepidemiologic StudiesAntibodies, BacterialJournal article