Human bovine tuberculosis - remains in the differential

Flavonoids of Chromolaena odorata (L.) R.M.King & H.Rob. as potential leads for treatment against tuberculosis

Tuberculosis (TB) is currently rated as the 13th leading cause of mortality and the second leading cause of death after COVID-19, and above AIDS. Existing challenges relating to the development of multidrug-resistant strains and dangerous side effects of currently used drugs add impetus to the search for additional TB treatments. Hence, interest has grown in the use of medicinal plants as a source of bioactive preparations with efficacy against TB-causing organisms, and also with the ability to ameliorate the negative effects of TB drugs. This study aimed to evaluate the antimycobacterial and hepatoprotective potentials of extracts and isolated flavonoid compounds from invasive Chromolaena odorata. Test organisms used were pathogenic Mycobacterium bovis and M. tuberculosis H37RV, and the fast-growing M. aurum, M. fortuitum and M. smegmatis. The selectivity index (SI) values of the test substances were determined through cytotoxicity assays to promote these extracts and compounds as leads for the development of effective and safe anti-tubercular drugs. The antimycobacterial activity was evaluated using a serial microdilution method, and the SI was calculated from the 50% lethal concentrations calculated from cytotoxicity tests. Hepatoprotective activity was determined using HepG2 liver cells treated with rifampicin as a toxin. The extracts and compounds had a range of antimycobacterial activity with minimum inhibitory concentration (MIC) values ranging from 0.031 to 2.5 mg/mL. Two flavonoid compounds, 5,7,4'-trimethoxy flavanone and 5‑hydroxy-3,7,4'-trimethoxyflavone showed promising antimycobacterial potential, and minimal toxicity was observed, as most SI values were higher than 1. The flavonoid compound 5,7,4'-trimethoxy flavanone had the highest SI (6.452), which was against M. tuberculosis H37RV. The HepG2 cells were reduced to 65% due to toxicity by rifampicin, however, the flavonoid compounds were able to improve cell viability to between 81 and 89% at different concentrations tested. Results obtained indicate that C. odorata may serve as a lead for the development of safe and effective antimycobacterial and hepatoprotective drugs.

Revisiting tuberculosis screening: An insight to complementary diagnosis and prospective molecular approaches for the recognition of the dormant TB infection in human and cattle hosts

Tuberculosis (TB) is defined as a chronic infection in both human and cattle hosts and many subclinical cases remain undetected. After the pathogen is inhaled by a host, phagocyted bacilli can persist inside macrophages surviving intracellularly. Hosts develop granulomatous lesions in the lungs or lymph nodes, limiting infection. However, bacilli become persister cells. Immunological diagnosis of TB is performed basically by routine tuberculin skin test (TST), and in some cases, by ancillary interferon-gamma release assay (IGRA). The concept of human latent TB infection (LTBI) by M. tuberculosis is recognized in cohorts without symptoms by routine clinical diagnostic tests, and nowadays IGRA tests are used to confirm LTBI with either active or latent specific antigens of M. tuberculosis. On the other hand, dormant infection in cattle by M. bovis has not been described by TST or IGRA testing as complications occur by cross-reactive immune responses to homolog antigens of environmental mycobacteria or a false-negative test by anergic states of a wained bovine immunity, evidencing the need for deciphering more specific biomarkers by new-generation platforms of analysis for detection of M. bovis dormant infection. The study and description of bovine latent TB infection (boLTBI) would permit the recognition of hidden animal infection with an increase in the sensitivity of routine tests for an accurate estimation of infected dairy cattle. Evidence of immunological and experimental analysis of LTBI should be taken into account to improve the study and the description of the still neglected boLTBI.

Mycobacterium bovis in a bull on a university farm: public health implications

An unsuspected bull in a private herd of forty cattle heads in south-western Nigeria died suddenly following three days´ treatment against tick infestation. Post-mortem findings revealed multi-focal widespread nodules in all lobes of the lungs with markedly enlarged lymph nodes. Isolate from cultured sample was subjected to spoligotyping which confirmed the isolate as Mycobacterium bovis (M. bovis) belonging to the SB1027 clade with octal number 676773776277600 (Figure 1). This finding has implications on the health of the cattle handlers considering aerosol inhalation of disseminated bacilli from the lungs of the infected bull through cough sprays. Routine screening of cattle for tuberculosis is therefore emphasized.

Prevalence of bovine tuberculosis in slaughtered cattle and factors associated with risk of disease transmission among cattle handlers at Oko-Oba Abattoir, Lagos, Nigeria

Background and Aim:

Bovine tuberculosis (bTB) is a zoonotic disease of major public health importance, especially in many developing countries, including Nigeria, where control measures are largely not applied, and the risks of human infection are high. This study was aimed at determining the current prevalence of bTB in slaughtered cattle and identifying factors associated with the risk of disease transmission among cattle handlers toward making informed control measures to limit human-animal interface disease transmission.

Materials and Methods:

Serum samples at slaughter and lesions suggestive of bTB collected during postmortem examination of 187 slaughtered cattle at the Oko–Oba Abattoir, Agege, Lagos State, Nigeria, were subjected to lateral flow and Ziehl–Neelsen (ZN) techniques, respectively. Furthermore, a structured questionnaire was interviewer-administered to 156 cattle handlers to investigate associated exposure factors to bTB infection. Data were analyzed using bivariate and multivariate logistic regression.

Results:

The prevalence of bTB in cattle was 25.7% and 7.0% by lateral flow technique and ZN, respectively. The seropositivity was highest in cattle with poor body condition (50.0%), then with good (36.4%) and fair (25.0%) body conditions. The questionnaire survey revealed that being in livestock handling business for >6 years (p=0.001), not knowing the mode of transmission (p=0.02) and ignoring TB lesions at slaughter (p=0.02) were exposure factors associated with increased risk of bTB infection among the cattle handlers. Further, multivariate analysis showed that those who spent more than 6 years in livestock handling were about 4 times (Adjusted odds ratio [AOR]=3.5; 95% confidence interval [CI]=1.1-7.6, p=0.01) more likely to be exposed to bTB infection than those with lesser years. Again, respondents who called the attention of meat inspectors on seeing lesions in animals were about 4 times less likely to be exposed to bTB infection than those who ignored it (AOR=0.3; CI=0.1-0.8, p=0.01).

Conclusion:

This study has reiterated the endemicity of bTB in cattle population in Nigeria, with the prevalence of 25.7% and 7.0% of bTB by lateral flow and ZN techniques, respectively. This portends potential risk for disease transmission at the human-animal interface, particularly at the abattoir setting. The study also identified important knowledge and practice gaps which would enable informed, all-inclusive, and well-directed programs for effective control of the disease in both human and cattle populations.

Zoonotic Tuberculosis in Humans: Control, Surveillance, and the One Health Approach

Zoonotic tuberculosis is a reemerging infectious disease in high-income countries and a neglected one in low- and middle-income countries. Despite major advances in its control as a result of milk pasteurization, its global burden is unknown, especially due the lack of surveillance data. Additionally, very little is known about control strategies. The purpose of this review was to contextualize the current knowledge about the epidemiology of zoonotic tuberculosis and to describe the available evidence regarding surveillance and control strategies in high-, middle-, and low-income countries. We conducted this review enriched by a One Health perspective, encompassing its inherent multifaceted characteristics. We found that the burden of zoonotic tuberculosis is likely to be underreported worldwide, with higher incidence in low-income countries, where the surveillance systems are even more fragile. Together with the lack of specific political commitment, surveillance data is affected by lack of a case definition and limitations of diagnostic methods. Control measures were dependent on risk factors and varied greatly between countries. This review supports the claim that a One Health approach is the most valuable concept to build capable surveillance systems, resulting in effective control measures. The disease characteristics and suggestions to implement surveillance and control programs are discussed.

Detection of a streptomycin-resistant Mycobacterium bovis strain through antitubercular drug susceptibility testing of Tunisian Mycobacterium tuberculosis complex isolates from cattle

Background

A rising isolation trend of drug-resistant M. bovis from human clinical cases is documented in the literature. Here we assessed Mycobacterium tuberculosis complex isolates from cattle for drug susceptibility by the gold standard agar proportion method and a simplified resazurin microtitre assay (d-REMA). A total of 38 M. tuberculosis complex strains, including M. bovis (n = 36) and M. caprae (n = 2) isolates, from cattle in Tunisia were tested against isoniazid, rifampin, streptomycin, ethambutol, kanamycin and pyrazinamide.

Results

M. caprae isolates were found to be susceptible to all test drugs. All M. bovis strains were resistant to pyrazinamide, as expected. In addition, one M. bovis isolate showed high-level resistance to streptomycin (MIC > 500.0 μg/ml). Concordant results with the two methods were found. The most common target genes associated with streptomycin resistance, namely the rrs, rpsL and gidB genes, were DNA sequenced. A non-synonymous mutation at codon 43 (K43R) was found in the rpsL gene. To the best of our knowledge, this is the first report describing the isolation of a streptomycin-resistant M. bovis isolate from animal origin.

Conclusions

Antitubercular drug susceptibility testing of M. bovis isolates from animals should be performed in settings where bTB is endemic in order to estimate the magnitude of the risk of drug-resistant tuberculosis transmission to humans.

Occupational exposure to human Mycobacterium bovis infection: A systematic review

BACKGROUND

Mycobacterium bovis (M. bovis) is the main causative agent of bovine zoonotic tuberculosis. The aim of this systematic review is to highlight the occupational exposure to bovine tuberculosis due to M. bovis.

METHODOLOGY/PRINCIPAL FINDINGS

A computer based literature search was carried out to identify papers published between January 2006 and March 2017. "PubMed, Cochrane Library and Science Direct" databases were searched systematically. Articles presenting the following properties were included: (i) focusing on M. bovis; (ii) concerning occupational exposure to bovine tuberculosis. A quality assessment was performed after selection of studies. Our search strategy identified a total of 3,264 papers of which 29 studies met the inclusion criteria. Of the 29 articles, 17 were cross-sectional studies (6 were of high quality and scored in the range of 6-7, 11 were of moderate quality and scored in the range 3-5), 10 were case reports, and 2 were reviews. Different occupational fields exposing to the disease were described: livestock sector, particularly in contact with dairy cattle (farmers, veterinaries and assistants, abattoir workers) and working in contact with wildlife (hunters, taxidermists).

CONCLUSIONS

A specific guideline for occupational practitioners taking care of employees exposed to bovine tuberculosis is warranted and should be tailored to level of exposure. This review was intended to be the first step of such a project. Articles were identified from various continents and countries with different socio-economic situations, broadening our understanding of the worldwide situation. Published data on occupational exposure in developed countries are scarce. We had to extrapolate findings from countries with higher prevalence of the disease.

THE PREVALENCE OF TUBERCULOSIS IN CATTLE AND THEIR HANDLERS IN NORTH TONGU, VOLTA REGION, GHANA

BACKGROUND

The need to understand the contribution of bovine tuberculosis (BTB) to the general tuberculosis burden in a poor resource setting is paramount. The aim of this study is to determine the burden of BTB among herdsmen and cattle in the North Tongu district of Volta Region in Ghana.

MATERIALS AND METHODS

A cross- sectional study was conducted in the North Tongu District of the Volta Region between the period of October 2011- March 2012. A well-structured questionnaire was used to collect socio-demographic information and possible risk factor information on cattle from participants. Sputum samples from 68 herdsmen and blood samples from 200 cattle belonging to these herdsmen were also collected. Sputum samples were analyzed using Ziehl- Neelsen staining while Anigen Rapid BTB Test was used for Cattle blood samples.

RESULTS

Ninety percent (61/68) of respondents were also found to consume fresh milk while 84% (57/68) do not use protective clothing. Of a total of 1580 cattle owned by the herdsmen, 200 cattle consisting of 14 bulls and 186 cows were screened where the prevalence of bovine TB was 19% (38/200) and those affected were all females. All (100%) human sample tested negative for Acid-Fast Bacilli (AFB). However, the seropositivity of cattle and kraal density were statistically associated (p= 0.001).

CONCLUSION

Bovine TB is prevalent in cattle in North Tongu district. Although herdsmen indulge in risky lifestyles that expose them to BTB, a zero prevalence of BTB was observed, further study is envisaged using a larger sample size.

Prevalence and risk factors for bovine tuberculosis in Minas Gerais State, Brazil

The aim of the present study was to estimate the prevalence and regional spread of bovine tuberculosis in the state of Minas Gerais, Brazil, to identify herd-level risk factors, and to provide guidance for disease control and mitigation of its impact in public health. The study comprised a large-scale random sample survey of 22,990 animals and 1586 herds, distributed in seven regions. A questionnaire was applied on each farm to collect epidemiological and herd management data. Overall, 5.04 % of herds and 0.81 % of animals were positive for bovine tuberculosis. The highest herd prevalence was found in Alto Paranaíba, an expanding dairy region. The more technologically advanced dairy herds showed a prevalence ratio of 2.83 compared to others and are obvious candidates for risk-based surveillance and herd accreditation schemes. Small farms cannot be left out of disease control efforts because they are the vast majority of herds, albeit with lower individual risk. With regard to public health, there is widespread practice of producing homemade fresh cheese with raw milk and of slaughtering culled cows in places without sanitary inspection. This poses a risk to consumers and limits the efficacy of surveillance at slaughter.

Professional Acquisition ofM. bovisin Calabria Region (Southern Italy): A Challenging Case of Osteomyelitis in a Migrant Patient from Bulgaria

We report herein the first case of a coinfection withBrucellaspp.,M. bovis, andEnterobacter cloacaein a butcher who moved from Bulgaria to Italy. Molecular typing suggested professional acquisition ofM. bovisin Italy. So, surveillance and preventive measures need to be implemented.

Tuberculin screening of some selected Fulani lactating cows in North-Central Nigeria

The prevalence of mycobacterial infection among lactating Fulani cows was investigated in the Federal Capital Territory, Abuja and Kaduna State of Nigeria. Tuberculin testing using single comparative intradermal tuberculin test showed a 14.6 % positive, 4 % doubtful, and 81.4 % negative reactors. Mycobacterial infection was found to be present in the nomadic (constantly moving) and seminomadic (limited movement) management systems studied but management showed no significant effect on the prevalence of the disease. However, the prevalence was significantly higher in older age groups than the younger ones (P < 0.05).

Prevalence study on bovine tuberculosis and molecular characterization of its causative agents in cattle slaughtered at Addis Ababa municipal abattoir, Central Ethiopia

A cross-sectional study was conducted on 500 cattle slaughtered at Addis Ababa abattoir to determine the prevalence of bovine tuberculosis (BTB) and characterize its causative agents. Postmortem examination, mycobacteriological culturing, region of difference-4 (RD4)-based PCR and spoligotyping were applied. The prevalence of BTB was 5 % on the basis of postmortem inspection alone but 1.2 % based on molecular confirmation. Factors including age, sex, and breed showed statistically significant association with BTB (p < 0.05). Gross lesions were observed most frequently (68 %) in the lungs and lung-associated lymph nodes compared to other organs and lymph nodes. Of the 25 grossly suspicious TB lesions processed and cultured, only six (24 %) were culture-positive, yielding Mycobacterium bovis confirmed by RD4 deletion typing. Further characterization of the six M. bovis isolates at the strain level by using spoligotyping revealed that one did not belong to any previously known type, while the others belonged to types SB1176 (two), SB1477 (two), and SB0133 (one). The new strain was submitted to the international M. Bovis.org database for international code designation. The study confirms the considerable prevalence of bovine tuberculosis in cattle slaughtered at Addis Ababa abattoir and highlights the need for control of bovine tuberculosis in the country.

The influence of cattle breed on susceptibility to bovine tuberculosis in Ethiopia

Bovine tuberculosis in domestic livestock such as cattle is an economically important disease with zoonotic potential, particularly in countries with emerging economies. We discuss the findings of recent epidemiological and immunological studies conducted in Ethiopia on host susceptibility differences between native zebu and the exotic Holstein–Friesian cattle that are increasingly part of the Ethiopian National herd, due to the drive to increase milk yields. These findings support the hypothesis that native Zebu cattle are more resistant to bovine tuberculosis. We also summarise the results of experimental infections that support the epidemiological data, and of laboratory experiments that suggest a role for the innate immune response, and in particular interleukin-6, in the outcome of bovine tuberculosis infection.

Perspectives on the History of Bovine TB and the Role of Tuberculin in Bovine TB Eradication

Tuberculosis remains a significant disease of animals and humans worldwide. Bovine tuberculosis is caused by Mycobacteria with an extremely wide host range and serious, although currently probably underdiagnosed, zoonotic potential. Where bovine tuberculosis controls are effective, human zoonotic TB, due to Mycobacterium bovis or M. caprae, is uncommon and clinical cases are infrequent in cattle. Therefore, the control and ultimate eradication of bovine tuberculosis is desirable. Tuberculin tests are the primary screening tool used in bovine eradication. The choice of tuberculin test is dependent on the environment in which it is to be used. Tuberculin potency is critical to test performance, and the accurate determination of potency is therefore particularly important. The design of a control or eradication programme should take into consideration the fundamental scientific knowledge, the epidemiological profile of disease, the experience of other eradication programmes, and the presence, in the same ecosystem, of maintenance hosts, in which infection is self-sustaining and which are capable of transmitting infection. A control or eradication programme will necessarily require modification as it progresses and must be under constant review to identify the optimal desirable goals, the efficacy of policy, and constraints to progress.