Rift Valley fever and Brucella spp. in ruminants, Somalia

Serological and molecular detection of Toxoplasma gondii and Neospora caninum in ruminants from Somalia

Toxoplasma gondii and Neospora caninum infect a wide range of domestic and wild animals, including humans, in the case of T. gondii, and cause economic losses in livestock due to abortion and neonatal mortality. In Somalia, zoonotic diseases are concerning due to cultural practices and livestock's economic importance, but surveillance is limited. This study aimed to determine the seroprevalence and molecular prevalence of T. gondii and N. caninum in Somali sheep, goats, and cattle. A cross-sectional study was conducted between December 2018 and January 2020 in Benadir and Lower Shabelle regions of Somalia. Blood samples were collected from 128 cattle, 184 goats, and 46 sheep. Serum samples were tested for anti-T. gondii and anti-N. caninum antibodies using IFAT, and PCR was performed on extracted DNA to detect T. gondii and N. caninum DNA. Overall, 106/358 (29.6%) animals tested positive for anti-T. gondii antibodies, with the highest prevalence in sheep (62.5%), followed by goats (30.4%) and cattle (15.6%) (P < 0.001). For anti-N. caninum antibodies, 13/358 (3.6%) animals tested positive, with cattle showing the highest prevalence (6.2%), followed by goats and sheep (both 2.2%). Co-seropositivity for both antibodies was found in cattle and sheep. Molecular detection of T. gondii DNA revealed a prevalence of 9/358 (2.5%), primarily in sheep (15.2%) and cattle at 1.6% while all goat samples tested negative. No samples were positive for the N. caninum Nc5 gene. This study reveals T. gondii and N. caninum prevalence in Somali ruminants, highlighting the need for better surveillance and control.

The socioeconomic impacts of Rift Valley fever: A rapid review

Rift Valley fever (RVF) is a neglected vector-borne disease which is endemic in many countries across Africa and has seen recent geographical expansions into the Arabian Peninsula. RVF can cause severe infections in both animals and humans. RVF infections in livestock can lead to mass fatalities. In humans, the symptoms are nonspecific and can often lead to misdiagnosis. However, a small proportion progresses to haemorrhagic infection with a significantly higher mortality rate. The culmination of this can cause severe socioeconomic impacts. This review aims to identify the main socioeconomic impacts caused by RVF outbreaks as well as existing knowledge gaps. Ninety-three academic and grey papers were selected, covering 19 countries and 10 methodological approaches. A variety of socioeconomic impacts were found across all levels of society: Livestock trade disruptions consequently impacted local food security, local and national economies. Most livestock farmers in endemic countries are subsistence farmers and so rely on their livestock for sustenance and income. RVF outbreaks resulted in a variety of socioeconomic impacts, e.g., the inability to pay for school fees. Main barriers to vaccine uptake in communities were lack of access, funds, interest along with other social aspects. The occupational risks for women (and pregnant women) are largely unknown. To our knowledge, this is the first review on RVF to highlight the clear knowledge gap surrounding the potential gender differences on risks of RVF exposure, as well as differences on occupational health risk in pastoral communities. Further work is required to fill the gaps identified in this review and inform control policies.

One Health in Somalia: Present status, opportunities, and challenges

One Health (OH) is an integrated approach aiming at improving the health of people, animals, and ecosystems. It recognizes the interconnectedness of human health with the health of animals, plants, and the environment. Since Somali people's livelihoods are mainly based on livestock, agriculture, marine resources, and their shared environment, OH-oriented initiatives could significantly impact the country toward reducing complex problems affecting the health of humans, animals, and the environment. The term "One Health" was first introduced into the global scientific community in September 2004 and in 2013 in Somalia. After ten years, there is still a long road ahead for implementing the OH approach in the country. Herein, we present the status, opportunities, and challenges of OH in Somalia and recommend ways to promote and institutionalize it. The country has been involved in various OH initiatives solely driven by external funding, focusing on research, capacity development, and community interventions, apart from university-led initiatives such as Somali One Health Centre. In Somalia, OH initiatives face numerous challenges, ranging from limited infrastructure and resources to weak governance and institutional capacity. We urge the Somali government to address these challenges and prioritize OH as the main approach to tackling critical health issues. We suggest the Somali government institutionalize and implement OH actions at all administrative levels, including Federal, State, District, and community, through a mechanism to improve multisectoral coordination and collaboration to predict, prevent, detect, control, and respond to communicable and non-communicable diseases at the human-animal-ecosystem interface for improving health outcomes for all.

Exploring the Complex Landscape of Spine Brucellosis

INTRODUCTION

Brucellosis is an infectious illness contracted by humans through the consumption of unpasteurized milk and dairy items. Brucella organisms are diminutive, gram-negative, non-motile, and non-spore-forming facultative intracellular, aerobic intracellular coccobacilli residing within the reproductive organs of host animals, leading to conditions such as abortions and sterility. Numerous species of Brucella have been identified, with the following four exhibiting varying degrees of pathogenicity in humans: Brucella melitensis (originating from sheep), Brucella suis (associated with pigs), Brucella abortus (linked to cattle), and Brucella canis (found in dogs). B. melitensis and B. suis demonstrate the highest level of pathogenicity, while B. abortus and B. canis exhibit a more moderate degree of pathogenicity. The illness can progress to systemic involvement, with the musculoskeletal system being particularly susceptible to complications. Spinal epidural abscess is an infrequent complication that may occur during spondylitis caused by Brucella species. Epidural abscesses most commonly affect the lumbar vertebrae, while their involvement in the cervical spine is relatively rare.

OBJECTIVE

In this review, we explore spine brucellosis, covering its epidemiology, pathogenesis, clinical manifestations, diagnostics, and evolving treatments. We aim to enhance early detection, timely intervention, and patient outcomes.

PATIENTS AND METHODS

This retrospective chart analysis was conducted by revising all medical files for patients in whom spinal brucellosis was diagnosed and managed.

RESULTS

This study was conducted at King Hussein Medical Center (KHMC), Jordan, and included a total of 20 patients who were diagnosed with spine brucellosis during the study period. Within the final cohort, 65% of the patients were male (13/20), with an average age at diagnosis of 47.53±14.98 years (ranging from 4 to 61 years). The female group, on the other hand, had an average age at diagnosis of 51.12±15.55 years (ranging from 3 to 58 years). Statistical analysis of the data revealed no significant demographic differences between the two groups. Regarding the co-morbidities, no statistical differences were observed between the two groups. Examining the occupational status of the two groups, no differences were observed. Also, no differences were observed between the two groups regarding the residence place, or the spinal segment involved.

CONCLUSION

Spine brucellosis, although uncommon, poses a complex clinical challenge. Early diagnosis and a multidisciplinary approach are crucial for effective management. Further research is needed to refine diagnostic tools and treatment guidelines for spine brucellosis.

Zoonoses research in Somalia: A scoping review using a One Health approach

Zoonoses are likely to cause a substantial burden on both human and animal health systems in Somalia, given the close proximity between the pastoralist majority and their livestock. However, decades of instability leading to weak disease surveillance have meant that data on the burden of zoonoses is lacking. The aim of this scoping review was to assess and synthesize the available literature on the presence and burden of zoonoses in Somalia. We used keywords to search Web of Science for relevant publications. Studies were included if they contained relevant data on a zoonosis and were undertaken in Somalia or were undertaken in another country where exposure could reasonably be assumed to have occurred in Somalia (e.g., migrants/refugees, returning soldiers, exported animals). Studies were not included if they focused on Somali ethnic communities permanently living elsewhere or if zoonotic aspects were not considered. We extracted data on disease(s) reported, geographic focus, data reported (human, animal, environment), study design and author affiliation. A total of 22 zoonotic infections were documented in 76 publications. The most frequently studied diseases were Rift Valley Fever (n = 15, 17%), brucellosis (n = 13, 14%) and hepatitis E (n = 10, 11%). Around 30% of papers reported data from relevant populations outside Somalia. Only 18 papers undertook laboratory analysis within Somalia. Most papers reported data on humans (45%) and animals (36%) with limited research on the environmental domain. Descriptive studies (47%) dominated and most were led by non-Somali researchers (89% in first authors and 95% of last authors). This study highlights the need for well-designed zoonoses research in Somalia supported by capacity building of local researchers and investments in diagnostic laboratories.

Spinal brucellosis causing spondylodiscitis

Introduction

and Importance: Brucellosis is a common prevalent zoonotic disease in developing countries including Somalia. Brucellosis may affect many organs. However involvement in the spine and paravertebral muscles is common and may lead to diagnostic challenges since it presents with non-specific symptoms.

Case presentation

Here we report 18-year old male patient who presented with low back pain, low grade fever, difficult voiding and progressive lower extremity weakness for 5 months. The pain was localized to the lumbar vertebra (tender on palpation) and radiating to both lower limbs. There was slight weakness on the left lower limb (muscle power 3+/5). There were no associated sensory symptoms or deep tendon reflex abnormality. But he had mild urine retention.Lumbar magnetic resonance imaging (MRI) revealed spondylodiscitis. Rose-Bengal test was positive for brucellosis. A Brucella standard tube agglutination test was positive at a titer of 1:64. Given the test results and the imaging finding, the patient was diagnosed with Spinal brucellosis. He was treated with oral doxycycline (100 mg, two times daily) and Rifampicin (600Mg) orally once daily for 6 months. Streptomycin was added during the first three weeks. The patient had massive improvement after 3 months of treatment, (the patient's symptoms almost disappeared).

Clinical discussion

Spinal brucellosis is characterized by the involvement of the vertebral column, interspinal spaces, and/or paraspinal areas. Its subacute or chronic forms typically affect the spinal column. Spinal brucellosis may cause Spondylitis, spondylodiscitis or epidural abscess causing spinal compression. This case presented with spondylodiscitis and was successfully treated without the need for surgical intervention.

Conclusions

Brucella spondylodiscitis, though uncommon and challenging, it should be kept in mind in the differential diagnosis of patients presenting with chronic back pain and lower extremity weakness living in endemic areas like Somalia. The duration of treatments should be prolonged in patients with worse physical condition.