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Seid G, Alemu A, Diriba G, Zerihun B, Abebaw Y, Moga S, Abdela S, Habtemariam S, Gumi B. Routine tuberculosis contact investigation yield and preventive treatment cascade in central Ethiopia. Heliyon 2024; 10:e30942. [PMID: 38770348 PMCID: PMC11103515 DOI: 10.1016/j.heliyon.2024.e30942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 05/08/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024] Open
Abstract
Introduction There is a global gap between tuberculosis incident cases and the notified cases. Active household contact investigation is one of the strategies to narrow this gap. It has the advantage of giving early diagnosis and preventive treatment to vulnerable and eligible groups. This study assessed the practice of contact investigation and tuberculosis preventive treatment adherence in central Ethiopia. Method A cross-sectional study covering all registered bacteriologically confirmed pulmonary tuberculosis patients and their close contacts was conducted in central Ethiopia from January 1, 2022, to December 30, 2022. Result A total of 1372 household contacts were declared by the index cases. From these 79.44 % (1090) contacts received a one-time tuberculosis screening giving a total of four (0.36 %) active TB cases. Among 484 household contacts of drug-resistant tuberculosis index cases, 5.53 % (14) had presumptive tuberculosis and 0.79 % (2) had active tuberculosis. While among 837 household contacts of drug-susceptible tuberculosis index cases presumptive TB cases were 1.91 % (16) and active TB cases were 0.23 % (2). Of the 142 eligible under 15 children 81.69 % (116) had started tuberculosis preventive treatment and 84.48 % (98) completed the treatment. On multivariable logistic regression, the associated factor for tuberculosis preventive treatment non-adherence was age 2-5 years (aOR, 0.02, 95 % CI (0.002-0.20) and age 5-15 years (aOR, 0.04,95 % CI (0.002-0 0.95)) P=<0.05). Conclusion There was low contact screening practice in the DR-TB index cases as compared to national and global targets. The yield of routine contact investigation was low and it indicates the quality of screening. Tuberculosis preventive treatment initiation and completion rates were also low as compared to those of many other countries and global achievements which need further improvement, especially for completion. Alternative mechanisms should be planned to increase the yield of tuberculosis screening and tuberculosis preventive treatment adherence.
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Affiliation(s)
- Getachew Seid
- Ethiopian Public Health Institute, P.o.box 1242, Addis Ababa Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Po. Box 1176, Addis Ababa, Ethiopia
| | - Ayinalem Alemu
- Ethiopian Public Health Institute, P.o.box 1242, Addis Ababa Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Po. Box 1176, Addis Ababa, Ethiopia
| | - Getu Diriba
- Ethiopian Public Health Institute, P.o.box 1242, Addis Ababa Ethiopia
| | - Betselot Zerihun
- Ethiopian Public Health Institute, P.o.box 1242, Addis Ababa Ethiopia
| | - Yeshiwork Abebaw
- Ethiopian Public Health Institute, P.o.box 1242, Addis Ababa Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Po. Box 1176, Addis Ababa, Ethiopia
| | - Shewki Moga
- Ethiopian Public Health Institute, P.o.box 1242, Addis Ababa Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Po. Box 1176, Addis Ababa, Ethiopia
| | - Saro Abdela
- Ethiopian Public Health Institute, P.o.box 1242, Addis Ababa Ethiopia
| | - Solomon Habtemariam
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Po. Box 1176, Addis Ababa, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Po. Box 1176, Addis Ababa, Ethiopia
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Alemu J, Gumi B, Tsegaye A, Rahimeto Z, Fentahun D, Ibrahim F, Abubeker A, Gebremedhin A, Gelanew T, Howe R. Seroprevalence of SARS-CoV-2 and Hepatitis B Virus Coinfections among Ethiopians with Acute Leukemia. Cancers (Basel) 2024; 16:1606. [PMID: 38672687 PMCID: PMC11049053 DOI: 10.3390/cancers16081606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
SARS-CoV-2 and blood-borne viral coinfections are well reported. Nevertheless, little is known regarding the seroprevalence of SARS-CoV-2 and coinfection with blood-borne viruses in hematologic malignancy patients in Ethiopia. We aimed to assess the seroprevalence of SARS-CoV-2 and associated infections with hepatitis B and other viruses among adolescent and adult acute leukemia patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. A cross-sectional study was conducted from July 2020 to June 2021. Blood samples were tested for the presence of anti-SARS-CoV-2, HBV, HCV, and HIV with ELISA kits and occult hepatitis B infection with a real-time polymerase chain reaction assay. Out of a total 110 cases, the SARS-CoV-2 seroprevalence was 35.5%. The prevalence showed a significant increment from July 2020 to the end of June 2021 (p = 0.015). In 22.7% and 2.7% of leukemia cases, HBV and HIV, respectively, were detected. No HCV was identified. The rate of SARS-CoV-2 coinfection with HBV and HIV was 28% (11/39) and 2.6% (1/39), respectively; however, there was no statistically significant association between SARS-CoV-2 seropositivity with HBV and HIV (p > 0.05). There is a need for viral screening in leukemia cases to monitor infections and inform management.
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Affiliation(s)
- Jemal Alemu
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia;
- Armauer Hansen Research Institute, Addis Ababa P.O. Box 1005, Ethiopia; (Z.R.); (D.F.); (F.I.); (T.G.); (R.H.)
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia;
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia;
| | - Aster Tsegaye
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia;
| | - Ziyada Rahimeto
- Armauer Hansen Research Institute, Addis Ababa P.O. Box 1005, Ethiopia; (Z.R.); (D.F.); (F.I.); (T.G.); (R.H.)
| | - Dessalegn Fentahun
- Armauer Hansen Research Institute, Addis Ababa P.O. Box 1005, Ethiopia; (Z.R.); (D.F.); (F.I.); (T.G.); (R.H.)
| | - Fozia Ibrahim
- Armauer Hansen Research Institute, Addis Ababa P.O. Box 1005, Ethiopia; (Z.R.); (D.F.); (F.I.); (T.G.); (R.H.)
| | - Abdulaziz Abubeker
- Department of Internal Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia; (A.A.); (A.G.)
| | - Amha Gebremedhin
- Department of Internal Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia; (A.A.); (A.G.)
| | - Tesfaye Gelanew
- Armauer Hansen Research Institute, Addis Ababa P.O. Box 1005, Ethiopia; (Z.R.); (D.F.); (F.I.); (T.G.); (R.H.)
| | - Rawleigh Howe
- Armauer Hansen Research Institute, Addis Ababa P.O. Box 1005, Ethiopia; (Z.R.); (D.F.); (F.I.); (T.G.); (R.H.)
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Fromsa A, Willgert K, Srinivasan S, Mekonnen G, Bedada W, Gumi B, Lakew M, Tadesse B, Bayissa B, Sirak A, Girma Abdela M, Gebre S, Chibssa T, Veerasami M, Vordermeier HM, Bakker D, Berg S, Ameni G, Juleff N, de Jong MCM, Wood J, Conlan A, Kapur V. BCG vaccination reduces bovine tuberculosis transmission, improving prospects for elimination. Science 2024; 383:eadl3962. [PMID: 38547287 DOI: 10.1126/science.adl3962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/24/2024] [Indexed: 04/02/2024]
Abstract
Bacillus Calmette-Guérin (BCG) is a routinely used vaccine for protecting children against Mycobacterium tuberculosis that comprises attenuated Mycobacterium bovis. BCG can also be used to protect livestock against M. bovis; however, its effectiveness has not been quantified for this use. We performed a natural transmission experiment to directly estimate the rate of transmission to and from vaccinated and unvaccinated calves over a 1-year exposure period. The results show a higher indirect efficacy of BCG to reduce transmission from vaccinated animals that subsequently become infected [74%; 95% credible interval (CrI): 46 to 98%] compared with direct protection against infection (58%; 95% CrI: 34 to 73%) and an estimated total efficacy of 89% (95% CrI: 74 to 96%). A mechanistic transmission model of bovine tuberculosis (bTB) spread within the Ethiopian dairy sector was developed and showed how the prospects for elimination may be enabled by routine BCG vaccination of cattle.
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Affiliation(s)
- Abebe Fromsa
- Aklilu Lemma Institutes of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Bishoftu, Ethiopia
| | - Katriina Willgert
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, UK
| | - Sreenidhi Srinivasan
- Huck Institutes of Life Sciences, The Pennsylvania State University, University Park, PA, USA
- Department of Animal Science, The Pennsylvania State University, University Park, PA, USA
- The Global Health Initiative, Henry Ford Health, Detroit, MI, USA
| | | | | | - Balako Gumi
- Aklilu Lemma Institutes of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Berecha Bayissa
- Aklilu Lemma Institutes of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Musse Girma Abdela
- Aklilu Lemma Institutes of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | | | | | - Douwe Bakker
- Huck Institutes of Life Sciences, The Pennsylvania State University, University Park, PA, USA
- Technical Consultant and Independent Researcher, Lelystad, Netherlands
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, Madrid, Spain
| | - Stefan Berg
- Animal and Plant Health Agency, Weybridge, UK
| | - Gobena Ameni
- Aklilu Lemma Institutes of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, United Arab Emirates
| | - Nick Juleff
- The Bill & Melinda Gates Foundation Seattle, WA, USA
| | - Mart C M de Jong
- Quantitative Veterinary Epidemiology Group, Wageningen UR, The Netherlands
| | - James Wood
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, UK
| | - Andrew Conlan
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, UK
| | - Vivek Kapur
- Huck Institutes of Life Sciences, The Pennsylvania State University, University Park, PA, USA
- Department of Animal Science, The Pennsylvania State University, University Park, PA, USA
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Meaza A, Yenew B, Amare M, Alemu A, Hailu M, Gamtesa DF, Kaba M, Medhin G, Ameni G, Gumi B. Correction: Prevalence of tuberculosis and associated factors among presumptive TB refugees residing in refugee camps in Ethiopia. BMC Infect Dis 2023; 23:892. [PMID: 38124050 PMCID: PMC10731706 DOI: 10.1186/s12879-023-08905-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Abyot Meaza
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), P.O. Box 1176, Addis Ababa, Ethiopia.
- Ethiopian Public Health Institute (EPHI), Swaziland Street, PO Box 1242, Addis Ababa, Ethiopia.
| | - Bazezew Yenew
- Ethiopian Public Health Institute (EPHI), Swaziland Street, PO Box 1242, Addis Ababa, Ethiopia
| | - Miskir Amare
- Ethiopian Public Health Institute (EPHI), Swaziland Street, PO Box 1242, Addis Ababa, Ethiopia
| | - Ayinalem Alemu
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), P.O. Box 1176, Addis Ababa, Ethiopia
- Ethiopian Public Health Institute (EPHI), Swaziland Street, PO Box 1242, Addis Ababa, Ethiopia
| | - Michael Hailu
- Ethiopian Public Health Institute (EPHI), Swaziland Street, PO Box 1242, Addis Ababa, Ethiopia
| | - Dinka Fikadu Gamtesa
- Ethiopian Public Health Institute (EPHI), Swaziland Street, PO Box 1242, Addis Ababa, Ethiopia
| | - Mirgissa Kaba
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), P.O. Box 1176, Addis Ababa, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), P.O. Box 1176, Addis Ababa, Ethiopia
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, PO Box 15551, Al Ain, UAE
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), P.O. Box 1176, Addis Ababa, Ethiopia
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Shamebo T, Gumi B, Zewude A, Gashaw F, Mohammed T, Girma M, Zerihun B, Getu M, Mekasha S, Getahun M, Wondale B, Petros B, Ameni G. Molecular epidemiology and drug sensitivity of Mycobacterium tuberculosis in homeless individuals in the Addis Ababa city, Ethiopia. Sci Rep 2023; 13:21370. [PMID: 38049519 PMCID: PMC10695943 DOI: 10.1038/s41598-023-48407-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 11/26/2023] [Indexed: 12/06/2023] Open
Abstract
Although homeless segment of the society could be the hotspots for tuberculosis (TB) transmission, there is little data on TB in homeless individuals in Ethiopia. The objective of this study was to investigate the molecular epidemiology and drug sensitivity of Mycobacterium tuberculosis (M. tuberculosis) isolated from homeless individuals in Addis Ababa, Ethiopia. The study was conducted on 59 M. tuberculosis isolates, which were recovered by the clinical screening of 5600 homeless individuals and bacteriological examination of 641 individuals with symptoms of pulmonary tuberculosis (PTB). Region of difference-9 (RD9) based polymerase-chain reaction (PCR), Spoligotyping and 24-loci Mycobacterial Interspersed Repetitive Unit-Variable Number Tandem Repeat (MIRU-VNTR) typing were used for genotyping of the isolates. In addition, drug sensitivity test was performed on the isolates using BD Bactec Mycobacterial Growth Inhibition Tube (MGIT) 960. Fifty-eight of the 59 isolates were positive by spoligotyping and spoligotyping International type (SIT) 53, SIT 37, and SIT 149 were the dominant spoligotypes; each consisting of 19%, 15.5%, and10.3% of the isolates, respectively. The majority of the isolates (89.7%) were members of the Euro-American (EA) major lineage. MIRU-VNTR identified Ethiopia_3, Delhi/CAS, Ethiopia_2, TUR, X-type, Ethiopia_H37Rv-like strain, Haarlem and Latin-American Mediterranean (LAM) sub lineages. The proportion of clustering was 77.6% (45/58) in spoligotyping while it was 39.7% (23/58) in 24-loci MIRU-VNTR typing. Furthermore, the proportion of clustering was significantly lowered to 10.3% (6/58) when a combination of spoligotyping and 24-loci MIRU-VNTRplus was used. The recent transmission index (RTI) recorded by spoligotyping, 24-loci MIRU-VNTR typing, and a combination of the two genotyping methods were 58.6%, 27.6% and 5.2%, respectively. Young age and living in groups were significantly associated with strain clustering (P < 0.05). The drug sensitivity test (DST) result showed 8.9% (4/58) of the isolates were resistant to one or more first line ant-TB drugs; but multidrug resistant isolate was not detected. Clustering and RTI could suggest the transmission of TB in the homeless individuals, which could suggest a similar pattern of transmission between homeless individuals and the general population. Hence, the TB control program should consider homeless individuals during the implementation of TB control program.
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Affiliation(s)
- Tsegaye Shamebo
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, PO. Box 1176, Addis Ababa, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Po. Box 1176, Addis Ababa, Ethiopia
| | - Aboma Zewude
- Ethiopian National Tuberculosis Reference Laboratory, Ethipian Public Health Institute, PO. Box 1242 or 5654, Addis Ababa, Ethiopia
- Arba Minch University, Araba Minch, Ethiopia
| | - Fikru Gashaw
- Kotebe University of Education, Addis Ababa, Ethiopia
| | - Temesgen Mohammed
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, PO Box 15551, Al Ain, United Arab Emirates
- Arba Minch University, Araba Minch, Ethiopia
| | - Muse Girma
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Po. Box 1176, Addis Ababa, Ethiopia
| | - Betselot Zerihun
- Ethiopian National Tuberculosis Reference Laboratory, Ethipian Public Health Institute, PO. Box 1242 or 5654, Addis Ababa, Ethiopia
| | - Melak Getu
- Ethiopian National Tuberculosis Reference Laboratory, Ethipian Public Health Institute, PO. Box 1242 or 5654, Addis Ababa, Ethiopia
| | - Sindew Mekasha
- Ethiopian National Tuberculosis Reference Laboratory, Ethipian Public Health Institute, PO. Box 1242 or 5654, Addis Ababa, Ethiopia
| | - Muluwork Getahun
- Ethiopian National Tuberculosis Reference Laboratory, Ethipian Public Health Institute, PO. Box 1242 or 5654, Addis Ababa, Ethiopia
| | | | - Beyene Petros
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, PO. Box 1176, Addis Ababa, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Po. Box 1176, Addis Ababa, Ethiopia.
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, PO Box 15551, Al Ain, United Arab Emirates.
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Meaza A, Riviere E, Bonsa Z, Rennie V, Gebremicael G, de Diego-Fuertes M, Meehan CJ, Medhin G, Abebe G, Ameni G, Van Rie A, Gumi B. Genomic transmission clusters and circulating lineages of Mycobacterium tuberculosis among refugees residing in refugee camps in Ethiopia. Infect Genet Evol 2023; 116:105530. [PMID: 38008242 DOI: 10.1016/j.meegid.2023.105530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/15/2023] [Accepted: 11/19/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND Understanding the transmission dynamics of Mycobacterium tuberculosis (Mtb) could benefit the design of tuberculosis (TB) prevention and control strategies for refugee populations. Whole Genome Sequencing (WGS) has not yet been used to document the Mtb transmission dynamics among refugees in Ethiopia. We applied WGS to accurately identify transmission clusters and Mtb lineages among TB cases in refugee camps in Ethiopia. METHOD AND DESIGN We conducted a cross-sectional study of 610 refugees in refugee camps in Ethiopia presenting with symptoms of TB. WGS data of 67 isolates was analyzed using the Maximum Accessible Genome for Mtb Analysis (MAGMA) pipeline; iTol and FigTree were used to visualize phylogenetic trees, lineages, and the presence of transmission clusters. RESULTS Mtb culture-positive refugees originated from South Sudan (52/67, 77.6%), Somalia (9/67, 13.4%). Eritrea (4/67, 6%), and Sudan (2/67, 3%). The majority (52, 77.6%) of the isolates belonged to Mtb lineage (L) 3, and one L9 was identified from a Somalian refugee. The vast majority (82%) of the isolates were pan-susceptible Mtb, and none were multi-drug-resistant (MDR)-TB. Based on the 5-single nucleotide polymorphisms cutoff, we identified eight potential transmission clusters containing 23.9% of the isolates. Contact investigation confirmed epidemiological links with either family or social interaction within the refugee camps or with neighboring refugee camps. CONCLUSION Four lineages (L1, L3, L4, and L9) were identified, with the majority of strains being L3, reflecting the Mtb L3 dominance in South Sudan, where the majority of refugees originated from. Recent transmission among refugees was relatively low (24%), likely due to the short study period. The improved understanding of the Mtb transmission dynamics using WGS in refugee camps could assist in designing effective TB control programs for refugees.
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Affiliation(s)
- Abyot Meaza
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), PO Box 1176, Sefere Selam campus, Addis Ababa, Ethiopia; Ethiopian Public Health Institute (EPHI), PO Box 1242, Swaziland Street, Addis Ababa, Ethiopia.
| | - Emmanuel Riviere
- Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Zegeye Bonsa
- Mycobacteriology Research Center, Jimma University, Jimma, Ethiopia
| | - Vincent Rennie
- Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Gebremedhin Gebremicael
- Ethiopian Public Health Institute (EPHI), PO Box 1242, Swaziland Street, Addis Ababa, Ethiopia
| | - Miguel de Diego-Fuertes
- Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Conor J Meehan
- Department of Biosciences, Nottingham Trent University, Nottingham, UK
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), PO Box 1176, Sefere Selam campus, Addis Ababa, Ethiopia
| | - Gemeda Abebe
- Mycobacteriology Research Center, Jimma University, Jimma, Ethiopia; Department of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), PO Box 1176, Sefere Selam campus, Addis Ababa, Ethiopia; Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, PO Box 15551, Al Ain, United Arab Emirates
| | - Annelies Van Rie
- Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), PO Box 1176, Sefere Selam campus, Addis Ababa, Ethiopia
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Mohammed T, Mamo G, Zewude A, Sirak A, Gumi B, Ameni G. Prevalence of paratuberculosis in cattle based on gross and microscopic lesions in Ethiopia. BMC Vet Res 2023; 19:203. [PMID: 37833766 PMCID: PMC10571307 DOI: 10.1186/s12917-023-03725-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 09/08/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Paratuberculosis, caused by Mycobacterium avium subsp. paratuberculosis (MAP), is a chronic progressive granulomatous enteritis mainly affecting domestic and wild ruminants worldwide. Although paratuberculosis could be prevail in Ethiopia, there is a scarcity of epidemiological data on paratuberculosis in the country. Thus, this study was conducted to estimate the prevalence of paratuberculosis based on gross and microscopic lesions in cattle slaughtered at ELFORA Abattoir, central Ethiopia. Small intestines and associated lymph nodes of 400 apparently healthy cattle which were slaughtered at ELFORA export abattoir were examined for gross and microscopic lesions of paratuberculosis. The microscopic lesions were classified into four grades (I-IV) based on the type and number of cells infiltrated into the lesion. The prevalence of paratuberculosis was estimated on the basis of gross as well as microscopic lesion of paratuberculosis. RESULTS The prevalence of paratuberculosis was 11.25% (95% Confidence interval, CI = 0.083-0.148) on the basis of gross lesion. However, relatively lower prevalence (2.0%, 95% CI = 0.01, 0.039) was recorded based on microscopic lesion. The gross lesions were characterized by intestinal thickening, mucosal corrugations and enlargement of associated mesenteric lymph nodes. On the other hand, the microscopic lesions were characterized by granuloma of different grades ranging from grade I to grade III lesions. CONCLUSIONS The present study indicated the occurrence of paratuberculosis in cattle of Ethiopia based on the detection of gross and microscopic lesions consistent with the lesion of paratuberculosis. The result of this study could be used as baseline information for future studies on the epidemiology and economic significance of paratuberculosis.
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Affiliation(s)
- Temesgen Mohammed
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, Al Ain, United Arab Emirates.
| | - Gezahegne Mamo
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Bishoftu, Ethiopia
| | - Aboma Zewude
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Asegedech Sirak
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, Al Ain, United Arab Emirates.
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Meaza A, Yenew B, Amare M, Alemu A, Hailu M, Gamtesa DF, Kaba M, Medhin G, Ameni G, Gumi B. Prevalence of tuberculosis and associated factors among presumptive TB refugees residing in refugee camps in Ethiopia. BMC Infect Dis 2023; 23:498. [PMID: 37507672 PMCID: PMC10386672 DOI: 10.1186/s12879-023-08469-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Tuberculosis (TB) causes significant morbidity and mortality in refugee populations. Although Ethiopia is the third largest refugee-hosting country in Africa, there is limited published data on the prevalence and associated factors of TB in refugees. The objective of this study was to estimate the prevalence of bacteriologically confirmed pulmonary TB (PTB) and explore associated factors in presumptive TB refugees residing in refugee camps in Ethiopia. METHODS A facility-based cross-sectional study was conducted between February and August 2021 in refugee camps in Ethiopia. Data were collected consecutively from 610 presumptive TB refugees who attended for TB diagnosis in selected refugee camp clinics in Ethiopia. A pre-tested questionnaire was used to collect data, and sputum samples were collected from eligible study participants. The Xpert Mycobacterium tuberculosis (MTB)/Rifampicin (RIF) assay was performed on direct spot sputum samples, whereas morning sputum samples were processed and inoculated for bacteriological culture using Mycobacterium Growth Indicator Tube (MGIT) and Lowsteen Jensen (LJ) methods. The statistical software package (STATA version 14) was used for statistical analysis. A logistic regression model was used for the evaluation of the association between bacteriologically confirmed TB cases and the associated factors. Descriptive statistics were used for the expression of the results, and statistical significance was assumed at p < 0.05. RESULTS Out of 610 study participants, more than half were female (54.9%), and the mean age was 37.9 years (SD, 16.64). The prevalence of bacteriologically confirmed PTB cases among refugees residing in refugee camps in Ethiopia was 13.3% (95% CI, 10.7-16.2%) using the Xpert MTB/RIF assay and/or culture. MTB was detected in 12.8% (95% CI, 10.2-15.7%) of the individuals using the Xpert MTB/RIF assay, while culture positivity was observed in 11.6% (95% CI, 9.2-14.5%). The multivariable logistic regression model showed South Sudan origins (adjusted odds ratio, AOR = 7.74; 95% CI, 3.05-19.64), age group, 19-38 years old (AOR = 5.66; 95% CI, 1.86-17.28), and male sex (AOR = 2.69; 95% CI, 1.58-4.56) were significantly associated with the bacteriologically confirmed TB among refugees residing in refugee camps in Ethiopia. CONCLUSION The prevalence of bacteriologically confirmed PTB among presumptive TB refugees residing in refugee camps in Ethiopia was high. The national TB program should strengthen TB prevention and control activities in the refugee camps of Ethiopia. Moreover, an active TB survey program should be implemented in refugee camps in Ethiopia.
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Affiliation(s)
- Abyot Meaza
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), P.O. Box 1176, Addis Ababa, Ethiopia.
- Ethiopian Public Health Institute (EPHI), Swaziland Street, PO Box 1242, Addis Ababa, Ethiopia.
| | - Bazezew Yenew
- Ethiopian Public Health Institute (EPHI), Swaziland Street, PO Box 1242, Addis Ababa, Ethiopia
| | - Miskir Amare
- Ethiopian Public Health Institute (EPHI), Swaziland Street, PO Box 1242, Addis Ababa, Ethiopia
| | - Ayinalem Alemu
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), P.O. Box 1176, Addis Ababa, Ethiopia
- Ethiopian Public Health Institute (EPHI), Swaziland Street, PO Box 1242, Addis Ababa, Ethiopia
| | - Michael Hailu
- Ethiopian Public Health Institute (EPHI), Swaziland Street, PO Box 1242, Addis Ababa, Ethiopia
| | - Dinka Fikadu Gamtesa
- Ethiopian Public Health Institute (EPHI), Swaziland Street, PO Box 1242, Addis Ababa, Ethiopia
| | - Mirgissa Kaba
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), P.O. Box 1176, Addis Ababa, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), P.O. Box 1176, Addis Ababa, Ethiopia
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, PO Box 15551, Al Ain, UAE
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), P.O. Box 1176, Addis Ababa, Ethiopia
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Alemu A, Bitew ZW, Diriba G, Seid G, Moga S, Abdella S, Gashu E, Eshetu K, Tollera G, Dangisso MH, Gumi B. Poor treatment outcome and associated risk factors among patients with isoniazid mono-resistant tuberculosis: A systematic review and meta-analysis. PLoS One 2023; 18:e0286194. [PMID: 37467275 PMCID: PMC10355410 DOI: 10.1371/journal.pone.0286194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 05/10/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND To date, isoniazid mono-resistant tuberculosis (TB) is becoming an emerging global public health problem. It is associated with poor treatment outcome. Different studies have assessed the treatment outcome of isoniazid mono-resistant TB cases, however, the findings are inconsistent and there is limited global comprehensive report. Thus, this study aimed to assess the poor treatment outcome and its associated risk factors among patients with isoniazid mono-resistant TB. METHODS Studies that reported the treatment outcomes and associated factors among isoniazid mono-resistant TB were searched from electronic databases and other sources. We used Joana Briggs Institute critical appraisal tool to assess the study's quality. We assessed publication bias through visual inspection of the funnel plot and confirmed by Egger's regression test. We used STATA version 17 for statistical analysis. RESULTS Among 347 studies identified from the whole search, data were extracted from 25 studies reported from 47 countries. The pooled successful and poor treatment outcomes were 78% (95%CI; 74%-83%) and 22% (95%CI; 17%-26%), respectively. Specifically, complete, cure, treatment failure, mortality, loss to follow-up and relapse rates were 34%(95%CI; 17%-52%), 62% (95%CI; 50%-73%), 5% (95%CI; 3%-7%), 6% (95%CI; 4%-8%), 12% (95%CI; 8%-17%), and 1.7% (95%CI; 0.4%-3.1%), respectively. Higher prevalence of pooled poor treatment outcome was found in the South East Asian Region (estimate; 40%, 95%C; 34%-45%), and African Region (estimate; 33%, 95%CI; 24%-42%). Previous TB treatment (OR; 1.74, 95%CI; 1.15-2.33), having cancer (OR; 3.53, 95%CI; 1.43-5.62), and being initially smear positive (OR; 1.26, 95%CI; 1.08-1.43) were associated with poor treatment outcome. While those patients who took rifampicin in the continuation phase (OR; 0.22, 95%CI; 0.04-0.41), had extrapulmonary TB (OR; 0.70, 95%CI; 0.55-0.85), and took second-line injectable drugs (OR; 0.54, 95%CI; 0.33-0.75) had reduced risk of poor treatment outcome. CONCLUSION Isoniazid mono-resistant TB patients had high poor treatment outcome. Thus, determination of isoniazid resistance pattern for all bacteriologically confirmed TB cases is critical for successful treatment outcome. PROSPERO registration number: CRD42022372367.
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Affiliation(s)
- Ayinalem Alemu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Getu Diriba
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Getachew Seid
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Shewki Moga
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Saro Abdella
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Emebet Gashu
- Addis Ababa Health Bureau, Addis Ababa, Ethiopia
| | - Kirubel Eshetu
- USAID Eliminate TB Project, Management Sciences for Health, Addis Ababa, Ethiopia
| | | | | | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Alemu J, Gumi B, Tsegaye A, Abubeker A, Tadesse F, Shewaye A, Rahimeto Z, Mihret A, Mulu A, Gebremedhin A, Howe R. Frequency of viral infections in adolescent and adult in-patient Ethiopians with acute leukemia at presentation to a tertiary care teaching hospital: a cross-sectional study. Infect Agent Cancer 2023; 18:44. [PMID: 37438754 DOI: 10.1186/s13027-023-00519-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/16/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Leukemic patients are prone to infectious agents such as viruses due to dysregulated immune system resulting from infiltration of the bone marrow by malignant cells, chronic stimulation, reactivation of some viruses and viral pathogenicity as well as rarely from acquisition of a new infections leading to severe complications. However, the prevalence of these infections has not been systematically documented in resource-limited settings such as Ethiopia. OBJECTIVE To determine the prevalence of HBV, HCV, and HIV among adult and adolescent in-patients with acute leukemia before the administration of chemotherapy, at the Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia. METHODS A cross sectional study was conducted on 176 adult and adolescent inpatient Ethiopians, who were diagnosed with acute leukemia from April 2019 to June 2021. Socio-demographic characteristics and relevant clinical data were collected. Peripheral blood samples were collected and tested for HBV, HIV, and HCV using Enzyme-Linked Immunosorbent Assay (ELISA) and real-time PCR. Chi-square tests were used to assess associations between variables. RESULTS Of the 176 patients, 109(62%) were males. The median age was 25[IQR,18-35] yr, with a range from 13 to 76 year. The prevalence of HBV (positivity for HBsAg plus HBV DNA), HCV and HIV was 21.6%, 1.7%, and 1.7%, respectively. HBsAg was positive in 19 cases (10.8%). Among 157 HBsAg negative patients, 52(33.1%) were positive for Anti-HBcAg; of these seropositive cases, 47.5% were positive for HBV DNA. Most DNA positive, HBsAg negative cases (79.0%) had DNA concentrations below 200 IU/ml indicating true occult HBV infection (OBI). Of the 176 cases, 122 had a history of blood transfusions, but no statistically significant association was found between HBV infection and blood product transfusion history (P = 0.963). CONCLUSIONS The prevalence of HBV, HIV and HCV in patients with acute leukemia was similar to the national prevalence level of these infections. Given the HBsAg positivity and the high prevalence of occult hepatitis B infection in our study, these patients may be at increased risk for chemotherapy related hepatitis flares. Hence, clinicians caring these patients are strongly advised to screen their patients for HBV and also for HIV and HCV infections routinely.
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Affiliation(s)
- Jemal Alemu
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis, Ababa, Ethiopia.
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Aster Tsegaye
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis, Ababa, Ethiopia
| | - Abdulaziz Abubeker
- Department of Internal Medicine, College of Health Sciences, Addis Ababa University, Addis, Ababa, Ethiopia
| | - Fisihatsion Tadesse
- Department of Internal Medicine, College of Health Sciences, Addis Ababa University, Addis, Ababa, Ethiopia
| | - Abel Shewaye
- Department of Laboratory, ALERT Hospital, Addis Ababa, Ethiopia
| | | | - Adane Mihret
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Amha Gebremedhin
- Department of Internal Medicine, College of Health Sciences, Addis Ababa University, Addis, Ababa, Ethiopia
| | - Rawleigh Howe
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
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Alemu A, Bitew ZW, Diriba G, Seid G, Moga S, Abdella S, Gashu E, Eshetu K, Tollera G, Dangisso MH, Gumi B. The prevalence of latent tuberculosis infection in patients with chronic kidney disease: A systematic review and meta-analysis. Heliyon 2023; 9:e17181. [PMID: 37484241 PMCID: PMC10361307 DOI: 10.1016/j.heliyon.2023.e17181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 07/25/2023] Open
Abstract
Objective To estimate the prevalence of latent tuberculosis infection (LTBI) in chronic kidney disease (CKD) patients. Methods This study was conducted following the PRISMA guidelines. We identified, 3694 studies from the whole search, and 59 studies were included. Each study's quality was assessed using JBI checklist. We employed STATA version 17 for statistical analysis. We assessed heterogeneity using I2 heterogeneity test. Publication bias was assessed using funnel plot and Egger's test. We estimated the pooled LTBI prevalence in CKD patients along with 95%CI. Results The pooled prevalence of LTBI among CKD patients using data collected from 53 studies having 12,772 patients was 30.2% (95%CI; 25.5, 34.8). The pooled prevalence among pre-dialysis, hemodialysis, peritoneal dialysis, and renal transplanted patients was 17.8% (95%CI; 3.3, 32.4), 34.8% (95%CI; 29.1, 40.5), 25% (95%CI; 11, 38), and 16% (95%CI; 7, 25), respectively. The pooled prevalence of LTBI stratified by the laboratory screening methods was 25.3% (95%CI: 20.3-30.3) using TST, 28.0% (95%CI; 23.9-32.0) using QFT, and 32.6%, (95%CI: 23.7-41.5) using T-SPOT. Conclusion There is high prevalence of LTBI among CKD patients mainly in patients on dialysis. Thus, early diagnosis and treatment of LTBI in CKD patients should be performed to prevent active TB in CKD patients.PROSPERO registration number: CRD42022372441.
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Affiliation(s)
- Ayinalem Alemu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Getu Diriba
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Getachew Seid
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Shewki Moga
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Saro Abdella
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Emebet Gashu
- Addis Ababa Health Bureau, Addis Ababa, Ethiopia
| | - Kirubel Eshetu
- USAID Eliminate TB Project, Management Sciences for Health, Addis Ababa, Ethiopia
| | | | | | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Meaza A, Diriba G, Girma M, Wondimu A, Worku G, Medhin G, Ameni G, Gumi B. Molecular typing and drug sensitivity profiles of M. Tuberculosis isolated from refugees residing in Ethiopia. J Clin Tuberc Other Mycobact Dis 2023; 31:100371. [PMID: 37113677 PMCID: PMC10127110 DOI: 10.1016/j.jctube.2023.100371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
Background Refugees in developing countries have poor access to Tuberculosis (TB) care and control services. The understanding of genetic diversity and drug sensitivity patterns of M. tuberculosis (MTB) is important for the TB control program. However, there is no evidence that shows the drug sensitivity profiles and genetic diversity of MTB circulating among refugees residing in Ethiopia. This study aimed to investigate the genetic diversity of MTB strains and lineages, and to identify the drug sensitivity profiles of MTB isolated from refugees residing in Ethiopia. Methods A cross-sectional study was conducted among 68 MTB positive cases isolated from presumptive TB refugees from February to August 2021. Data and samples were collected in the refugee camp clinics and both rapid TB Ag detection and region of difference (RD)-9 deletion typing were used to confirm the MTBs. Drug susceptibility test (DST) and molecular typing were done using Mycobacterium Growth Indicator Tube (MGIT) method and spoligotyping respectively. Results DST and spoligotyping results were available for all 68 isolates. The isolates were grouped into 25 spoligotype patterns, which consisted of 1-31 isolates with 36.8% strain diversity. The international shared type (SIT)25 was predominant spoligotype pattern consisting of 31 (45.6%) isolates, followed by SIT24 comprising 5 (7.4%) isolates. Further investigation showed that 64.7% (44/68) of the isolates were belonged to CAS1-Delhi family and 75% (51/68) of the isolates were belonged to lineage(L)-3. Multi-drug resistance (MDR)-TB was observed only in one isolate (1.5%) for first-line anti-TB drugs and the highest level of mono-resistance, 5.9% (4/68), was observed for PZA(Pyrazinamide). Mono-resistance was observed in 2.9 % (2/68) and while 97.0% (66/68) of the MTB positive cases were susceptible to the second-line anti-TB drugs. Conclusion The findings are useful evidence for the TB screening, treatment and control in refugee populations and surrounding communities in Ethiopia.
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Affiliation(s)
- Abyot Meaza
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), P.O. Box 1176, Addis Ababa, Ethiopia
- Ethiopian Public Health Institute (EPHI), PO Box 1242, Swaziland Street, Addis Ababa, Ethiopia
- Corresponding author.
| | - Getu Diriba
- Ethiopian Public Health Institute (EPHI), PO Box 1242, Swaziland Street, Addis Ababa, Ethiopia
| | - Musse Girma
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), P.O. Box 1176, Addis Ababa, Ethiopia
| | - Ammanuel Wondimu
- Ethiopian Public Health Institute (EPHI), PO Box 1242, Swaziland Street, Addis Ababa, Ethiopia
| | - Getnet Worku
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), P.O. Box 1176, Addis Ababa, Ethiopia
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Jigjiga University, Ethiopia
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), P.O. Box 1176, Addis Ababa, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), P.O. Box 1176, Addis Ababa, Ethiopia
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, PO Box 15551, Al Ain, United Arab Emirates
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU), P.O. Box 1176, Addis Ababa, Ethiopia
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Shamebo T, Mekesha S, Getahun M, Gumi B, Petros B, Ameni G. Prevalence of pulmonary tuberculosis in homeless individuals in the Addis Ababa City, Ethiopia. Front Public Health 2023; 11:1128525. [PMID: 37089500 PMCID: PMC10117819 DOI: 10.3389/fpubh.2023.1128525] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/27/2023] [Indexed: 04/08/2023] Open
Abstract
BackgroundHomeless individuals are at a high risk of infection with Mycobacterium tuberculosis (M. tuberculosis) as compared to the general population. The number of homeless individuals has been increasing in Addis Ababa City during the last three decades due to the migration of rural inhabitants to the City for better living conditions. The objective of this study was to estimate the prevalence of pulmonary tuberculosis (PTB) and evaluate associated risk factors in homeless individuals in Addis Ababa City.MethodsA total of 5,600 homeless individuals were screened for PTB symptoms using WHO guideline between February 2019 and December 2020. Sputum samples were cultured from individuals with symptoms of PTB for mycobacterial isolation. Logistic regression analysis was used to identify factors associated with PTB.ResultsThe prevalence of bacteriologically confirmed cases was 1.1% (59/5,600) or 10.54 per 1000 population. Multinomial logistic regression analysis showed that being homeless for more than 5 years, body mass index (BMI) < 18.5, smoking cigarette, living in a group of more than five individuals, close contact with chronic coughers, imprisonment and HIV infection were significantly associated with the prevalence of PTB in homeless individuals (P < 0.05).ConclusionIn conclusion, the result of this study indicated that the prevalence of PTB in homeless individuals was higher than the prevalence of PTB in the general population of Addis Ababa City requiring for the inclusion of the homeless individuals in the TB control program.
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Affiliation(s)
- Tsegaye Shamebo
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sindew Mekesha
- Ethiopian National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Muluwork Getahun
- Ethiopian National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Beyene Petros
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
- *Correspondence: Gobena Ameni ;
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Alemu A, Bitew ZW, Diriba G, Gashu E, Seid G, Eshetu K, Kebede A, Gumi B. Incidence and predictors of acquired resistance to second-line antituberculosis drugs during the course of multi-drug resistant tuberculosis treatment: protocol for a systematic review and meta-analysis. BMJ Open 2023; 13:e070143. [PMID: 37019479 PMCID: PMC10083796 DOI: 10.1136/bmjopen-2022-070143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/30/2023] [Indexed: 04/07/2023] Open
Abstract
INTRODUCTION To date, acquired resistance to second-line antituberculosis drugs (SLDs) during multi-drug resistant tuberculosis (MDR-TB) treatment is becoming a public health concern. Different studies have assessed the incidence of acquired resistance to SLDs. However, the findings are inconsistent and there is limited global evidence. Thus, we are going to assess the incidence and predictors of acquired resistance to SLDs during MDR-TB treatment. METHODS AND ANALYSIS We designed this protocol following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Electronic databases and grey literature sources will be searched systematically for articles published up to 25 March 2023. Studies reporting the incidence and predictors of acquired resistance to SLDs in MDR-TB patients will be explored. The studies will be managed using Endnote X8 citation manager and a stepwise approach will be followed to select studies. Data will be summarised using Microsoft Excel 2016 spreadsheet. A Newcastle-Ottawa Scale quality assessment and cochrane risk-of-bias tools will be used to assess the study's quality. The authors will independently search databases, select studies, assess the study's quality and extract data. Data will be analysed using STATA V.17 software. We will estimate the pooled incidence of acquired resistance with 95% CI. In addition, the pooled effect measures (OR, HR, risk ratio) with their 95% CI will be estimated. Heterogeneity will be assessed using the I2 statistics. Publication bias will be assessed using funnel plot and Egger's test. A subgroup analysis will be conducted for the primary outcome (acquired resistance) per each study characteristics such as WHO regional category, country's TB/MDR-TB burden, data collection period and per the specific second-line anti-TB drug. ETHICS AND DISSEMINATION Since this study will be based on data extraction from published studies, ethical approval is not mandatory. The study will be published in peer-reviewed scientific journals and the findings will be presented at different scientific conferences. PROSPERO REGISTRATION NUMBER CRD42022371014.
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Affiliation(s)
- Ayinalem Alemu
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zebenay Workneh Bitew
- Department of Pediatric Nursing, School of Nursing, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Getu Diriba
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Emebet Gashu
- Addis Ababa Health Bureau, Addis Ababa, Ethiopia
| | - Getachew Seid
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Abebaw Kebede
- Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Alemu A, Bitew ZW, Seid G, Diriba G, Gashu E, Berhe N, Mariam SH, Gumi B. Tuberculosis in individuals who recovered from COVID-19: A systematic review of case reports. PLoS One 2022; 17:e0277807. [PMID: 36441785 PMCID: PMC9704624 DOI: 10.1371/journal.pone.0277807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/03/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The emergence of COVID-19 overwhelmed tuberculosis (TB) prevention and control, resulting in a decrease in TB detection rate and an increase in TB deaths. Furthermore, the temporary immunosuppressive effects, lung inflammation, and the corticosteroids used to treat COVID-19, may play a direct role in immunosuppression, leading to reactivation of either previous infection or latent TB or the development of new TB. Thus, the aim of this study was to review TB incidence in individuals who recovered from COVID-19. METHODS We conducted a systematic search of available databases for previously published studies that reported TB in COVID-19 survivors. The PRISMA checklist was used to guide the review, and the JBI checklist was used to evaluate the study's quality. The descriptive data were summarized. RESULTS Data were extracted from 21 studies conducted in 13 countries having 33 cases. The median age was 44 years (range; 13.5-80), and more than half (18, 54.5%) were males. Twelve patients immigrated from TB endemic settings. All 17 patients assessed for HIV were seronegative, and all 11 patients assessed for BCG vaccination status were vaccinated. The majority (20, 69%) of patients had some type of comorbidity with diabetes (12/29) and hypertension (9/29) being the most common. Four patients (30.77%) had a history of TB. Corticosteroids were used to treat COVID-19 in 62.5% (10) of individuals. Dexamethasone, remdesivir, azithromycin, hydroxychloroquine, and enoxaparin were the most commonly used drugs to treat COVID-19. The most common TB symptoms were fever, cough, weight loss, dyspnea, and fatigue. Twenty, eleven, and two patients developed pulmonary, extrapulmonary, and disseminated/miliary TB respectively. It may take up to seven months after COVID-19 recovery to develop tuberculosis. Data on the final treatment outcome was found for 24 patients, and five patients died during the anti-TB treatment period. CONCLUSION Tuberculosis after recovering from COVID-19 is becoming more common, potentially leading to a TB outbreak in the post-COVID-19 era. The immunosuppressive nature of the disease and its treatment modalities may contribute to post COVID-19 TB. Thus, we recommend a further study with a large sample size. Furthermore, we recommend feasibility studies to assess and treat latent TB in COVID-19 patients residing in TB endemic counties since treatment of latent TB is done only in TB non-endemic countries.
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Affiliation(s)
- Ayinalem Alemu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail: ,
| | | | - Getachew Seid
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Getu Diriba
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Emebet Gashu
- Addis Ababa Health Bureau, Addis Ababa, Ethiopia
| | - Nega Berhe
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Solomon H. Mariam
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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16
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Seid G, Alemu A, Dagne B, Sinshaw W, Gumi B. Tuberculosis in Household Contacts of Tuberculosis Patients in sub-Saharan African countries: A Systematic Review and Meta-analysis. J Clin Tuberc Other Mycobact Dis 2022; 29:100337. [DOI: 10.1016/j.jctube.2022.100337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Worku G, Gumi B, Mohammedbirhan B, Girma M, Sileshi H, Hailu M, Wondimu A, Ashagre W, Tschopp R, Carruth L, Ameni G. Molecular epidemiology of tuberculosis in the Somali region, eastern Ethiopia. Front Med (Lausanne) 2022; 9:960590. [PMID: 36313999 PMCID: PMC9614095 DOI: 10.3389/fmed.2022.960590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/21/2022] [Indexed: 12/03/2022] Open
Abstract
Background Tuberculosis (TB) is one of the leading causes of morbidity and mortality in low-income countries like Ethiopia. However, because of the limited laboratory infrastructure there is a shortage of comprehensive data on the genotypes of clinical isolates of Mycobacterium tuberculosis (M. tuberculosis) complex (MTBC) in peripheral regions of Ethiopia. The objective of this study was to characterize MTBC isolates in the Somali region of eastern Ethiopia. Methods A cross-sectional study was conducted in three health institutions between October 2018 and December 2019 in the capital of Somali region. A total of 323 MTBC isolates (249 from pulmonary TB and 74 from extrapulmonary TB) were analyzed using regions of difference 9 (RD 9)-based polymerase chain reaction (PCR) and spoligotyping. Results Of the 323 MTBC isolates, 99.7% (95% CI: 99.1–100%) were M. tuberculosis while the remaining one isolate was M. bovis based on RD 9-based PCR. Spoligotyping identified 71 spoligotype patterns; 61 shared types and 10 orphans. A majority of the isolates were grouped in shared types while the remaining grouped in orphans. The M. tuberculosis lineages identified in this study were lineage 1, 2, 3, 4, and 7 with the percentages of 7.4, 2.2, 28.2, 60.4, and 0.6%, respectively. Most (87.9%) of the isolates were classified in clustered spoligotypes while the remaining 12.1% isolates were singletons. The predominant clustered spoligotypes identified were SIT 149, SIT 21, SIT 26, SIT 53, and SIT 52, each consisting of 17.6, 13.3, 8.4, 7.4, and 5%, respectively. Lineage 3 and lineage 4, as well as the age group (15–24), were associated significantly with clustering. Conclusion The MTBC isolated from TB patients in Somali region were highly diverse, with considerable spoligotype clustering which suggests active TB transmission. In addition, the Beijing spoligotype was isolated in relatively higher frequency than the frequencies of its isolation from the other regions of Ethiopia warranting the attention of the TB Control Program of the Somali region.
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Affiliation(s)
- Getnet Worku
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia,Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Binyam Mohammedbirhan
- Department of Pathology, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Musse Girma
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Henok Sileshi
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Michael Hailu
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Amanuel Wondimu
- National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wondimu Ashagre
- One-Health Unit, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Rea Tschopp
- One-Health Unit, Armauer Hansen Research Institute, Addis Ababa, Ethiopia,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Lauren Carruth
- School of International Studies, American University, Washington, DC, United States
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia,Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, Al Ain, United Arab Emirates,*Correspondence: Gobena Ameni
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18
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Alemu A, Bitew ZW, Diriba G, Gumi B. Risk factors associated with drug-resistant tuberculosis in Ethiopia: A systematic review and meta-analysis. Transbound Emerg Dis 2022; 69:2559-2572. [PMID: 34741434 DOI: 10.1111/tbed.14378] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/15/2021] [Accepted: 10/27/2021] [Indexed: 12/12/2022]
Abstract
The emergence of drug-resistant tuberculosis (DR-TB) is becoming a challenge to the national TB control programmes including Ethiopia. Different risk factors are associated with DR-TB. Identifying these risk factors in a local setting is important to strengthen the effort to prevent and control DR-TB. Thus, this study aimed to assess the risk factors associated with DR-TB in Ethiopia. The Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist was followed to conduct this study. We systematically searched the articles from electronic databases and grey literature sources. We used the JBI tools to assess the quality of studies. Data were analysed using STATA version 15. We estimated the pooled odds ratio (OR) along with 95% Confidence Interval (CI). The forest plot and I2 heterogeneity test were used to assess heterogeneity among studies. We explored the presence of publication bias through visual inspection of the funnel plot and Egger's regression test. After screening 2238 articles, 27 studies were included in the final analysis. Based on the pooled analysis of the OR, unemployment (OR; 2.71, 95% CI; 1.64, 3.78), previous TB history (OR; 4.83, 95% CI; 3.02, 6.64), contact with known TB patient (OR; 1.72, 95% CI; 1.05, 2.40), contact with the known multi-drug resistant (MDR) TB patient (OR; 2.54, 95% CI; 1.46, 3.63) and having pulmonary TB (PTB; OR; 1.80, 95% CI; 1.14, 2.45) were found to be the risk factors of DR-TB, while elders (OR; 0.77, 95%CI; 0.60, 0.95) including above 45 years (OR; 0.76, 95%CI; 0.55, 0.97) and males (OR; 0.86, 95%CI; 0.76, 0.97) had lower DR-TB risk, compared to their counterparts. A previous history of TB treatment is a major risk factor for acquiring DR-TB in Ethiopia that might be due to poor adherence during the first-line anti-TB treatment. Besides, having contact with a TB patient, contact with an MDR-TB patient, having PTB and being unemployed were the risk factors of DR-TB in Ethiopia. Thus, active screening of TB contacts for DR-TB might help to detect DR-TB cases as early as possible and could help to mitigate its further transmission across the community.
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Affiliation(s)
- Ayinalem Alemu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zebenay Workneh Bitew
- Department of Pediatric Nursing, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Getu Diriba
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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19
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Worku G, Gumi B, Girma M, Mohammedbirhan B, Diriba G, Seid G, Getu M, Amare M, Sinshaw W, Ashagre W, Tschopp R, Carruth L, Ameni G. Drug sensitivity of clinical isolates of Mycobacterium tuberculosis and its association with bacterial genotype in the Somali region, Eastern Ethiopia. Front Public Health 2022; 10:942618. [PMID: 36062084 PMCID: PMC9428271 DOI: 10.3389/fpubh.2022.942618] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/25/2022] [Indexed: 01/21/2023] Open
Abstract
Background Drug resistance is becoming a major bottleneck for tuberculosis (TB) control programs in countries with high TB burdens. Although several studies were conducted on the drug sensitivity of Mycobacterium tuberculosis (M. tuberculosis) in central Ethiopia, there is a lack of data on the drug sensitivity of M. tuberculosis in the peripheral regions of the country including in the Somali region. Therefore, the objective of this study was to evaluate the drug sensitivity of M. tuberculosis and its association with bacterial genotype and evaluate the performance of Xpert MTB/RIF (Xpert) in detecting resistance to rifampicin (RIF). Methods A total of 302 M. tuberculosis were tested using the BD BACTEC-Mycobacteria Growth Indicator Tube 960 (MGIT 960) system for their drug sensitivity to the first-line anti-TB drugs. Besides, the drug sensitivity of 10 multidrug-resistant (MDR) M. tuberculosis isolates was evaluated for the second-line anti-TB drugs. Additionally, 177 of the 302 isolates were tested for genotypic drug resistance using Xpert. Chi-square and Fisher's exact tests were used for the evaluation of the association between variables and drug sensitivity. Results The overall prevalence of resistance to at least one drug was 11.6% (95% CI: 7.9-15.2%), while the prevalence of MDR was 3.3% (95% CI: 1.3-5.3%). Two of the 10 MDR isolates were resistant to capreomycin. The spoligotype Shared International Type (SIT) 149 was significantly associated with either monoresistance or MDR (p < 0.05). Of the 177 isolates tested by Xpert, 6.2% (11/177) were RIF-resistant. Discordant between Xpert and MGIT 960 was observed in one isolate and linked with probe-binding delay (ΔCT max = 5.8). The sensitivity and specificity of the Xpert assay were 100 and 99.4%, respectively, while its positive and negative predictive values were 90.9 and 100%, respectively. Conclusion The magnitude of MDR M. tuberculosis in the Somali region of Ethiopia was higher than the national prevalence of MDR-TB warranting the strengthening of the TB control program in the Somali region. Besides, drug resistance was associated with SIT 149 spoligotype (genotype). The Xpert assay was observed to have high sensitivity and specificity in detecting RIF-resistant M. tuberculosis, which is encouraging for its application widely.
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Affiliation(s)
- Getnet Worku
- College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia,Animal Health and Zoonotic Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Balako Gumi
- Animal Health and Zoonotic Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Musse Girma
- Animal Health and Zoonotic Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Getu Diriba
- Ethiopian Public Health Institute, National Tuberculosis Reference Laboratory, Addis Ababa, Ethiopia
| | - Getachew Seid
- Ethiopian Public Health Institute, National Tuberculosis Reference Laboratory, Addis Ababa, Ethiopia
| | - Melak Getu
- Ethiopian Public Health Institute, National Tuberculosis Reference Laboratory, Addis Ababa, Ethiopia
| | - Misikir Amare
- Ethiopian Public Health Institute, National Tuberculosis Reference Laboratory, Addis Ababa, Ethiopia
| | - Waganeh Sinshaw
- Ethiopian Public Health Institute, National Tuberculosis Reference Laboratory, Addis Ababa, Ethiopia
| | - Wondimu Ashagre
- One-Health Unit, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Rea Tschopp
- One-Health Unit, Armauer Hansen Research Institute, Addis Ababa, Ethiopia,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Lauren Carruth
- School of International Service, American University, Washington DC, DC, United States
| | - Gobena Ameni
- Animal Health and Zoonotic Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia,Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, Al Ain, United Arab Emirates,*Correspondence: Gobena Ameni ;
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20
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Ameni G, Messele Kebede A, Zewude A, Girma Abdulla M, Asfaw R, Gobena MM, Kyalo M, Stomeo F, Gumi B, Sori T. Equine Histoplasmosis in Ethiopia: Phylogenetic Analysis by Sequencing of the Internal Transcribed Spacer Region of rRNA Genes. Front Cell Infect Microbiol 2022; 12:789157. [PMID: 35909976 PMCID: PMC9330904 DOI: 10.3389/fcimb.2022.789157] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 03/23/2022] [Indexed: 11/22/2022] Open
Abstract
Equine histoplasmosis commonly known as epizootic lymphangitis (EL) is a neglected granulomatous disease of equine that is endemic to Ethiopia. It is caused by Histoplasma capsulatum variety farciminosum, a dimorphic fungus that is closely related to H. capsulatum variety capsulatum. The objective of this study was to undertake a phylogenetic analysis of H. capsulatum isolated from EL cases of horses in central Ethiopia and evaluate their relationship with H. capsulatum isolates in other countries and/or clades using the internal transcribed spacer (ITS) region of rRNA genes. Clinical and mycological examinations, DNA extraction, polymerase chain reaction (PCR), Sanger sequencing, and phylogenetic analysis were used for undertaking this study. Additionally, sequence data of Histoplasma isolates were retrieved from GenBank and included for a comprehensive phylogenetic analysis. A total of 390 horses were screened for EL and 97 were positive clinically while H. capsulatum was isolated from 60 horses and further confirmed with PCR, of which 54 were sequenced. BLAST analysis of these 54 isolates identified 29 H. capsulatum isolates and 14 isolates from other fungal genera while the remaining 11 samples were deemed insufficient for further downstream analysis. The phylogenetic analysis identified five clades, namely, African, Eurasian, North American 1 and 2, and Latin American A and B. The Ethiopian isolates were closely aggregated with isolates of the Latin American A and Eurasian clades, whereas being distantly related to isolates from North American 1 and 2 clades as well as Latin American B clade. This study highlights the possible origins and transmission routes of Histoplasmosis in Ethiopia.
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Affiliation(s)
- Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University, Al Ain, United Arab Emirates
- *Correspondence: Gobena Ameni, ;
| | | | - Aboma Zewude
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Musse Girma Abdulla
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Rahel Asfaw
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mesfin Mamo Gobena
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Debre Zeit, Ethiopia
| | - Martina Kyalo
- Capacity Building, Biosciences for Eastern and Central Africa-International Livestock Research Institute (BecA-ILRI) Hub, Nairobi, Kenya
| | - Francesca Stomeo
- Capacity Building, Biosciences for Eastern and Central Africa-International Livestock Research Institute (BecA-ILRI) Hub, Nairobi, Kenya
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Teshale Sori
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Debre Zeit, Ethiopia
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21
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Meaza A, Tola HH, Eshetu K, Mindaye T, Medhin G, Gumi B. Tuberculosis among refugees and migrant populations: Systematic review. PLoS One 2022; 17:e0268696. [PMID: 35679258 PMCID: PMC9182295 DOI: 10.1371/journal.pone.0268696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 05/04/2022] [Indexed: 11/18/2022] Open
Abstract
Tuberculosis (TB) is an important cause of morbidity and mortality among refugees and migrant populations. These groups are among the most vulnerable populations at increased risk of developing TB. However, there is no systematic review that attempts to summarize TB among refugees and migrant populations. This study aimed to summarize evidence on the magnitude of TB among refugees and migrant populations. The findings of this review will provide evidence to improve TB prevention and control policies in refugees and migrants in refugee camps and in migrant-hosting countries. A systematic search was done to retrieve the articles published from 2014 to 2021 in English language from electronic databases. Key searching terms were used in both free text and Medical Subject Heading (MeSH). Articles which had reported the magnitude of TB among refugees and migrant populations were included in the review. We assessed the risk of bias, and quality of the included studies with a modified version of the Newcastle–Ottawa Scale (NOS). Included studies which had reported incidence or prevalence data were eligible for data synthesis. The results were shown as summary tables. In the present review, more than 3 million refugees and migrants were screened for TB with the data collection period between 1991 and 2017 among the included studies. The incidence and prevalence of TB ranged from 19 to 754 cases per 100,000 population and 18.7 to 535 cases per 100,000 population respectively among the included studies. The current findings show that the most reported countries of origin in TB cases among refugees and migrants were from Asia and Africa; and the incidence and prevalence of TB among refugees and migrant populations is higher than in the host countries. This implies the need to implement and improve TB prevention and control in refugees and migrant populations globally. Trial registration: The protocol of this review was registered on PROSPERO (International prospective register of systematic reviews) with ID number, CRD42020157619.
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Affiliation(s)
- Abyot Meaza
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
| | | | - Kirubel Eshetu
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Tedla Mindaye
- Sibley Memorial Hospital, Johns Hopkins Medicine, Washington, DC, United States of America
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Almaw G, Mihret A, Abebe T, Ameni G, Gumi B, Olani A, Tamiru M, Koran T, Aliy A, Sombo M, Ayalew S, Yesuf A, Taye H, Wood JLN, Berg S, Aseffa A, Tessema B, Belachew B, Fekadu E, Melese F, Gemechu G, Tschopp R, Haile S, Hailu T, Bekele A, Yirga C, Ambaw M, Mamo T, Solomon T, Teklewold T, Gebre S, Gari G, Sahle M, Sirak A, Mekonnen G, Guta S, Wood J, Conlan A, Clarke A, Moore HL, Hodge C, Hewinson RG, Vordermeier M, Nunez‐Garcia J, Bayissa B, Zewude A, Worku A, Terfassa L, Chanyalew M, Mohammed T, Zeleke Y. Spoligotype analysis of
Mycobacterium bovis
isolates from cattle and assessment of zoonotic
TB
transmission among individuals working in bovine
TB
‐infected dairy farms in Ethiopia. Zoonoses Public Health 2022. [PMCID: PMC9544066 DOI: 10.1111/zph.12955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Bovine tuberculosis (bTB) is a disease with impact on dairy productivity, as well as having the potential for zoonotic transmission. Understanding the genetic diversity of the disease agent Mycobacterium bovis is important for identifying its routes of transmission. Here we investigated the level of genetic diversity of M. bovis isolates and assessed the zoonotic potential in risk groups of people working in bTB‐infected dairy farms in central Ethiopia. M. bovis was isolated and spoligotyped from tissue lesions collected from slaughtered cattle as well as from raw milk collected from bTB positive cows in dairy farms from six urban areas of central Ethiopia. From consented dairy farm workers, knowledge and practices related to zoonotic TB transmission, together with demographic and clinical information, was collected through interviews. Sputum or Fine Needle Aspirate (FNA) samples were collected from suspected TB cases. Spoligotyping of 55 M. bovis isolates that originated either from cattle tissues with tuberculous lesion or from raw milk revealed seven spoligotype patterns where SB1176 was the most prevalent type (47.3%). Most isolates (89.1%) were of the M. bovis African 2 clonal complex. All sputum and FNA samples from 41 dairy farm workers with symptoms of TB were culture negative for any mycobacteria. Among the 41 TB suspected farm workers, 61% did not know about bTB in cattle and its zoonotic potential, and over two‐third of these workers practiced raw milk consumption. Our spoligotype analysis suggests a wider transmission of a single spoligotype in the study area. The results reported here may be useful in guiding future work to identify the source and direction of bTB transmission and hence design of a control strategy. Isolation of M. bovis from milk, knowledge gap on zoonotic TB and practice of consumption of raw milk in the study population showed potential risk for zoonotic transmission.
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Affiliation(s)
- Gizat Almaw
- National Animal Health Diagnostic and Investigation Center Sebeta Ethiopia
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences Addis Ababa University Addis Ababa Ethiopia
| | - Adane Mihret
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences Addis Ababa University Addis Ababa Ethiopia
- Armauer Hansen Research Institute Addis Ababa Ethiopia
| | - Tamrat Abebe
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences Addis Ababa University Addis Ababa Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology Addis Ababa University Addis Ababa Ethiopia
- Department of Veterinary Medicine, College of Food and Agriculture United Arab Emirates University Al Ain United Arab Emirates
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology Addis Ababa University Addis Ababa Ethiopia
| | - Abebe Olani
- National Animal Health Diagnostic and Investigation Center Sebeta Ethiopia
| | - Mekdes Tamiru
- National Animal Health Diagnostic and Investigation Center Sebeta Ethiopia
| | - Tafesse Koran
- National Animal Health Diagnostic and Investigation Center Sebeta Ethiopia
| | - Abde Aliy
- National Animal Health Diagnostic and Investigation Center Sebeta Ethiopia
| | - Melaku Sombo
- National Animal Health Diagnostic and Investigation Center Sebeta Ethiopia
| | - Sosina Ayalew
- Armauer Hansen Research Institute Addis Ababa Ethiopia
| | - Adem Yesuf
- Armauer Hansen Research Institute Addis Ababa Ethiopia
| | - Hawult Taye
- Armauer Hansen Research Institute Addis Ababa Ethiopia
| | - James L. N. Wood
- Disease Dynamics Unit, Department of Veterinary Medicine University of Cambridge Cambridge UK
| | - Stefan Berg
- Bacteriology Department Animal and Plant Health Agency Weybridge UK
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23
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Alemu A, Bitew ZW, Diriba G, Gumi B. Response to letter to Editor entitled "Insufficient evidence for risk factors associated with drug-resistant tuberculosis in Ethiopia" with a manuscript ID TBED-LE-1538-21. Transbound Emerg Dis 2022; 69:1682-1683. [PMID: 35304822 DOI: 10.1111/tbed.14514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/04/2022] [Accepted: 03/11/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Ayinalem Alemu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.,Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Getu Diriba
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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24
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Lakew M, Srinivasan S, Mesele B, Olani A, Koran T, Tadesse B, Mekonnen GA, Almaw G, Sahlu T, Seyoum B, Beyecha K, Gumi B, Ameni G, Ashenafi H, Bakker D, Kapur V, Gebre S. Utility of the Intradermal Skin Test in a Test-and-Cull Approach to Control Bovine Tuberculosis: A Pilot Study in Ethiopia. Front Vet Sci 2022; 9:823365. [PMID: 35330613 PMCID: PMC8940234 DOI: 10.3389/fvets.2022.823365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 01/17/2022] [Indexed: 11/30/2022] Open
Abstract
Bovine tuberculosis (bTB) is one of the top three, high-priority, livestock diseases in Ethiopia and hence, the need for evaluation of potential control strategies is critical. Here, we applied the test-and-segregate followed by cull strategy for the control of bTB in the intensive Alage dairy farm in Ethiopia. All cattle reared on this farm were repeatedly skin tested using the Comparative Cervical Tuberculin (CCT) test for a total of five times between 2015 and 2021. During the first (October 2015) and second (March 2017) rounds of testing, all reactor animals (>4 mm) were culled, while those that were deemed as inconclusive (1–4 mm) were segregated and retested. At retest, animals with CCT >2 mm were removed from the herd. In the third (December 2017) and fourth (June 2018) rounds of tuberculin testing, a more stringent approach was taken wherein all reactors per the severe mode of CCT test interpretation (>2 mm) were culled. A final herd status check was performed in May 2021. In summary, the number of CCT positives (>4 mm) in the farm dropped from 23.1% (31/134) in October 2015 to 0% in December 2017 and remained 0% until May 2021. In contrast, the number of Single Cervical Tuberculin (SCT) test positives (≥4 mm) increased from 1.8 to 9.5% (from 2017 to 2021), indicating that CCT test might not be sufficient to effectively clear the herd of bTB. However, a more stringent approach would result in a drastic increase in the number of false positives. The total cost of the bTB control effort in this farm holding 134–200 cattle at any given time was conservatively estimated to be ~US$48,000. This, together with the need for culling an unacceptably high number of animals based on skin test status, makes the test-and-cull strategy impractical for nationwide implementation in Ethiopia and other low- and middle-income countries (LMICs) where the infection is endemic. Hence, there is an increased emphasis on the need to explore alternate, affordable measures such as vaccination alongside accurate diagnostics to help control bTB in endemic settings.
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Affiliation(s)
- Matios Lakew
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- *Correspondence: Matios Lakew
| | - Sreenidhi Srinivasan
- Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, United States
| | - Beruhtesfa Mesele
- Alage Agricultural Technical and Vocational Education Training (ATVET) College, Alage, Ethiopia
| | - Abebe Olani
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Tafesse Koran
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Biniam Tadesse
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | | | - Gizat Almaw
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Temertu Sahlu
- Alage Agricultural Technical and Vocational Education Training (ATVET) College, Alage, Ethiopia
| | - Bekele Seyoum
- Alage Agricultural Technical and Vocational Education Training (ATVET) College, Alage, Ethiopia
| | - Kebede Beyecha
- Alage Agricultural Technical and Vocational Education Training (ATVET) College, Alage, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Hagos Ashenafi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Douwe Bakker
- Independent Researcher and Technical Consultant, Lelystad, Netherlands
| | - Vivek Kapur
- Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, United States
- Department of Animal Science, The Pennsylvania State University, University Park, PA, United States
| | - Solomon Gebre
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
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25
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Abdela MG, Teshale S, Gobena MM, Zewde A, Jaleta H, Gumi B, Ameni G. Epidemiology of Epizootic Lymphangitis Among Carthorses in Ethiopia. Front Vet Sci 2022; 8:762937. [PMID: 34970614 PMCID: PMC8713507 DOI: 10.3389/fvets.2021.762937] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/20/2021] [Indexed: 11/13/2022] Open
Abstract
Epizootic lymphangitis caused by Histoplasma capsulatum variety farciminosum is a debilitating disease incurring considerable economic losses and affecting the welfare of carthorses. Understanding of its epidemiology is important for devising effective prevention and control measures. A cross-sectional study was conducted on 4,162 carthorses in 17 towns in Ethiopia between October 2018 and June 2019. Clinical and microscopic examinations, fungal culturing, and polymerase chain reaction were used to undertake this study. The overall prevalence of epizootic lymphangitis was 16.67% (95% CI: 15.55-17.84) in carthorses. Epizootic lymphangitis was detected in carthorses found in 16 of the 17 towns included in the study. The highest prevalence was recorded at Kombolcha Town (33.33; 95% CI: 27.54-39.52) whereas the lowest was recorded at Debre Birhan Town (0.00; 95% CI: 0.00-1.27). The results of univariable firth logistic regression analysis showed that the difference between the prevalence of Kombolcha and the prevalences of all the other towns except Holota and Shashemene were statistically significant. Statistically significantly lower prevalence was observed in other towns. Classification of the cases into different clinical forms showed that 87.18, 4.33, and 0.58% were cutaneous, ocular, and respiratory forms respectively, while the remaining 7.93% (55/694; 95% CI: 6.03-10.19) were classified as mixed form. In terms of the severity of the disease, 28.67, 60.52, and 0.81% were mild, moderate, and severe cases, respectively. The majority of the lesions (43.95%) were observed in the skin followed by forelimbs (14.55%) and neck region (14.27%). Higher mean annual temperature, lower annual rainfall, and higher humidity of the study towns were statistically significantly associated with an increased risk of epizootic lymphangitis. In conclusion this study revealed widespread occurrence of epizootic lymphangitis in carthorses yet a heterogeneous prevalence between towns. The veterinary and livestock authorities should take this into account while devising disease control.
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Affiliation(s)
- Musse G Abdela
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sori Teshale
- Department of Clinical Studies, College of Veterinary Medicine and Agriculture, Addis Ababa University, Bishoftu, Ethiopia
| | - Mesfin M Gobena
- Department of Animal Sciences, University of Florida, Gainesville, FL, United States
| | - Aboma Zewde
- The Ethiopian Public Health Institute (EPHI), Addis Ketema Sub-city, Addis Ababa, Ethiopia
| | - Hawi Jaleta
- School of Veterinary Medicine, College of Health Science, Wollega University, Nekemte, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.,Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University, Al Ain, United Arab Emirates
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26
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Meaza A, Tesfaye E, Mohamed Z, Zerihun B, Seid G, Eshetu K, Amare M, Sinshaw W, Dagne B, Mollalign H, Diriba G, Getu M, Yenew B, Tadesse M, Fikadu D, Abebaw Y, Moga S, Kebede A, Tola HH, Alemu A, Getahun M, Gumi B. Diagnostic accuracy of Truenat Tuberculosis and Rifampicin-Resistance assays in Addis Ababa, Ethiopia. PLoS One 2021; 16:e0261084. [PMID: 34962949 PMCID: PMC8714111 DOI: 10.1371/journal.pone.0261084] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/23/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Rapid and sensitive Tuberculosis (TB) diagnosis closer to patients is a key global TB control priority. Truenat assays (MTB, MTB Plus, and MTB-RIF Dx) are new TB molecular diagnostic tools for the detection of TB and Rifampicin (RIF)-resistance from sputum samples. The diagnostic accuracy of the assays is needed prior to implementation in clinical use in Ethiopia. This study aimed to determine the sensitivity and specificity of Truenat assays; and aimed to compare the assays to the Xpert MTB/RIF assay. METHODS A prospective evaluation study was conducted among 200 presumptive TB patients in microscopy centers in Addis Ababa, Ethiopia from May 2019 to December 2020. Culture (Solid and Liquid methods) and phenotypic (liquid method) drug susceptibility testing (DST) were used as a reference standard. RESULTS Of 200 adult participants, culture confirmed TB cases were 25 (12.5%), and only one isolate was resistant to RIF by phenotypic DST. The sensitivity of Truenat MTB was 88.0% [95% CI 70.1, 95.8], while 91.7 [95% CI 74.2, 97.7] for Truenat MTB Plus at the microscopy centers. The specificity of Truenat MTB was 97.2% [95% CI 93.1, 98.9], while for Truenat MTB Plus was 97.2% [95% CI 93.0, 99.0]. The sensitivity of Truenat MTB was 90.5% while for MTB Plus, 100% compared to the Xpert MTB/RIF assay. CONCLUSION Truenat assays were found to have high diagnostic accuracy. The assays have the potential to be used as a point of care (POC) TB diagnostic tests.
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Affiliation(s)
- Abyot Meaza
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ephrem Tesfaye
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Zemedu Mohamed
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | | | - Getachew Seid
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Kirubel Eshetu
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Miskir Amare
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Waganeh Sinshaw
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Biniyam Dagne
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | | | - Getu Diriba
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Melak Getu
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Bazezew Yenew
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | | | - Dinka Fikadu
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | | | - Shewki Moga
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Abebaw Kebede
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | | | - Ayinalem Alemu
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | | | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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27
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Alemu A, Bitew ZW, Diriba G, Gumi B. Co-occurrence of tuberculosis and diabetes mellitus, and associated risk factors, in Ethiopia: a systematic review and meta-analysis. IJID Regions 2021; 1:82-91. [PMID: 35757829 PMCID: PMC9216412 DOI: 10.1016/j.ijregi.2021.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Ayinalem Alemu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Corresponding author.
| | | | - Getu Diriba
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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28
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Sirak A, Tulu B, Bayissa B, Gumi B, Berg S, Salguero FJ, Ameni G. Cellular and Cytokine Responses in Lymph Node Granulomas of Bacillus Calmette Guérin (BCG)-Vaccinated and Non-vaccinated Cross-Breed Calves Naturally Infected With Mycobacterium bovis. Front Vet Sci 2021; 8:698800. [PMID: 34604367 PMCID: PMC8483244 DOI: 10.3389/fvets.2021.698800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 08/02/2021] [Indexed: 11/16/2022] Open
Abstract
Local immunological responses at the site of infections, such as at the lymph nodes and lungs, do play a role in containing infection caused by Mycobacterium bovis (M. bovis). This bovine tuberculosis (bTB) study was conducted to evaluate cellular and cytokine responses in the lymph nodes and lungs of BCG-vaccinated and non-vaccinated calves that were naturally infected with M. bovis. Immunohistochemical assays were used for examination of the responses of macrophages, T cells, cytokines and chemical mediators of 40 (22 vaccinated and 18 non-vaccinated) Holstein-Friesian-zebu crossbred calves that were naturally exposed for 1 year to a known bTB positive cattle herd. The incidence rates of bTB visible lesion were 68.2% (15/22) and 89% (16/18) in vaccinated and non-vaccinated calves, respectively. The local responses of CD4+ and CD8+ T cells, and those of IFN-γ and TNF-α within the lesions, were stronger (P < 0.05) in BCG-vaccinated calves than in non-vaccinated calves. However, there was no statistically significant difference between the two groups (P > 0.05) in the response of CD68+ cells. Thus, the findings of this study indicated stronger responses of a set of immunological cells and markers at the local granulomas of BCG-vaccinated calves than in non-vaccinated calves. Furthermore, BCG vaccination may also play a role in reducing the severity of the gross pathology at the primary site of infection.
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Affiliation(s)
- Asegedech Sirak
- Animal Health and Zoonotic Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.,National Animal Health Diagnostic and Investigation Centre, Sebeta, Ethiopia
| | - Begna Tulu
- National Animal Health Diagnostic and Investigation Centre, Sebeta, Ethiopia.,Medical Laboratory Science Department, Bahir Dar University, Bahir Dar, Ethiopia
| | - Berecha Bayissa
- Animal Health and Zoonotic Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.,Vaccine Production and Drug Formulation Directorate, National Veterinary Institute, Bishoftu, Ethiopia
| | - Balako Gumi
- Animal Health and Zoonotic Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Stefan Berg
- Bacteriology Department, Animal and Plant Health Agency, Weybridge, United Kingdom
| | - Francisco J Salguero
- Department of Pathology and Infectious Diseases, University of Surrey, Guildford, United Kingdom
| | - Gobena Ameni
- Animal Health and Zoonotic Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.,Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University, Al Ain, United Arab Emirates
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29
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Tulu B, Amsalu E, Zenebe Y, Abebe M, Fetene Y, Agegn M, Abate A, Ponpetch K, Bekana T, Gumi B, Ameni G. Diabetes mellitus and HIV infection among active tuberculosis patients in Northwest Ethiopia: health facility-based cross-sectional study. Trop Med Health 2021; 49:68. [PMID: 34454627 PMCID: PMC8403380 DOI: 10.1186/s41182-021-00358-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/20/2021] [Indexed: 12/04/2022] Open
Abstract
Background The prevalence of diabetes mellitus (DM) is increasing globally and its comorbidity with tuberculosis (TB) is re-emerging, especially in low- and middle-income countries. Objective The main aim of this study is to determine the prevalence of DM and HIV infection and their associated risk factors among active tuberculosis patients in Northwest Ethiopia. Methods This hospital-based cross-sectional study was conducted between February 1st and June 30th, 2017 among active TB patients in two hospitals of Northwest Ethiopia. Two hundred and sixty-seven active TB cases aged 18 years or older were screened for diabetes using fasting blood glucose (FBG) test. Semi-structured questionnaires were used to collect demographic data, lifestyle habits and clinical data. Identification of pre-diabetes or diabetes in TB patients was achieved according to American Diabetes Association guidelines (2016). Results Prevalence of DM and TB comorbidity was 11.5% (95% confidence interval, CI 7.8–15.2) compared to 24.9% (95% CI 20.1–30.1) for pre-diabetes. Prevalence of HIV/TB co-infection was 21.9% (95% CI 16.7–26.8). Risk of DM was higher in TB patients from a rural location (adjusted odds ratio, aOR 3.13, 95% CI 1.02–9.62, p = 0.046). Similarly, DM was higher in TB patients who have a family history of DM (aOR 4.54, 95% CI 1.31–15.68, p = 0.017). Furthermore, HIV/TB co-infection was identified as a predictor of DM comorbidity in active TB patients (aOR 5.11, 95% CI 2.01–12.98, p = 0.001). Conclusion The magnitude of DM and pre-diabetes in active TB patients in Northwest Ethiopia was high, warranting collaborative efforts to improve screening and adopt better clinical management strategies for DM–TB comorbid patients. Furthermore, being rural residents, family history of DM and HIV/TB co-infection were found to associate with DM among TB patients, highlighting the importance of the above-mentioned risk factors in the clinical management of this comorbidity.
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Affiliation(s)
- Begna Tulu
- Department of Medical Laboratory Sciences, Bahir Dar University, Bahir Dar, Ethiopia. .,Aklilu Lemma Institute of Pathobiology, Addis Ababa University, PO Box 1176, Addis AbabaAddis Ababa, Ethiopia.
| | - Eden Amsalu
- Department of Pediatric Nursing, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yohannes Zenebe
- Department of Medical Laboratory Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melkamu Abebe
- Department of Pediatric Nursing, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yeshimebet Fetene
- Department of Pediatric Nursing, Bahir Dar University, Bahir Dar, Ethiopia
| | - Manamnot Agegn
- Department of Pediatric Nursing, Bahir Dar University, Bahir Dar, Ethiopia
| | - Alemayehu Abate
- Department of Pediatric Nursing, Bahir Dar University, Bahir Dar, Ethiopia
| | - Keerati Ponpetch
- Sirindhorn College of Public Health Trang, Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, Ministry of Public Health, Nonthaburi, Thailand
| | - Teshome Bekana
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, PO Box 1176, Addis AbabaAddis Ababa, Ethiopia.,Department of Biomedical Sciences, Faculty of Public Health and Medical Science, Mettu University, Mettu, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, PO Box 1176, Addis AbabaAddis Ababa, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, PO Box 1176, Addis AbabaAddis Ababa, Ethiopia.,Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, PO Box 15551, Al Ain, United Arab Emirates
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30
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Bayissa B, Sirak A, Zewude A, Worku A, Gumi B, Berg S, Hewinson RG, Wood JLN, Jones GJ, Vordermeier HM, Ameni G. Field evaluation of specific mycobacterial protein-based skin test for the differentiation of Mycobacterium bovis-infected and Bacillus Calmette Guerin-vaccinated crossbred cattle in Ethiopia. Transbound Emerg Dis 2021; 69:e1-e9. [PMID: 34331511 PMCID: PMC8801543 DOI: 10.1111/tbed.14252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Bovine tuberculosis (bTB) challenges intensive dairy production in Ethiopia and implementation of the test and slaughter control strategy is not economically acceptable in the country. Vaccination of cattle with Bacillus Calmette–Guerin (BCG) could be an important adjunct to control, which would require a diagnostic test to differentiate Mycobacterium bovis (M. bovis)‐infected and BCG‐vaccinated animals (DIVA role). This study describes an evaluation of a DIVA skin test (DST) that is based on a cocktail (DSTc) or fusion (DSTf) of specific (ESAT‐6, CFP‐10 and Rv3615c) M. bovis proteins in Zebu–Holstein–Friesians crossbred cattle in Ethiopia. The study animals used were 74 calves (35 BCG vaccinated and 39 unvaccinated) aged less than 3 weeks at the start of experiment and 68 naturally infected ‘TB reactor’ cows. Six weeks after vaccination, the 74 calves were tested with the DSTc and the single intradermal cervical comparative tuberculin (SICCT) test. The TB reactor cows were tested with the DSTc and the SICCT test. Reactions to the DSTc were not observed in BCG‐vaccinated and unvaccinated calves, while SICCT test reactions were detected in vaccinated calves. DSTc reactions were detected in 95.6% of the TB reactor cows and single intradermal tuberculin positive reactions were found in 98.2% (95% confidence interval, CI, 92.1–100%). The sensitivity of the DSTc was 95.6% (95% CI, 87.6–99.1%), and significantly (p < .001) higher than the sensitivity (75%, 95% CI, 63.0–84.7%) of the SICCT test at 4 mm cut‐off. DSTf and DSTc reactions were correlated (r = 0.75; 95% CI = 0.53–0.88). In conclusion, the DSTc could differentiate M. bovis‐infected from BCG‐vaccinated cattle in Ethiopia. DST had higher sensitivity than the SICCT test. Hence, the DSTc could be used as a diagnostic tool for bTB if BCG vaccination is implemented for the control of bTB in Ethiopia and other countries.
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Affiliation(s)
- Berecha Bayissa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.,Vaccine Production and Drug Formulation Directorate, National Veterinary Institute, Bishoftu, Ethiopia
| | - Asegedech Sirak
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.,National Animal Health Diagnostic and Investigation Centre, Sebeta, Ethiopia
| | - Aboma Zewude
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adane Worku
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Stefan Berg
- Department of Bacteriology, Animal and Plant Health Agency, New Haw, Addlestone, Surrey, UK
| | | | - James L N Wood
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Gareth J Jones
- Department of Bacteriology, Animal and Plant Health Agency, New Haw, Addlestone, Surrey, UK
| | | | - H Martin Vordermeier
- Department of Bacteriology, Animal and Plant Health Agency, New Haw, Addlestone, Surrey, UK.,Aberystwyth University, Ceredigion, UK
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.,Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University, Al Ain, United Arab Emirates
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31
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Bayissa B, Sirak A, Worku A, Zewude A, Zeleke Y, Chanyalew M, Gumi B, Berg S, Conlan A, Hewinson RG, Wood JLN, Vordermeier HM, Ameni G. Evaluation of the Efficacy of BCG in Protecting Against Contact Challenge With Bovine Tuberculosis in Holstein-Friesian and Zebu Crossbred Calves in Ethiopia. Front Vet Sci 2021; 8:702402. [PMID: 34368285 PMCID: PMC8339472 DOI: 10.3389/fvets.2021.702402] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/11/2021] [Indexed: 12/13/2022] Open
Abstract
Bovine tuberculosis (bTB) is prevalent in intensive dairy farms in Ethiopia. Vaccination could be an alternative control approach given the socio-economic challenges of a test-and-slaughter control strategy. The efficacy of the BCG was evaluated on 40 Holstein-Friesian (HF) and zebu crossbred calves recruited from single intradermal cervical comparative tuberculin (SICCT) test negative herds and randomly allocated into two groups. Twenty-two calves were vaccinated within 2 weeks of age, and 18 were kept as a control. Six weeks post-vaccination, the two groups were exposed and kept mixed with known SICCT test positive cows for 1 year. Immune responses were monitored by interferon gamma (IFN-γ) release assay (IGRA), SICCT test, and antibody assay. Vaccinated calves developed strong responses to the SICCT test at the sixth week post-vaccination, but did not respond to ESAT-6/CFP-10 peptide antigen-based IGRA. During the exposure, IFN-γ response to the specific peptide cocktail [F(2.44, 92.67) = 26.96; p < 0.001] and skin reaction to the specific proteins cocktail [F(1.7, 64.3); p < 0.001] increased progressively in both groups while their antibody responses were low. The prevalence of bTB was 88.9% (95% CI: 65.3–98.6) and 63.6% (95% CI: 40.7–83.8) in the control and vaccinated calves, respectively, based on Mycobacterium bovis isolation, giving a direct protective efficacy estimate of 28.4% (95% CI: −2.7 to 50.1). The proportion of vaccinated calves with lesion was 7.0% (34/484) against 11.4% (45/396) in control calves, representing a 38% (95% CI: 5.8–59.4) reduction of lesion prevalence. Besides, the severity of pathology was significantly lower (Mann–Whitney U-test, p < 0.05) in vaccinated (median score = 2.0, IQR = 0–4.75) than in control (median score = 5, IQR = 3.0–6.25) calves. Moreover, survival from M. bovis infection in vaccinated calves was significantly (log-rank test: χ2 = 6.749, p < 0.01) higher than that of the control calves. In conclusion, the efficacy of BCG was low, but the reduced frequency and severity of lesion in vaccinated calves could suggest its potential role in containing onward transmission.
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Affiliation(s)
- Berecha Bayissa
- Animal Health and Zoonotic Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.,Vaccine Production and Drug Formulation Directorate, National Veterinary Institute, Debre Zeit, Ethiopia
| | - Asegedech Sirak
- Animal Health and Zoonotic Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.,National Animal Health Diagnostic and Investigation Centre, Sebeta, Ethiopia
| | - Adane Worku
- Animal Health and Zoonotic Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Aboma Zewude
- Animal Health and Zoonotic Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yemisrach Zeleke
- Animal Health and Zoonotic Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mahlet Chanyalew
- Animal Health and Zoonotic Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Balako Gumi
- Animal Health and Zoonotic Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Stefan Berg
- Animal and Plant Health Agency, Addlestone, United Kingdom
| | - Andrew Conlan
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - R Glyn Hewinson
- Institute of Biology, Environmental and Rural Sciences, Aberystwyth University, Ceredigion, United Kingdom
| | | | - James L N Wood
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - H Martin Vordermeier
- Animal and Plant Health Agency, Addlestone, United Kingdom.,Institute of Biology, Environmental and Rural Sciences, Aberystwyth University, Ceredigion, United Kingdom
| | - Gobena Ameni
- Animal Health and Zoonotic Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.,Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University, Al Ain, United Arab Emirates
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32
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Almaw G, Conlan AJK, Ameni G, Gumi B, Alemu A, Guta S, Gebre S, Olani A, Garoma A, Shegu D, Yimesgen L, Nigussie D, Wood JLN, Abebe T, Mihret A, Berg S. The variable prevalence of bovine tuberculosis among dairy herds in Central Ethiopia provides opportunities for targeted intervention. PLoS One 2021; 16:e0254091. [PMID: 34214106 PMCID: PMC8253440 DOI: 10.1371/journal.pone.0254091] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 06/19/2021] [Indexed: 02/04/2023] Open
Abstract
Bovine tuberculosis (bTB) is an important disease for dairy productivity, as well as having the potential for zoonotic transmission. Previous prevalence studies of bTB in the dairy sector in central Ethiopia have suggested high prevalence, however, they have been limited to relatively small scale surveys, raising concerns about their representativeness. Here we carried out a cross sectional one-stage cluster sampling survey taking the dairy herd as a cluster to estimate the prevalence of bTB in dairy farms in six areas of central Ethiopia. The survey, which to date is by far the largest in the area in terms of the number of dairy farms, study areas and risk factors explored, took place from March 2016 to May 2017. This study combined tuberculin skin testing and the collection of additional herd and animal level data by questionnaire to identify potential risk factors contributing to bTB transmission. We applied the single intradermal cervical comparative tuberculin (SICCT) test using >4mm cut-off for considering an individual animal as positive for bTB; at least one reactor animal was required for a herd to be considered bTB positive. Two hundred ninety-nine dairy herds in the six study areas were randomly selected, from which 5,675 cattle were tested. The overall prevalence of bTB after standardisation for herd-size in the population was 54.4% (95% CI 48.7–60%) at the herd level, and it was 24.5% (95% CI 23.3–25.8) at the individual animal level. A Generalized Linear Mixed Model (GLMM) with herd and area as random effect was used to explore risk factors association with bTB status. We found that herd size, age, bTB history at farm, and breed were significant risk factors for animals to be SICCT positive. Animals from large herds had 8.3 times the odds of being tuberculin reactor (OR: 8.3, p-value:0.008) as compared to animals from small herds. The effect of age was strongest for animals 8–10 years of age (the oldest category) having 8.9 times the odds of being tuberculin reactors (OR: 8.9, p-value:<0.001) compared to the youngest category. The other identified significant risk factors were bTB history at farm (OR: 5.2, p-value:0.003) and cattle breed (OR: 2.5, p-value: 0.032). Our study demonstrates a high prevalence of bTB in central Ethiopia but with a large variation in within-herd prevalence between herds, findings that lays an important foundation for the future development of control strategies.
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Grants
- D43 TW009127 FIC NIH HHS
- Medical Research Council
- Biotechnology and Biological Sciences Research Council
- This research was financially supported by the Ethiopia Control of Bovine Tuberculosis Strategies (ETHICOBOTS) project funded by the Biotechnology and Biological Sciences Research Council, the Department for International Development, the Economic & Social Research Council, the Medical Research Council, the Natural Environment Research Council and the Defence Science &Technology Laboratory, under the Zoonoses and Emerging Livestock Systems (ZELS) program.Stefan Berg was also funded by Defra, United Kingdom, ref: TBSE3294. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
- ETHICOBOTS
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Affiliation(s)
- Gizat Almaw
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
| | - Andrew J. K. Conlan
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemseged Alemu
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Sintayehu Guta
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Solomon Gebre
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Abebe Olani
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Abebe Garoma
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Dereje Shegu
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Letebrhan Yimesgen
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Demeke Nigussie
- Ethiopian Institute of Agricultural Research, Addis Ababa, Ethiopia
| | - James L. N. Wood
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Tamrat Abebe
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adane Mihret
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Stefan Berg
- Bacteriology Department, Animal and Plant Health Agency, Weybridge, United Kingdom
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Balemi A, Gumi B, Amenu K, Girma S, Gebru M, Tekle M, Ríus AA, D’Souza DH, Agga GE, Kerro Dego O. Prevalence of Mastitis and Antibiotic Resistance of Bacterial Isolates from CMT Positive Milk Samples Obtained from Dairy Cows, Camels, and Goats in Two Pastoral Districts in Southern Ethiopia. Animals (Basel) 2021; 11:ani11061530. [PMID: 34073967 PMCID: PMC8225129 DOI: 10.3390/ani11061530] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/16/2021] [Accepted: 05/18/2021] [Indexed: 02/07/2023] Open
Abstract
Simple Summary A study was carried out from August 2017 to February 2018 on lactating dairy cows, one-humped dromedary camels, and goats to determine mastitis in the Bule Hora and Dugda Dawa districts of in Southern Ethiopia. Milk samples from 564 udder quarters and udder halves from 171 animals consisting of 60 dairy cows, 51 camels, and 60 goats were tested for mastitis. Sixty-four positive udder milk samples were cultured, and bacterial mastitis pathogens were isolated and identified. The antibiotic resistance of bacterial isolates from milk with mastitis was tested against nine antimicrobials commonly used in the study area. Cow-level prevalence of mastitis in dairy cows, camels, and goats was 33.3%, 26.3%, and 25%, respectively. The quarter-level prevalence of mastitis in cows, camels and goats was 17.6%, 14.5%, and 20%, respectively. In cattle, the prevalence was significantly higher in Dugda Dawa than in Bule Hora. Major bacterial isolates were coagulase-negative Staphylococcus species (39.1%), S. aureus (17.2%), S. hyicus (14.1%), and S. intermedius and Escherichia coli (9.4% each). In camels, udder abnormality and mastitis were significantly higher in late lactation than in early lactation. Mastitis tends to increase with parity in camels. E. coli isolates were highly resistant to spectinomycin, vancomycin, and doxycycline, whereas most S. aureus isolates were multidrug-resistant. Most of the rural and periurban communities in this area consume raw milk, which indicates a high risk of infection with multidrug-resistant bacteria. We recommend community-focused training programs to improve community awareness of the risk of raw milk consumption and the need to boil milk. Abstract A study was carried out from August 2017 to February 2018 on lactating dairy cows, one-humped dromedary camels, and goats to determine mastitis in the Bule Hora and Dugda Dawa districts of in Southern Ethiopia. Milk samples from 564 udder quarters and udder halves from 171 animals consisting of 60 dairy cows, 51 camels, and 60 goats were tested for mastitis. Sixty-four positive udder milk samples were cultured, and bacterial mastitis pathogens were isolated and identified. The antibiotic resistance of bacterial isolates from milk with mastitis was tested against nine antimicrobials commonly used in the study area. Cow- and quarter-level prevalence of mastitis in dairy cows, camels, and goats was 33.3%, 26.3%, and 25% and 17.6%, 14.5%, and 20%, respectively. In cattle, the prevalence was significantly higher in Dugda Dawa than in Bule Hora. Major bacterial isolates were coagulase-negative Staphylococcus species (39.1%), S. aureus (17.2%), S. hyicus (14.1%), and S. intermedius and Escherichia coli (9.4% each). In camels, udder abnormality and mastitis were significantly higher in late lactation than in early lactation. Mastitis tends to increase with parity in camels. E. coli isolates were highly resistant to spectinomycin, vancomycin, and doxycycline, whereas most S. aureus isolates were multidrug-resistant. Most of the rural and periurban communities in this area consume raw milk, which indicates a high risk of infection with multidrug-resistant bacteria. We recommend a community-focused training program to improve community awareness of the need to boil milk and the risk of raw milk consumption.
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Affiliation(s)
- Amanuel Balemi
- College of Veterinary Sciences, Mekelle University, Mekelle, P.O. Box 231, Ethiopia; (A.B.); (M.G.)
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, P.O. Box 1176, Ethiopia;
| | - Kebede Amenu
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Bishoftu, P.O. Box 34, Ethiopia; (K.A.); (M.T.)
| | - Sisay Girma
- College of Agriculture, Bule Hora University, Bule Hora, P.O. Box 144, Ethiopia;
| | - Mu'uz Gebru
- College of Veterinary Sciences, Mekelle University, Mekelle, P.O. Box 231, Ethiopia; (A.B.); (M.G.)
| | - Muluken Tekle
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Bishoftu, P.O. Box 34, Ethiopia; (K.A.); (M.T.)
| | - Agustin A. Ríus
- Department of Animal Science, The University of Tennessee, Knoxville, TN 37996, USA;
| | - Doris H. D’Souza
- Department of Food Science, The University of Tennessee, Knoxville, TN 37998, USA;
| | - Getahun E. Agga
- Food Animal Environmental Systems Research Unit, Agricultural Research Service, U.S. Department of Agriculture, Bowling Green, KY 42101, USA;
| | - Oudessa Kerro Dego
- Department of Animal Science, The University of Tennessee, Knoxville, TN 37996, USA;
- Correspondence:
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Almaw G, Mekonnen GA, Mihret A, Aseffa A, Taye H, Conlan AJK, Gumi B, Zewude A, Aliy A, Tamiru M, Olani A, Lakew M, Sombo M, Gebre S, Diguimbaye C, Hilty M, Fané A, Müller B, Hewinson RG, Ellis RJ, Nunez-Garcia J, Palkopoulou E, Abebe T, Ameni G, Parkhill J, Wood JLN, Berg S, van Tonder AJ. Population structure and transmission of Mycobacterium bovis in Ethiopia. Microb Genom 2021; 7:000539. [PMID: 33945462 PMCID: PMC8209724 DOI: 10.1099/mgen.0.000539] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 02/02/2021] [Indexed: 12/03/2022] Open
Abstract
Bovine tuberculosis (bTB) is endemic in cattle in Ethiopia, a country that hosts the largest national cattle herd in Africa. The intensive dairy sector, most of which is peri-urban, has the highest prevalence of disease. Previous studies in Ethiopia have demonstrated that the main cause is Mycobacterium bovis, which has been investigated using conventional molecular tools including deletion typing, spoligotyping and Mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR). Here we use whole-genome sequencing to examine the population structure of M. bovis in Ethiopia. A total of 134 M. bovis isolates were sequenced including 128 genomes from 85 mainly dairy cattle and six genomes isolated from humans, originating from 12 study sites across Ethiopia. These genomes provided a good representation of the previously described population structure of M. bovis, based on spoligotyping and demonstrated that the population is dominated by the clonal complexes African 2 (Af2) and European 3 (Eu3). A range of within-host diversity was observed amongst the isolates and evidence was found for both short- and long-distance transmission. Detailed analysis of available genomes from the Eu3 clonal complex combined with previously published genomes revealed two distinct introductions of this clonal complex into Ethiopia between 1950 and 1987, likely from Europe. This work is important to help better understand bTB transmission in cattle in Ethiopia and can potentially inform national strategies for bTB control in Ethiopia and beyond.
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Affiliation(s)
- Gizat Almaw
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Getnet Abie Mekonnen
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adane Mihret
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Hawult Taye
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | | | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Aboma Zewude
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abde Aliy
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Mekdes Tamiru
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Abebe Olani
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Matios Lakew
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Melaku Sombo
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Solomon Gebre
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Colette Diguimbaye
- Institut de Recherches en Elevage pour le Développement & Clinique Médico-Chirurgicale PROVIDENCE, N'Djaména, Chad
| | - Markus Hilty
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Adama Fané
- Laboratoire Centrale Vétérinaire, Bamako, Mali
| | | | | | | | | | | | - Tamrat Abebe
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University, Al Ain, UAE
| | - Julian Parkhill
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - James L. N. Wood
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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Gashaw F, Erko B, Mekonnen Y, Yenew B, Amare M, Gumi B, Ameni G. Phenotypic and genotypic drug sensitivity profiles of Mycobacterium tuberculosis infection and associated factors in northeastern Ethiopia. BMC Infect Dis 2021; 21:261. [PMID: 33711936 PMCID: PMC7953820 DOI: 10.1186/s12879-021-05961-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/02/2021] [Indexed: 11/21/2022] Open
Abstract
Background Tuberculosis is a devastating and a deadly disease despite the novel advances in its diagnostic tools and drug therapy. Drug resistant Mycobacterium contributes a great share to tuberculosis mortality. Status of drug resistance and patients’ awareness toward the disease is unknown in northeastern Ethiopia. Thus, the aim of this study was to determine the phenotypic and genotypic drug sensitivity patterns and associated factors in Oromia Special Zone and Dessie Town, northeastern Ethiopia. Methods In a cross-sectional study, 384 smear positive tuberculosis cases were recruited and Löwenstein-Jensen culture was done. The performance of GenoTypic MTBDRplus assay using the conventional BACTEC MGIT 960 as a “gold standard” was determined. Drug resistant strains were identified using spoligotyping. Pearson Chi-square test was used to determine the association of drug sensitivity test and tuberculosis type, lineages, dominant strains and clustering of the isolates. Results The 384 smear positive Mycobacterium samples were cultured on LJ media of which 29.2% (112/384) as culture positive. A fair agreement was found between MTBDRplus assay and the conventional MGIT test in detecting the Mycobacterium tuberculosis with sensitivity, specificity, positive and negative predictive value of 94.2, 30.2, 68.4 and 76.5%, respectively. Among LJ culture positive samples 95 of them gave valid result for MTBDRplus assay and 16.8% (16/95) as drug resistant. Similarly, MGIT subculture was made for the 112 isolates and 69 of them gave positive result with 15.9% (11/69) as drug resistant. Cohen’s kappa value showed almost a perfect agreement between the two testing methods in detecting rifampicin (sensitivity 100% and specificity 98.3%) and multi-drug resistance (sensitivity 83.3% and specificity 100%). Spoligotyping identified 76.5% (13/17) of the drug resistant isolates as Euro-American and family 33 as the predominant family. Significant association was observed between drug resistant isolates and the dominant strains (χ2: 34.861; p = 0.040) of the Mycobacterium. Conclusion Higher magnitude of drug resistance was found in the study area. The GenoTypic MDRTBplus assay had an acceptable drug sensitivity testing performance.
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Affiliation(s)
- Fikru Gashaw
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia. .,Department of Microbial, Cellular and Molecular Biology, College of Natural Sciences, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia. .,Department of Biology, College of Natural and Computational Sciences, Kotebe Metropolitan University, P.O. Box 31248, Addis Ababa, Ethiopia.
| | - Berhanu Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Yalemtsehay Mekonnen
- Department of Microbial, Cellular and Molecular Biology, College of Natural Sciences, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Bazezew Yenew
- Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia
| | - Misikir Amare
- Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.,Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University, Al Ain, P.O. Box 15551, Abu Dhabi, United Arab Emirates
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Tulu B, Zewede A, Belay M, Zeleke M, Girma M, Tegegn M, Ibrahim F, Jolliffe DA, Abebe M, Balcha TT, Gumi B, Martineau HM, Martineau AR, Ameni G. Epidemiology of Bovine Tuberculosis and Its Zoonotic Implication in Addis Ababa Milkshed, Central Ethiopia. Front Vet Sci 2021; 8:595511. [PMID: 33681321 PMCID: PMC7925636 DOI: 10.3389/fvets.2021.595511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/05/2021] [Indexed: 11/13/2022] Open
Abstract
Bovine tuberculosis (bTB) continues to be one of the most widely distributed chronic infectious diseases of zoonotic importance, which causes a significant economic loss in animal production. A cross-sectional study was conducted to estimate the prevalence of bTB and its associated risk factors and type the Mycobacterium bovis isolated in central Ethiopia. A total of 65 dairy farms and 654 cattle were tested for bTB using a single intradermal comparative cervical tuberculin (SICCT) test. Data on farm management, animal-related characteristics, and the owner's knowledge of the zoonotic importance of bTB were collected using a structured questionnaire. In addition, a total of 16 animals from different farms were identified for postmortem examination. Lowenstein Jensen (LJ) culture was also conducted, and spoligotyping was used to type the M. bovis strains isolated. Chi-square test and logistic regression models were used to analyze the herd- and animal-level risk factors. Herd- and animal-level prevalence rates of bTB were 58.5% (95% CI: 46.2%-69.2%) and 39.3% (95% CI: 35.5%-43.5%), respectively. At the herd level, poor farm management was the predictor for bTB positivity (p < 0.05). Animal breed, poor BCS, farm type, and poor farm management conditions were significant predictors of bTB positivity (p < 0.05) at an individual animal level. All animals identified for postmortem examination were found to have gross TB-like lesions. A total of 14 M. bovis strains were identified from 12 animals that were positive for LJ culture. The strain with the largest number of clusters (five isolates) was SB1176, followed by SB0134 (three isolates), SB0192 (two isolates), and SB2233 (two isolates), and two new strains, each consisting of only one isolate. The majority (58.5%) of the respondents did not know the zoonotic importance of bTB. The result of this study showed a high prevalence of bTB in the Addis Ababa milkshed and a low level of consciousness of the owners on its transmission to humans. Therefore, the launching of acceptable control measures of bTB and the creation of public awareness about its zoonotic transmission and prevention measures are required.
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Affiliation(s)
- Begna Tulu
- Aklilu Lemma Institute of Pathobiology, Sefere Selam Campus, Addis Ababa University, Addis Ababa, Ethiopia.,Department of Medical Laboratory Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Aboma Zewede
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mulugeta Belay
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Miserach Zeleke
- Aklilu Lemma Institute of Pathobiology, Sefere Selam Campus, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mussie Girma
- Aklilu Lemma Institute of Pathobiology, Sefere Selam Campus, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Fozia Ibrahim
- Armeur Hansen Research Institute, Addis Ababa, Ethiopia
| | - David A Jolliffe
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Markos Abebe
- Armeur Hansen Research Institute, Addis Ababa, Ethiopia
| | | | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Sefere Selam Campus, Addis Ababa University, Addis Ababa, Ethiopia
| | - Henny M Martineau
- Department of Pathology, The Royal Veterinary College, Hatfield, United Kingdom
| | - Adrian R Martineau
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Sefere Selam Campus, Addis Ababa University, Addis Ababa, Ethiopia.,Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University, Al Ain, United Arab Emirates
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Asfaw YT, Ameni G, Medhin G, Gumi B, Wieland B. Poultry health services in Ethiopia: availability of diagnostic, clinical, and vaccination services. Poult Sci 2021; 100:101023. [PMID: 33872862 PMCID: PMC8080080 DOI: 10.1016/j.psj.2021.101023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/29/2020] [Accepted: 01/19/2021] [Indexed: 11/28/2022] Open
Abstract
Currently, there is a need for more and better poultry health services in Ethiopia. However, nationwide data showing the weaknesses of poultry health services are scanty. Hence, availability of diagnostic, vaccination, and clinical services for poultry was assessed. Focus group discussions and household questionnaire survey were conducted with poultry keepers in 10 districts. Lack of poultry health experts, clinical services, drugs, vaccination, and knowledge and skills were identified as top five key findings. In total, 31.6% of respondents reported availability of poultry diagnosis service. Having flock size of 11-20 chickens had higher probabilities of accessing better diagnosis service (AOR = 2.77; 95% CI: 1.12-3.64). Access to diagnosis was directly linked with the availability of veterinary clinics in their localities (AOR = 2.65; 95% CI: 1.16-6.63). Moreover, low access to treatment services (22.98%) was reported and traditional remedies with priority index of 0.68 were reported to be the most commonly used. Chicken flocks with a history of disease occurrence were more likely to have a decision to go for modern treatment services (AOR = 4.26; 95% CI: 2.28-7.95). Only 35.7% of chicken keepers had their flocks vaccinated, and this was irregularly and randomly given, mainly against Newcastle disease. Only 52.9% of them were vaccinated by trained animal health experts. Chicken flocks with availability of veterinary clinics within 5 km were more likely (AOR = 1.62; 95% CI: 1.03-2.54) to have access to vaccination services. Only 53.0% of the chicken flocks had availability of clinics and chicken flocks in Tigray (AOR = 2.15; 95% CI: 1.03- 4.52) and Oromia (AOR = 5.74; 95%CI: 2.51-13.10) had better availability of clinics. Chicken flocks found in Bako district were less likely (AOR = 0.41; 95% CI: 0.18-0.92). The low availability of diagnostic, vaccination, and clinical services shows that poultry health services in Ethiopia have not received attention despite its top national agenda. Hence, the existing low poultry health services need to be solved through public-private partnership, producing adequate poultry health experts, availing vaccines, diagnostics, and therapeutics in the local markets.
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Affiliation(s)
- Yohannes T Asfaw
- Animal and Human Health, International Livestock Research Institute (ILRI) 5689, Addis Ababa, Ethiopia; Aklilu Lemma Institute of Pathobiology, Addis Ababa University 1176, Addis Ababa, Ethiopia; College of Veterinary Sciences, Mekelle University 8024, Mekelle, Ethiopia.
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University 1176, Addis Ababa, Ethiopia; Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University 15551, Al Ain, United Arab Emirates
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University 1176, Addis Ababa, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University 1176, Addis Ababa, Ethiopia
| | - Barbara Wieland
- Animal and Human Health, International Livestock Research Institute (ILRI) 5689, Addis Ababa, Ethiopia
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Asfaw YT, Ameni G, Medhin G, Gumi B, Hagos Y, Wieland B. Poultry disease occurrences and their impacts in Ethiopia. Trop Anim Health Prod 2021; 53:54. [PMID: 33389207 PMCID: PMC7779415 DOI: 10.1007/s11250-020-02465-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 10/29/2020] [Indexed: 11/01/2022]
Abstract
Poultry production contributes significantly to the livelihoods of Ethiopian farmers and to the national economy although it is hampered by different factors, including poultry diseases. There is scarcity of published evidences on the occurrence and impacts of poultry diseases although such evidences are important for policy makers in designing appropriate interventions. A total of 595 households were interviewed and 11 FGDs were conducted to collect data on the occurrence of diseases and the number of dead chickens in the last 12 months. Hence, respiratory diseases, sudden death, and eye-face-head diseases were mentioned in all of the FGDs as the most frequently occurring disease in the districts. Of households interviewed, 86.1% reported poultry disease occurrence in the last 12 months, and gastrointestinal, eye-face-head, and neurological diseases were identified to be the top three ranked diseases of chickens in the districts. Flocks with access to diagnostic services (Adj. OR = 4.16; P = 0.004) and/or access to animal health providers (Adj. OR = 10.50; P = 0.001) were more likely to report disease occurrence. In the studied population, the diseases resulted in deaths of 2219 chickens valued at 352,219.5 Birr (11,740.65 USD) and a mean crude mortality of 31.87%. Female-lead households (mean difference = 5.95%; P = 0.018) and multiple age units present on the farm (mean difference = 20.92%; P = < 0.000) had higher chicken mortality. Similarly, higher mortality was reported in flocks without access to diagnosis (mean difference = 9.97%; P = < 0.000) and vaccination (mean difference = 12.34%; P = < 0.000) services. The high occurrence of disease and mortalities might be explained by a lack of an organized poultry health service delivery system in the country. Therefore, a carefully designed health service delivery system addressing needs of poultry producers, supported by relevant policy and corresponding strategies, is recommended to address the indicated challenges. Moreover, private health providers with well-defined roles need to be engaged to successfully and sustainably solve the poultry disease problems.
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Affiliation(s)
- Yohannes T Asfaw
- International Livestock Research Institute (ILRI), P.O. Box: 5689, Addis Ababa, Ethiopia. .,Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P. O. Box: 1176, Addis Ababa, Ethiopia. .,College of Veterinary Sciences, Mekelle University, P. O. Box: 8024, Mekelle, Ethiopia.
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P. O. Box: 1176, Addis Ababa, Ethiopia.,Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University, P.O. Box 15551, Al Ain, UAE
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P. O. Box: 1176, Addis Ababa, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P. O. Box: 1176, Addis Ababa, Ethiopia
| | - Yohannes Hagos
- College of Veterinary Sciences, Mekelle University, P. O. Box: 8024, Mekelle, Ethiopia
| | - Barbara Wieland
- International Livestock Research Institute (ILRI), P.O. Box: 5689, Addis Ababa, Ethiopia
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Mekonnen GA, Gumi B, Berg S, Conlan AJK, Ameni G, Wood JLN. A case of early neonate bovine tuberculosis in Ethiopia. Clin Case Rep 2021; 9:487-490. [PMID: 33489201 PMCID: PMC7812992 DOI: 10.1002/ccr3.3563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/05/2020] [Accepted: 09/07/2020] [Indexed: 01/22/2023] Open
Abstract
This report illustrates that calves may be infected with bovine tuberculosis at early age under natural conditions and progression can be rapid. Thus, testing of calves needs to be considered in any control program to reduce the risk of transmission.
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Affiliation(s)
- Getnet Abie Mekonnen
- National Animal Health Diagnostic and Investigation CenterSebetaEthiopia
- Aklilu Lemma Institute of PathobiologyAddis Ababa UniversityAddis AbabaEthiopia
| | - Balako Gumi
- Aklilu Lemma Institute of PathobiologyAddis Ababa UniversityAddis AbabaEthiopia
| | | | - Andrew J. K. Conlan
- Disease Dynamics UnitDepartment of Veterinary MedicineUniversity of CambridgeCambridgeUK
| | - Gobena Ameni
- Aklilu Lemma Institute of PathobiologyAddis Ababa UniversityAddis AbabaEthiopia
- Department of Veterinary MedicineCollege of Food and AgricultureUnited Arab Emirates UniversityAl AinUnited Arab Emirates
| | - James L. N. Wood
- Disease Dynamics UnitDepartment of Veterinary MedicineUniversity of CambridgeCambridgeUK
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40
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Mekonnen GA, Mihret A, Tamiru M, Hailu E, Olani A, Aliy A, Sombo M, Lakew M, Gumi B, Ameni G, Wood JLN, Berg S. Genotype Diversity of Mycobacterium bovis and Pathology of Bovine Tuberculosis in Selected Emerging Dairy Regions of Ethiopia. Front Vet Sci 2020; 7:553940. [PMID: 33195524 PMCID: PMC7554335 DOI: 10.3389/fvets.2020.553940] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/14/2020] [Indexed: 11/26/2022] Open
Abstract
Bovine tuberculosis (bTB) is endemic in Ethiopia with higher prevalence in cattle, particularly in the central parts. Spread of Mycobacterium bovis (M. bovis) to wider regions is inevitable in uncontrolled conditions. This study was conducted to explore the pathology, characterize M. bovis strains, and describe genotypic diversity to demonstrate possible epidemiological links in emerging dairy areas of Ethiopia, namely, Mekelle and Gondar. Twenty-seven bTB positive cattle identified by the Single Intradermal Comparative Cervical Tuberculin (SICCT) test were subjected to post-mortem inspection to determine lesion distribution and pathological score. Samples from tissues with visible tuberculous or suspected non-visible lesions were processed and cultured following a standard protocol. Isolates identified as M. bovis by Region of Difference (RD)-based Polymerase Chain Reaction (PCR) were also spoligotyped to determine their spoligotype patterns. Post-mortem inspection of visceral organs indicated bTB suggestive lesions in 41% of the animals, with 25% being in the lungs. Lymph nodes from 77% of the animals had lesions. Fifty-five isolates identified from 24 of the slaughtered animals were confirmed as M. bovis. No other mycobacterial species were isolated. Spoligotyping classified strains from 21 of these animals into seven spoligotype patterns: SB0133, SB0134, SB1176, SB2233, SB2290, SB2467, and SB2520. More than one spoligotype were identified from five of these animals, and none of the last four spoligotypes had been reported in Ethiopia before. SB0134 was the most predominant type (47%) followed by SB0133 (25.5%). SB0133, SB2290, SB2467, and SB1176 are spoligotypes lacking spacers 3–7, characteristics of M. bovis strains of the African 2 (Af2) clonal complex, while SB0134, SB2233, and SB2520 do not belong to any of the established clonal complexes and likely to have a different evolutionary history. Despite a small sample size, the present study showed strain diversity with multiple genotypes identified in a single herd and even within a single animal, and the genotypes showed no sign of geographical localization, which could be a consequence of significant movement of bTB diseased cattle around the country, spreading the disease. Therefore, any future control programme of bTB in Ethiopia needs to address the risks of cattle movement.
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Affiliation(s)
- Getnet Abie Mekonnen
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia.,Animal Health and Zoonotic Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adane Mihret
- Bacterial and Viral Diseases Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Mekdes Tamiru
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Elena Hailu
- Bacterial and Viral Diseases Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Abebe Olani
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Abde Aliy
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Melaku Sombo
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Matios Lakew
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Balako Gumi
- Animal Health and Zoonotic Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gobena Ameni
- Animal Health and Zoonotic Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.,Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University, Al Ain, United Arab Emirates
| | - James L N Wood
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Stefan Berg
- Animal and Plant Health Agency, Weybridge, United Kingdom
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Chekesa B, Gumi B, Chanyalew M, Zewude A, Ameni G. Prevalence of latent tuberculosis infection and associated risk factors in prison in East Wollega Zone of western Ethiopia. PLoS One 2020; 15:e0233314. [PMID: 32428042 PMCID: PMC7237014 DOI: 10.1371/journal.pone.0233314] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/01/2020] [Indexed: 01/07/2023] Open
Abstract
Background Latent tuberculosis infection (LTBI) is the major source of active TB and is an obstacle to the strategy of World Health Organization to end TB by 2035. In Ethiopia, there are hundreds of prisons and they are conducive settings for the transmission of TB and could serve as the sources of infection to the general public. However, there is little data on the epidemiology of TB in prisons in Ethiopia. The objective of the present study was to estimate the prevalence of LTBI and evaluate associated risk factors in prisons in East Wollega Zone in western Ethiopia. Methods A cross-sectional design and systematic sampling technique were used to select 352 prisoners from a total of 2620 prisoners during the two months (May and June, 2019). The selected inmates were consented for their willingness to participate in the study. Thereafter, they were interviewed and 2ml of blood sample was collected from each prisoner and screened for LTBI using interferon-gamma release assay (IGRA). The data were analyzed using SPSS version 25 and logistic regression was used to model the likelihood of LTBI occurrence and to identify risk factors associated with LTBI. Results The prevalence of LTBI was 51.2% (95% CI: 46.45–57%) and higher prevalence was recorded in males (53%) than in females (43.5%) although the difference was not significant. Prisoners whose age ≥45 years (AOR = 2.48, 95%CI, 1.04–5.9), who chewed khat (AOR = 2.27; 95% CI, 1.27–4.19), who were prisoned over a year (AOR = 1.81, 95%CI, 1.04–3.18) and who were in overcrowded pens (AOR = 1.91, 95% CI, 1.002–3.65) were at higher risk of LTBI. Conclusions The prevalence of LTBI in prisoners in West Wollega Zone of western Ethiopia was high and could serve as sources of infection to the public. Hence optimum handling of prisoners, and regular follow up and treatment of TB cases in prisons were recommended to minimize the burden of TB in the Zone.
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Affiliation(s)
- Basha Chekesa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Collage of Natura and Computational Science, Wollega University, Nekemte, Ethiopia
- * E-mail:
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mahlet Chanyalew
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Aboma Zewude
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University, Al Ain, United Arab Emirates
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Loiseau C, Menardo F, Aseffa A, Hailu E, Gumi B, Ameni G, Berg S, Rigouts L, Robbe-Austerman S, Zinsstag J, Gagneux S, Brites D. An African origin for Mycobacterium bovis. Evol Med Public Health 2020; 2020:49-59. [PMID: 32211193 PMCID: PMC7081938 DOI: 10.1093/emph/eoaa005] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 12/24/2019] [Accepted: 01/24/2020] [Indexed: 12/20/2022]
Abstract
Background and objectives Mycobacterium bovis and Mycobacterium caprae are two of the most important agents of tuberculosis in livestock and the most important causes of zoonotic tuberculosis in humans. However, little is known about the global population structure, phylogeography and evolutionary history of these pathogens. Methodology We compiled a global collection of 3364 whole-genome sequences from M.bovis and M.caprae originating from 35 countries and inferred their phylogenetic relationships, geographic origins and age. Results Our results resolved the phylogenetic relationship among the four previously defined clonal complexes of M.bovis, and another eight newly described here. Our phylogeographic analysis showed that M.bovis likely originated in East Africa. While some groups remained restricted to East and West Africa, others have subsequently dispersed to different parts of the world. Conclusions and implications Our results allow a better understanding of the global population structure of M.bovis and its evolutionary history. This knowledge can be used to define better molecular markers for epidemiological investigations of M.bovis in settings where whole-genome sequencing cannot easily be implemented. Lay summary During the last few years, analyses of large globally representative collections of whole-genome sequences (WGS) from the human-adapted Mycobacterium tuberculosis complex (MTBC) lineages have enhanced our understanding of the global population structure, phylogeography and evolutionary history of these pathogens. In contrast, little corresponding data exists for M. bovis, the most important agent of tuberculosis in livestock. Using whole-genome sequences of globally distributed M. bovis isolates, we inferred the genetic relationships among different M. bovis genotypes distributed around the world. The most likely origin of M. bovis is East Africa according to our inferences. While some M. bovis groups remained restricted to East and West Africa, others have subsequently dispersed to different parts of the world driven by cattle movements.
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Affiliation(s)
- Chloé Loiseau
- Molecular Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Fabrizio Menardo
- Molecular Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Abraham Aseffa
- Mycobacterial Diseases Directorate, Armauer Hansen Research Centre, Addis Ababa, Ethiopia
| | - Elena Hailu
- Mycobacterial Diseases Directorate, Armauer Hansen Research Centre, Addis Ababa, Ethiopia
| | - Balako Gumi
- Department of Animal Science and Range Management, Bule Hora University, Bule Hora Town, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Stefan Berg
- Bacteriology Department, Animal & Plant Health Agency (APHA), Weybridge, Surrey, UK
| | - Leen Rigouts
- Mycobacteriology Unit, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.,Collection of Mycobacterial Cultures (BCCM/ITM), Institute of Tropical Medicine, Antwerp, Belgium.,Department of Biomedical Sciences, Antwerp University, Antwerp, Belgium
| | - Suelee Robbe-Austerman
- Diagnostic Bacteriology and Pathology Laboratory, National Veterinary Services Laboratories, United States Department of Agriculture, Ames, IA, USA
| | - Jakob Zinsstag
- Molecular Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Sebastien Gagneux
- Molecular Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Daniela Brites
- Molecular Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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43
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Chaka H, Aboset G, Garoma A, Gumi B, Thys E. Cross-sectional survey of brucellosis and associated risk factors in the livestock-wildlife interface area of Nechisar National Park, Ethiopia. Trop Anim Health Prod 2018; 50:1041-1049. [PMID: 29476407 DOI: 10.1007/s11250-018-1528-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 01/24/2018] [Indexed: 11/29/2022]
Abstract
A cross-sectional survey was carried out to investigate the seroprevalence of ovine and bovine brucellosis in the livestock-wildlife interface area of Nechisar National Park, Ethiopia. Furthermore, producer's knowledge about brucellosis and its zoonotic potential was assessed using a structured questionnaire. A total of 268 cattle and 246 goat sera were collected from 50 herds and 46 flocks and subjected to Rose Bengal test (RBT) and enzyme-linked immunosorbent assay (ELISA) in parallel to detect anti-Brucella species antibodies. Positive reactions were further confirmed with compliment fixation test (CFT). Flock and herd level seroprevalence rate was 12.8% (95% CI 4.8-25.7) and 32.0% (95% CI 19.5-46.7) in goats and cattle, respectively. An overall animal-level seroprevalence of 4.5% (95% CI 2.25-7.86) and 9.7% (95% CI 6.44-13.89) was recorded for goats and cattle, respectively. Seroprevalence showed an increasing trend with age, where adult cattle > 2 years. Goats (> 1 year) recorded relatively higher seroprevalence, but the differences were not statistically significant. Similarly, female cattle and goats recorded a relatively higher seroprevalence, 11 and 5.6%, respectively, compared to males but the difference was not significant. However, a significant (P < 0.01) variation of seroprevalence was noted for parity (bovine), higher in animals in second parity, and abortion history, in both species, higher in animals that experienced abortion. Interviews revealed lack of awareness about brucellosis and food safety related to the zoonotic potential from consuming raw animal products (milk and meat). Ninety-eight percent of respondents did not consider handling abortion material is risky, and only a very low proportion (8%, n = 50) was able to mention limited zoonotic diseases (anthrax and Taenia cysticercosis) could be transmissible to people. The study indicated that brucellosis is endemic in domestic animals in the interface area and calls for further broad epidemiological investigation of the disease in livestock, human and wildlife following 'one health' unified research approaches beside enhancing public awareness.
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Affiliation(s)
- Hassen Chaka
- National Animal Health Diagnostic and Investigation Centre (NAHDIC), P.O. Box 34, Sebeta, Ethiopia.
| | - Gezahegn Aboset
- Ministry of Livestock and Fisheries, P.O. Box 57535, Addis Ababa, Ethiopia
| | - Abebe Garoma
- National Animal Health Diagnostic and Investigation Centre (NAHDIC), P.O. Box 34, Sebeta, Ethiopia
| | - Balako Gumi
- Bule Hora University, P.O. Box 144, Bule Hora, Ethiopia
| | - Eric Thys
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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44
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Comas I, Hailu E, Kiros T, Bekele S, Mekonnen W, Gumi B, Tschopp R, Ameni G, Hewinson RG, Robertson BD, Goig GA, Stucki D, Gagneux S, Aseffa A, Young D, Berg S. Population Genomics of Mycobacterium tuberculosis in Ethiopia Contradicts the Virgin Soil Hypothesis for Human Tuberculosis in Sub-Saharan Africa. Curr Biol 2015; 25:3260-6. [PMID: 26687624 PMCID: PMC4691238 DOI: 10.1016/j.cub.2015.10.061] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 10/26/2015] [Accepted: 10/28/2015] [Indexed: 02/06/2023]
Abstract
Colonial medical reports claimed that tuberculosis (TB) was largely unknown in Africa prior to European contact, providing a "virgin soil" for spread of TB in highly susceptible populations previously unexposed to the disease [1, 2]. This is in direct contrast to recent phylogenetic models which support an African origin for TB [3-6]. To address this apparent contradiction, we performed a broad genomic sampling of Mycobacterium tuberculosis in Ethiopia. All members of the M. tuberculosis complex (MTBC) arose from clonal expansion of a single common ancestor [7] with a proposed origin in East Africa [3, 4, 8]. Consistent with this proposal, MTBC lineage 7 is almost exclusively found in that region [9-11]. Although a detailed medical history of Ethiopia supports the view that TB was rare until the 20(th) century [12], over the last century Ethiopia has become a high-burden TB country [13]. Our results provide further support for an African origin for TB, with some genotypes already present on the continent well before European contact. Phylogenetic analyses reveal a pattern of serial introductions of multiple genotypes into Ethiopia in association with human migration and trade. In place of a "virgin soil" fostering the spread of TB in a previously naive population, we propose that increased TB mortality in Africa was driven by the introduction of European strains of M. tuberculosis alongside expansion of selected indigenous strains having biological characteristics that carry a fitness benefit in the urbanized settings of post-colonial Africa.
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Affiliation(s)
- Iñaki Comas
- Genomics and Health Unit, FISABIO Public Health, Valencia 46020, Spain; CIBER (Centros de Investigación Biomédica en Red) in Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid 28029, Spain.
| | - Elena Hailu
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
| | - Teklu Kiros
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
| | - Shiferaw Bekele
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
| | - Wondale Mekonnen
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
| | - Balako Gumi
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
| | - Rea Tschopp
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia; Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel 4002, and University of Basel, Basel 4003, Switzerland
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, PO Box 1176, Addis Ababa, Ethiopia
| | - R Glyn Hewinson
- Bovine TB Research Group, Animal and Plant Health Agency, Surrey KT15 3NB, UK
| | - Brian D Robertson
- Center for Molecular Bacteriology and Infection, Department of Medicine, Flowers Building, South Kensington, Imperial College London, London SW7 2AZ, UK
| | - Galo A Goig
- Genomics and Health Unit, FISABIO Public Health, Valencia 46020, Spain
| | - David Stucki
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel 4002, and University of Basel, Basel 4003, Switzerland
| | - Sebastien Gagneux
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel 4002, and University of Basel, Basel 4003, Switzerland
| | - Abraham Aseffa
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia
| | - Douglas Young
- The Francis Crick Institute, Mill Hill Laboratory, The Ridgeway, Mill Hill, London NW7 1AA, UK
| | - Stefan Berg
- Bovine TB Research Group, Animal and Plant Health Agency, Surrey KT15 3NB, UK.
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Berg S, Schelling E, Hailu E, Firdessa R, Gumi B, Erenso G, Gadisa E, Mengistu A, Habtamu M, Hussein J, Kiros T, Bekele S, Mekonnen W, Derese Y, Zinsstag J, Ameni G, Gagneux S, Robertson BD, Tschopp R, Hewinson G, Yamuah L, Gordon SV, Aseffa A. Investigation of the high rates of extrapulmonary tuberculosis in Ethiopia reveals no single driving factor and minimal evidence for zoonotic transmission of Mycobacterium bovis infection. BMC Infect Dis 2015; 15:112. [PMID: 25886866 PMCID: PMC4359574 DOI: 10.1186/s12879-015-0846-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 02/19/2015] [Indexed: 11/14/2022] Open
Abstract
Background Ethiopia, a high tuberculosis (TB) burden country, reports one of the highest incidence rates of extra-pulmonary TB dominated by cervical lymphadenitis (TBLN). Infection with Mycobacterium bovis has previously been excluded as the main reason for the high rate of extrapulmonary TB in Ethiopia. Methods Here we examined demographic and clinical characteristics of 953 pulmonary (PTB) and 1198 TBLN patients visiting 11 health facilities in distinct geographic areas of Ethiopia. Clinical characteristics were also correlated with genotypes of the causative agent, Mycobacterium tuberculosis. Results No major patient or bacterial strain factor could be identified as being responsible for the high rate of TBLN, and there was no association with HIV infection. However, analysis of the demographic data of involved patients showed that having regular and direct contact with live animals was more associated with TBLN than with PTB, although no M. bovis was isolated from patients with TBLN. Among PTB patients, those infected with Lineage 4 reported “contact with other TB patient” more often than patients infected with Lineage 3 did (OR = 1.6, CI 95% 1.0-2.7; p = 0.064). High fever, in contrast to low and moderate fever, was significantly associated with Lineage 4 (OR = 2.3; p = 0.024). On the other hand, TBLN cases infected with Lineage 4 tended to get milder symptoms overall for the constitutional symptoms than those infected with Lineage 3. Conclusions The study suggests a complex role for multiple interacting factors in the epidemiology of extrapulmonary TB in Ethiopia, including factors that can only be derived from population-based studies, which may prove to be significant for TB control in Ethiopia. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-0846-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stefan Berg
- Animal and Plant Health Agency, TB Research Group, New Haw, Addlestone, Surrey, KT15 3NB, UK.
| | - Esther Schelling
- Swiss Tropical and Public Health Institute, PO Box CH-4002, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Elena Hailu
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
| | - Rebuma Firdessa
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia. .,University of Würzburg, Institute for Molecular Infection Biology, Würzburg, Germany.
| | - Balako Gumi
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
| | - Girume Erenso
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
| | - Endalamaw Gadisa
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
| | - Araya Mengistu
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
| | - Meseret Habtamu
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
| | - Jemal Hussein
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
| | - Teklu Kiros
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
| | - Shiferaw Bekele
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
| | - Wondale Mekonnen
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
| | - Yohannes Derese
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute, PO Box CH-4002, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, PO Box 1176, Addis Ababa, Ethiopia.
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, PO Box CH-4002, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Brian D Robertson
- Center for Molecular Bacteriology and Infection, Department of Medicine, Flowers building, South Kensington, Imperial College London, London, SW7 2AZ, UK.
| | - Rea Tschopp
- Swiss Tropical and Public Health Institute, PO Box CH-4002, Basel, Switzerland. .,Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia. .,University of Basel, Basel, Switzerland.
| | - Glyn Hewinson
- Animal and Plant Health Agency, TB Research Group, New Haw, Addlestone, Surrey, KT15 3NB, UK.
| | - Lawrence Yamuah
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
| | - Stephen V Gordon
- UCD Schools of Veterinary Medicine, Medicine and Medical Science, Biomolecular and Biomedical Science and UCD Conway Institute, University College Dublin, Dublin, Republic of Ireland.
| | - Abraham Aseffa
- Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
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Firdessa R, Berg S, Hailu E, Schelling E, Gumi B, Erenso G, Gadisa E, Kiros T, Habtamu M, Hussein J, Zinsstag J, Robertson BD, Ameni G, Lohan AJ, Loftus B, Comas I, Gagneux S, Tschopp R, Yamuah L, Hewinson G, Gordon SV, Young DB, Aseffa A. Mycobacterial lineages causing pulmonary and extrapulmonary tuberculosis, Ethiopia. Emerg Infect Dis 2013; 19:460-3. [PMID: 23622814 PMCID: PMC3647644 DOI: 10.3201/eid1903.120256] [Citation(s) in RCA: 158] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Molecular typing of 964 specimens from patients in Ethiopia with lymph node or pulmonary tuberculosis showed a similar distribution of Mycobacterium tuberculosis strains between the 2 disease manifestations and a minimal role for M. bovis. We report a novel phylogenetic lineage of M. tuberculosis strongly associated with the Horn of Africa.
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Gumi B, Firdessa R, Yamuah L, Sori T, Tolosa T, Aseffa A, Zinsstag J, Schelling E. Seroprevalence of Brucellosis and Q-Fever in Southeast Ethiopian Pastoral Livestock. ACTA ACUST UNITED AC 2013; 2. [PMID: 24350302 DOI: 10.4172/2325-9590.1000109] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
To assess seroprevalences of Brucella and C. burnetii in pastoral livestock in southeast Ethiopia, a cross-sectional study was carried out in three livestock species (cattle, camels and goats). The study was conducted from July 2008 to August 2010, and eight pastoral associations (PAs) from the selected districts were included in the study. Sera from a total of 1830 animals, comprising 862 cattle, 458 camels and 510 goats were screened initially with Rose Bengal plate test (RBPT) for Brucella. All RBPT positive and 25% of randomly selected negative sera were further tested by ELISA. These comprise a total of 460 animals (211 cattle, 102 camels and 147 goats). Out of sera from total of 1830 animals, 20% were randomly selected (180 cattle, 90 camels and 98 goats) and tested for C. burnetii using ELISA. The seroprevalences of Brucella was 1.4% (95% confidence interval (CI), 0.8-2.6), 0.9% (95% CI, 0.3-2.7)b and 9.6% (95% CI, 5.2-17.1) in cattle, camels and goats, respectively. Goats and older animals were at higher risk of infection (OR=7.3, 95% CI, 2.8-19.1) and (OR=1.7 95% CI, 0.9-2.9), respectively. Out of 98 RBPT negative camel sera, 12.0% were positive for ELISA. The seroprevalences of C. burnetii were 31.6% (95% CI, 24.7-39.5), 90.0% (95% CI, 81.8-94.7) and 54.2% (95% CI, 46.1-62.1) in cattle, camels and goats, respectively. We found positive animals for C. burnetii test in all tested PAs for all animal species. Being camel and older animal was a risk factor for infection (OR=19.0, 95% CI, 8.9-41.2) and (OR=3.6, 95% CI, 2.0-6.6), respectively. High seropositivity of C. burnetii in all livestock species tested and higher seropositive in goats for Brucella, implies risks of human infection by both diseases. Thus, merit necessity of further study of both diseases in animals and humans in the area.
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Affiliation(s)
- Balako Gumi
- Bule Hora University, P.O. Box 144, Bule Hora, Ethiopia
| | - Rebuma Firdessa
- Armauer Hansen Research Institute, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Lawrence Yamuah
- Armauer Hansen Research Institute, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Teshale Sori
- Faculty of Veterinary Medicine, Addis Ababa University, P.O. Box 34, Debrezeit, Ethiopia
| | - Tadele Tolosa
- Jimma University College of Agriculture and Veterinary Medicine, P. O. Box 307, Jimma, Ethiopia
| | - Abraham Aseffa
- Armauer Hansen Research Institute, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute, P.O. Box CH-4002, Basel, Switzerland ; University of Basel, Basel, Switzerland
| | - Esther Schelling
- Swiss Tropical and Public Health Institute, P.O. Box CH-4002, Basel, Switzerland ; University of Basel, Basel, Switzerland
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48
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Gumi B, Schelling E, Berg S, Firdessa R, Erenso G, Mekonnen W, Hailu E, Melese E, Hussein J, Aseffa A, Zinsstag J. Zoonotic transmission of tuberculosis between pastoralists and their livestock in South-East Ethiopia. Ecohealth 2012; 9:139-49. [PMID: 22526748 PMCID: PMC3415617 DOI: 10.1007/s10393-012-0754-x] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2011] [Revised: 01/26/2012] [Accepted: 02/01/2012] [Indexed: 05/31/2023]
Abstract
Despite huge global efforts in tuberculosis (TB) control, pastoral areas remain under-investigated. During two years sputum and fine needle aspirate (FNA) specimens were collected from 260 Ethiopian pastoralists of Oromia and Somali Regional States with suspected pulmonary TB and from 32 cases with suspected TB lymphadenitis. In parallel, 207 suspected tuberculous lesions were collected from cattle, camels and goats at abattoirs. All specimens were processed and cultured for mycobacteria; samples with acid-fast stained bacilli (AFB) were further characterized by molecular methods including genus and deletion typing as well as spoligotyping. Non-tuberculous mycobacteria (NTM) were sequenced at the 16S rDNA locus. Culturing of AFB from human sputum and FNA samples gave a yield of 174 (67%) and 9 (28%) isolates, respectively. Molecular typing was performed on 173 of these isolates and 160 were confirmed as Mycobacterium tuberculosis, three as M. bovis, and the remaining 10 were typed as NTMs. Similarly, 48 AFB isolates (23%) yielded from tuberculous lesions of livestock, of which 39 were molecular typed, including 24 M. bovis and 4 NTMs from cattle, 1 M. tuberculosis and 1 NTM from camels and 9 NTMs from goats. Isolation of M. bovis from humans and M. tuberculosis from livestock suggests transmission between livestock and humans in the pastoral areas of South-East Ethiopia.
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Affiliation(s)
- Balako Gumi
- Jimma University College of Agriculture and Veterinary Medicine, P.O. Box 307, Jimma, Ethiopia
| | - Esther Schelling
- Swiss Tropical and Public Health Institute, P.O. Box, 4002 Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Stefan Berg
- Animal Health and Veterinary Laboratories Agency, New Haw, Surrey KT15 3NB UK
| | - Rebuma Firdessa
- Armauer Hansen Research Institute, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Girume Erenso
- Armauer Hansen Research Institute, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Wondale Mekonnen
- Armauer Hansen Research Institute, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Elena Hailu
- Armauer Hansen Research Institute, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Ermias Melese
- Jimma University College of Agriculture and Veterinary Medicine, P.O. Box 307, Jimma, Ethiopia
| | - Jemal Hussein
- Armauer Hansen Research Institute, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Abraham Aseffa
- Armauer Hansen Research Institute, P.O. Box 1005, Addis Ababa, Ethiopia
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute, P.O. Box, 4002 Basel, Switzerland
- University of Basel, Basel, Switzerland
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49
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Gumi B, Schelling E, Firdessa R, Aseffa A, Tschopp R, Yamuah L, Young D, Zinsstag J. Prevalence of bovine tuberculosis in pastoral cattle herds in the Oromia region, southern Ethiopia. Trop Anim Health Prod 2011; 43:1081-7. [PMID: 21499975 DOI: 10.1007/s11250-010-9777-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2010] [Indexed: 10/18/2022]
Abstract
A cross-sectional study of bovine tuberculosis (BTB) was conducted in pastoral cattle herds in southern Ethiopia, from February to August 2008 using the comparative intradermal tuberculin test. The prevalence of BTB and the risk factors for having positive reactor herds were assessed in four pastoral associations in two districts of southern Ethiopia, namely Goro-Dola with 242 cattle in 16 herds and Liben with 231 cattle in 15 herds. A herd was considered positive if there was at least one reactor animal in a herd. The test results were interpreted based on the Office Internationale des Epizooties recommended 4-mm and a recently suggested 2-mm cut-off. The apparent individual animal prevalence of tuberculin reactors was 5.5% (95% confidence interval (CI), 4.0-8.0%) and 7.0% (95% CI, 5.0-10.0%), whereas the true prevalence estimate was 4.4% (95% CI, 0.8-8.0%) and 6.1% (95% CI, 2.6-9.5%), when using the 4-mm and the 2-mm cut-offs, respectively. The overall herd apparent prevalence of tuberculin reactor animals was 41.9% (95% CI, 24.9-60.9%) and 48.4% (95% CI, 30.2-66.9%) with the 4-mm and 2-mm cut-offs, respectively. A positive tuberculin test was associated with the age of animals and the main drinking water sources during dry seasons. In order to investigate the public health risks and the epidemiological importance of BTB in the area, we recommend to include other livestock species (camels and goats) as well as humans in future studies.
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Affiliation(s)
- Balako Gumi
- Jimma University College of Agriculture and Veterinary Medicine, PO Box 307, Jimma, Ethiopia.
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Woldemeskel M, Gumi B. Prevalence of sarcocysts in one-humped camel (Camelus dromedarius) from southern Ethiopia. J Vet Med B Infect Dis Vet Public Health 2001; 48:223-6. [PMID: 11393818 DOI: 10.1046/j.1439-0450.2001.00446.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A survey of sarcocystis was made in camels from southern Ethiopia during a part of 1998-99. A total of 605 haematoxylin and eosin-stained tissue samples from cardiac, diaphragm, shoulder, masseter and oesophagus muscles of 121 adult camels and 20 tissue samples from four foetuses were examined for sarcocysts. Sarcocysts were detected in 55 of 121 (45.45%) camels examined. The infestation rate of oesophagus, diaphragm, shoulder, masseter and cardiac musculatures were 19.83, 11.57, 12.4, 8.26 and 9.17%, respectively. There was no significant (P > 0.05) variation between males (48.6%) and females (40.82%), nor between the two sites studied (Dollo Addo, 40.00% versus Neghelle Borana 47.25%). None of the 20 tissue samples from the four foetuses examined harboured sarcocysts. The possible impact of sarcocysts on camel production is indicated. This is the first report of the presence of sarcocysts in camels from Ethiopia.
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Affiliation(s)
- M Woldemeskel
- Addis Ababa University, Faculty of Veterinary Medicine, Debre-Zeit, Ethiopia
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