Percentage of reactor animals to single comparative cervical intradermal tuberculin (SCCIT) in small ruminants in Punjab Pakistan

A one health-focused literature review on bovine and zoonotic tuberculosis in Pakistan from the past two decades: challenges and way forward for control

Bovine tuberculosis (bTB), caused by Mycobacterium bovis (M. bovis), is a globally prevalent zoonotic infectious disease. World Organization for Animal Health (WOAH) estimates indicate that up to 10% of the total human TB cases in developing countries are attributed to M. bovis. Pakistan ranks 4th in global milk production with a livestock population of over 212 million animals. Over 8 million families are involved in raising these animals as a means of livelihood. To date, there is an absence of national-level data on the prevalence of bTB and an effective control program is still lacking. The multifaceted impacts and substantial economic losses render addressing bTB a daunting, but highly important challenge. In this review, we summarise all the freely available literature on M. bovis infection from Pakistan using Google scholar and PubMed databases. A total of 40 animal studies were identified using search terms: "bovine tuberculosis in Pakistan, bTB, Pakistan, Mycobacterium bovis in Pakistan, M. bovis in Pakistan"; while seven human studies were identified using the terms: zoonotic tuberculosis in Pakistan', 'M. bovis in humans Pakistan', 'zTB in TB patients in Pakistan". We have summarized all these studies to identify critical risk factors involved in transmission of bTB among animals and humans. Despite lack of comprehensive and geographically representative studies, the literature suggests a varying prevalence of bTB in animals, ranging from as low as 2% to as high as 19%. Regarding zTB prevalence in humans, estimates range from 1.5% to 13% in high-risk group of farm and abattoir workers, with notably higher percentages in extra-pulmonary TB cases. The review also addresses the challenges that Pakistan faces in formulating an effective policy for the control and eradication of bTB. We conclude with one-health based recommendations as a way forward for controlling TB caused by M. bovis in cattle and humans.

Mycobacterium bovis Tuberculosis in Two Goat Farms in Multi-Host Ecosystems in Sicily (Italy): Epidemiological, Diagnostic, and Regulatory Considerations

Mycobacterium bovis (M. bovis) is the causative agent of animal tuberculosis (bTB), infecting and causing disease in several animal species. In areas where there are complex interactions between reservoir hosts and susceptible species, the control of this pathogen is a challenge. The authors report two outbreaks of goat tuberculosis caused by M. bovis in multi-host ecosystems within two protected natural areas of Sicily, where TB is historically endemic. The first outbreak (Farm A) was identified after the incidental detection at the slaughterhouse of TB-like lesions in goat viscera ready to be disposed. Single intradermal cervical tuberculin test (SICT) was performed in Farm A on 205 goats, resulting positive in 10 (4.9%). After slaughtering, six out of ten animals showed TB-like lesions, from which M. bovis spoligotype SB0841 was isolated. The typing did not reveal any epidemiological connection with the neighboring cattle, suggesting that free-ranging type of management exposed the affected goat livestock or wildlife infected with other strains. The second outbreak (Farm B) was detected in a mixed farm (bovine, caprine, and ovine), where relapsing outbreaks of TB in cattle were registered in the previous years after performing the SICT in cohabiting goats. SICT resulted positive in 6/153 (3.9%), and two animals showed bTB-like lesions. No mycobacteria were cultured, and the final diagnosis of TB was achieved by histopathology and immunohistochemistry. The reported outbreaks highlight the importance of assessing the epidemiological, diagnostic, and regulatory critical issue, which is fundamental to optimizing the strategies of eradicating TB in the endemic multi-host ecosystem described.

First-time detection of Mycobacterium bovis in livestock tissues and milk in the West Bank, Palestinian Territories

Background

Bovine tuberculosis, bTB, is classified by the WHO as one of the seven neglected zoonontic diseases that cause animal health problems and has high potential to infect humans. In the West Bank, bTB was not studied among animals and the prevalence of human tuberculosis caused by M. bovis is unknown. Therefore, the aim of this study was to estimate the prevalence of bTB among cattle and goats and identify the molecular characteristics of bTB in our area.

Methodology/principal findings

A total of 208 tissue samples, representing 104 animals, and 150 raw milk samples, obtained from cows and goats were examined for the presence of mycobacteria. The tissue samples were collected during routine meat inspection from the Jericho abattoir. DNA was extracted from all samples, milk and tissue biopsies (n = 358), and screened for presence of TB DNA by amplifying a 123-bp segment of the insertion sequence IS6110. Eight out of 254 animals (3.1%) were found to be TB positive based on the IS6110-PCR. Identification of M. bovis among the positive TB samples was carried out via real time PCR followed by high resolution melt curve analysis, targeting the A/G transition along the oxyR gene. Spoligotyping analysis revealed a new genotype of M. bovis that was revealed from one tissue sample.

Significance

Detection of M. bovis in tissue and milk of livestock suggests that apparently healthy cattle and goats are a potential source of infection of bTB and may pose a risk to public health. Hence, appropriate measures including meat inspection at abattoirs in the region are required together with promotion of a health campaign emphasizing the importance of drinking pasteurized milk. In addition, further studies are essential at the farm level to determine the exact prevalence of bTB in goats and cattle herds in the West Bank and Israel.

Bovine tuberculosis (caused by Mycobacterium bovis) is a zoonotic disease causing major public health concerns. Animals, both wild and domestic, tested positive to bovine tuberculosis are being slaughtered and the affected herds are placed under temporary movement restrictions. Hence, bTB can have strong economic implications. In the West Bank, bTB has not been reported during the past 20 years. Our study determined the presence of M. bovis in tissue and milk samples of goats and cattle. Tissues were collected from slaughtered animals during routine meat inspection at the abattoir and were categorized as negative for mycobacteria. The frequency of the detected bTB was low but indicated the low sensitivity of the routine meat inspection compared to diagnosis of M. bovis infection via PCR assay. Furthermore, M. bovis was found in goat milk samples. As bTB is considered a neglected disease, known in high frequency in Africa and Asia, we recommend conducting a regional survey to assess the prevalence of the disease among cattle, sheep and goat herds. The results of the survey will undoubtedly be a platform for new public health policies.

Low prevalence of bovine tuberculosis in Somali pastoral livestock, southeast Ethiopia

A cross-sectional study of bovine tuberculosis (BTB) detected by the comparative intradermal tuberculin test (CIDT) was conducted in livestock of the Somali region in southeast Ethiopia--in four pastoral associations from January to August 2009. In 94 herds, each of 15 cattle, camels, and goats was tested per herd leading to a total of 1,418 CIDT tested animals, with 421 cattle, 479 camels, and 518 goats. A herd was considered positive if it had at least one reactor. Prevalence per animal species was calculated using a xtgee model for each species. The individual animal prevalence was 2.0% [95% confidence interval (CI), 0.5-8.4], 0.4% (95% CI, 0.1-3%), and 0.2% (95% CI, 0.03-1.3) in cattle, camels, and goats, respectively. Prevalence of avian mycobacterium purified protein derivative (PPD) reactors in cattle, camels, and goats was 0.7% (95% CI, 0.2-2.0%), 10.0% (95% CI, 7.0-14.0%), and 1.9 (95% CI, 0.9-4.0%), respectively, whereby camels had an odds ratio of 16.5 (95% CI, 5.0-55.0) when compared to cattle. There was no significant difference between livestock species in BTB positivity. In the present study, the prevalence of bovine tuberculosis was low in Somali pastoral livestock in general and in camels and goats in particular. The high proportion of camel reactors to avian PPD needs further investigation of its impact on camel production.

Avaliação da região corpórea e dose da tuberculina no diagnóstico imunoalérgico em ovinos (Ovis aries) experimentalmente sensibilizados com inóculo inativado de Mycobacterium bovis

O objetivo foi a investigação do local de aplicação do derivado proteico purificado (PPD) bovino, empregado no teste imunoalérgico da tuberculose, em 15 ovinos (Ovis aries) experimentalmente sensibilizados com Mycobacterium bovis AN5. A partir da melhor resposta obtida na fase de identificação da região corpórea, avaliou-se a dose de PPD bovino a ser aplicada. Decorridos 60 dias da sensibilização, o PPD bovino foi aplicado em cinco distintas regiões corpóreas (cervical média, torácica dorsal, abdominal dorsal, prega da cauda e face medial proximal do membro pélvico - face interna da coxa) com a mensuração da espessura da dobra de pele e da reação através de cutímetro de mola, nos momentos antes (0h) e após aplicação (12h, 24h, 48h, 72h e 96h). A análise dos resultados obtidos foi significante, em ordem decrescente, para as regiões: torácica dorsal, cervical média e abdominal dorsal às 48 e 72h após aplicação do PPD bovino. Elegeu-se a região torácica dorsal como melhor local de aplicação. Recomenda-se que a leitura da reação tuberculínica em ovinos deve ser efetuada às 72h da aplicação do PPD, utilizando-se a dose de 0,1 mL.

Bovine tuberculosis at a cattle-small ruminant-human interface in Meskan, Gurage region, Central Ethiopia

BACKGROUND

Bovine tuberculosis (BTB) is endemic in Ethiopian cattle. The aim of this study was to assess BTB prevalence at an intensive contact interface in Meskan Woreda (district) in cattle, small ruminants and suspected TB-lymphadenitis (TBLN) human patients.

METHODS

The comparative intradermal test (CIDT) was carried out for all animals involved in the cross-sectional study and results interpreted using a > 4 mm and a > 2 mm cut-off. One PPD positive goat was slaughtered and lymph nodes subjected to culture and molecular typing. In the same villages, people with lymphadenitis were subjected to clinical examination. Fine needle aspirates (FNA) were taken from suspected TBLN and analyzed by smear microscopy and molecular typing.

RESULTS

A total of 1214 cattle and 406 small ruminants were tested for BTB. In cattle, overall individual prevalence (> 2 mm cut-off) was 6.8% (CI: 5.4-8.5%) with 100% herd prevalence. Only three small ruminants (2 sheep and 1 goat) were reactors. The overall individual prevalence in small ruminants (> 2 mm cut-off) was 0.4% (CI: 0.03-5.1%) with 25% herd prevalence. Cattle from owners with PPD positive small ruminants were all PPD negative. 83% of the owners kept their sheep and goats inside their house at night and 5% drank regularly goat milk.FNAs were taken from 33 TBLN suspected cases out of a total of 127 screened individuals with lymph node swellings. Based on cytology results, 12 were confirmed TBLN cases. Nine out of 33 cultures were AFB positive. Culture positive samples were subjected to molecular typing and they all yielded M. tuberculosis. M. tuberculosis was also isolated from the goat that was slaughtered.

CONCLUSIONS

This study highlighted a low BTB prevalence in sheep and goats despite intensive contact with cattle reactors. TBLN in humans was caused entirely by M. tuberculosis, the human pathogen. M. tuberculosis seems to circulate also in livestock but their role at the interface is unknown.

Risk factors identified associated with tuberculosis in cattle at 11 livestock experiment stations of Punjab Pakistan

The study was carried out in cattle kept at 11 livestock experiment stations of Punjab by using single comparative cervical intradermal tuberculin (SCCIT) test. Sahiwal was the main breed kept at these farms. Sixty three percent of animals were between four and 10 years of age. Seventy-six percent of animals weighed between 300 and 400 kg and 66% produced 5-10l of milk/day. Animals other than cattle were present at about 64% of these farms. The positive SCCIT test was recorded in 7.6% of animals at the 11 farms. However, the prevalence of tuberculosis varied from 2.0% to 19.3% at these farms. Bivariate frequency analysis showed that the chances of a positive SCCIT test were higher in older animals, in cattle with higher number of calving and those produced up to 1800l of milk. However, the chances of positive SCCIT test decreases with further increase in milk production. Results of bivariate and/or multivariate logistic regression analysis after controlling for the farm showed a significant association of age of cattle, numbers of calving, total milk produced, per day milk, lactation length, presence of sheep at the farm and total numbers of animals at the farm with a positive SCCIT test. It can be concluded from the study that herd prevalence of tuberculosis was 100%, while animal prevalence was about 8% at these farms. The stronger risk factors identified by logistic analysis were the age of cattle, numbers of calving, total milk produced and lactation length, while the presence of sheep at the farm has protective effect.

First-time detection of mycobacterium species from goats in Ethiopia

Tuberculosis (TB) is an important zoonosis affecting a wide range of hosts. An abattoir study was conducted on 1,536 randomly selected male goats slaughtered at Modjo Modern Export Abattoir to determine the prevalence of tuberculosis in slaughtered goats. Carcasses and organs of all the study animals were first examined by routine meat inspection followed by detailed meat inspection. Samples from tuberculous lesions were cultured for mycobacterial isolation and identification. Histopathology was done on 31 samples with tuberculous lesions. Detailed meat inspection detected 65 (4.2%; 95% confidence interval (CI) = 3.3-5.4%) tuberculous lesions. From these, 20 (30.8%) samples were confirmed mycobacterium positive on culture, out of which 18 were Mycobacterium bovis and two were Mycobacterium tuberculosis. Routine meat inspection failed to detect tuberculous lesions in 23% of carcasses with TB lesions detected by detailed examination. However, no statistically significant difference was observed between both methods in detecting tuberculous lesions (Kappa = 0.87). Origin and age of the goats did not statistically affect the disease prevalence (P > 0.05). Histopathologic lesions were observed in 21 samples (68%; 95% CI = 50.1-81.4%) out of the 31 carcasses with gross tuberculous lesions examined by histopathology. Eighteen (58%) tuberculous samples positive for histopathology were also culture positive. The sensitivity and specificity of histopathology were 90% (95% CI = 76.9-100%) and 72.7% (95% CI = 46.4-99%), respectively, using culture as a reference test. To the best of our knowledge, this is the first report of caprine tuberculosis from Ethiopia. Further studies are required at the farm level to determine the prevalence of tuberculosis in the general goat population.

Bovine tuberculosis at the wildlife-livestock-human interface in Hamer Woreda, South Omo, Southern Ethiopia

Bovine tuberculosis (BTB) is endemic in cattle in the Ethiopian Highlands but no studies have been done so far in pastoralists in South Omo. This study assessed the prevalence of bovine tuberculosis (BTB) at an intensive interface of livestock, wildlife and pastoralists in Hamer Woreda (South Omo), Ethiopia. A cross-sectional survey including a comparative intradermal skin testing (CIDT) was conducted in 499 zebu cattle and 186 goats in 12 settlements. Sputum samples from 26 symptomatic livestock owners were cultured for TB. Fifty-one wildlife samples from 13 different species were also collected in the same area and tested with serological (lateral flow assay) and bacteriological (culture of lymph nodes) techniques. Individual BTB prevalence in cattle was 0.8% (CI: 0.3%–2%) with the >4 mm cut-off and 3.4% (CI: 2.1%–5.4%) with the >2 mm cut-off. Herd prevalence was 33.3% and 83% when using the >4 and the >2 mm cut-off respectively. There was no correlation between age, sex, body condition and positive reactors upon univariate analysis. None of the goats were reactors for BTB. Acid fast bacilli (AFB) were detected in 50% of the wildlife cultures, 79.2% of which were identified as Mycobacterium terrae complex. No M. bovis was detected. Twenty-seven percent of tested wildlife were sero-positive. Four sputum cultures (15.4%) yielded AFB positive colonies among which one was M. tuberculosis and 3 non-tuberculous mycobacteria (NTM). The prevalence of M. avium-complex (MAC) was 4.2% in wildlife, 2.5% in cattle and 0.5% in goats. In conclusion, individual BTB prevalence was low, but herd prevalence high in cattle and BTB was not detected in goats, wildlife and humans despite an intensive contact interface. On the contrary, NTMs were highly prevalent and some Mycobacterium spp were more prevalent in specific species. The role of NTMs in livestock and co-infection with BTB need further research.