Department of Primary Health Care Sciences, Family Medicine, Global and Public Health Unit, University of Zimbabwe, Harare, Zimbabwe.
Harare City Health Department, Harare, Zimbabwe.
PLoS One. 2022 Dec 12;17(12):e0278537. doi: 10.1371/journal.pone.0278537. eCollection 2022.
Anthrax continues to be a disease of public health concern in Zimbabwe. Between December 2021 and February 2022, Tengwe reported 36 cases of human anthrax. Gastrointestinal anthrax has the potential to cause serious outbreaks leading to loss of human life. We investigated the outbreak, identified the risk factors using one health approach to inform outbreak control.
We conducted descriptive analysis of the outbreak and a 1:2 unmatched case control study to identify risk factors for anthrax. A case was any Tengwe resident who developed an ulcer and/or abdominal symptoms and epidemiologically linked to a confirmed environmental exposure. Validated, structured interviewer-administered questionnaires were used to collect data from the cases and neighbourhood controls. Soil and dried meat samples were collected for laboratory investigations. District preparedness and response was assessed using a checklist. Data was analysed using Epi Info version 7.2.5. The odds of exposure were calculated for each risk factor examined. Multivariable logistic regression analysis was performed to identify the independent factors associated with contracting anthrax.
Through active case finding we identified 36 cases, 31 were interviewed. Twenty-one (67.7%) were males. The median age was 33 years (Inter quartile range: 22-54). Nineteen (61.2%) cases presented with abdominal symptoms with zero deaths reported. The independent risk factor for contracting anthrax was eating under-cooked meat (aOR = 12.2, 95% CI: 1.41-105.74, p = 0.023). All samples collected tested positive for anthrax. No livestock vaccinations or zoonotic meetings were being conducted prior to the outbreak. Notification of the outbreak was done 11 days after index case presentation however one health response was instituted within 24 hours.
The anthrax was confirmed in Tengwe. Consumption of under-cooked meat was associated with gastrointestinal anthrax. The timely one health response resulted in excellent outcomes. Using one health approach in managing zoonotic threats is encouraged.
炭疽仍然是津巴布韦公共卫生关注的疾病。2021 年 12 月至 2022 年 2 月，滕韦报告了 36 例人类炭疽病例。胃肠道炭疽有可能导致严重疫情，导致人员死亡。我们调查了疫情，采用一种健康方法确定了危险因素，以指导疫情控制。
我们对疫情进行了描述性分析，并进行了 1:2 不匹配的病例对照研究，以确定炭疽的危险因素。病例是指任何在滕韦居住并出现溃疡和/或腹部症状且与确认的环境暴露有流行病学联系的人。使用经过验证的、结构化的访谈者管理问卷从病例和邻里对照中收集数据。采集土壤和干肉样本进行实验室调查。使用检查表评估地区准备和应对情况。使用 Epi Info 版本 7.2.5 分析数据。对检查的每个危险因素进行了暴露几率的计算。进行多变量逻辑回归分析，以确定与感染炭疽相关的独立因素。
通过主动病例发现，我们共发现 36 例病例，其中 31 例接受了访谈。21 例（67.7%）为男性。中位年龄为 33 岁（四分位间距：22-54）。19 例（61.2%）病例出现腹部症状，无死亡报告。感染炭疽的独立危险因素是食用未煮熟的肉（优势比=12.2，95%置信区间：1.41-105.74，p=0.023）。采集的所有样本均检测出炭疽阳性。在疫情爆发前，没有对牲畜进行疫苗接种或进行人畜共患会议。在首例病例出现 11 天后才对疫情进行了通报，但在 24 小时内实施了一种健康的应对措施。
在滕韦确诊了炭疽。食用未煮熟的肉与胃肠道炭疽有关。及时的一种健康应对措施取得了极好的效果。鼓励采用一种健康方法来管理人畜共患威胁。
