RESUMO
Mycobacterium bovis causes tuberculosis in cattle and when transmitted to humans typically causes extra-pulmonary tuberculosis (EPTB). Bovine tuberculosis (bTB) has a global distribution and is controlled in most countries to protect animal and public health. Recent studies revealed that bTB is established on dairy farms in Fiji where EPTB cases have been reported in people. The aims of this pilot investigation were to look for putative zoonotic TB (EPTB) cases in people and to evaluate practices that might contribute to the persistence and transmission of M. bovis between cattle and to humans. Existing data sets were shared between the Fiji Ministry of Agriculture and Ministry of Health and a questionnaire-based survey was implemented using One Health principles. Statistically significant co-location and close proximity of EPTB cases and bovine TB affected farms were identified. The bTB infection status of farms was significantly associated with unfenced water sources where cattle grazed. Of 247 households, 65 % shared drinking water sources with cattle and 36 % consumed raw milk without boiling, while 62 % of participants reported backyard slaughter of cattle. Several participants reported current symptoms potentially suggestive of TB (chronic cough) but the impact of smoking and history of previous TB treatment could not be evaluated. Farmers had limited understanding of the practices required to prevent bTB at farm level. Further study is recommended and should include an assessment of lifetime EPTB diagnoses, classification of farms based on more recent bTB test data and molecular typing of mycobacterial isolates from humans, cattle and the environment. A targeted awareness and education approach is required to reduce the future risk of zoonotic TB and to help ensure uptake of recommendations and practices aimed at controlling and preventing bTB.
RESUMO
Control of bovine tuberculosis (bTB) is a priority for animal health, biosecurity, and human health authorities in Fiji as evident from the long-term funding of the Bovine Brucellosis and Tuberculosis Eradication and Control program (BTEC) and notable improvements to the program described in this paper. To evaluate the performance of the Fiji BTEC program from 2015 to 2020, all available bTB data for cattle were analyzed. Data sources included BTEC bTB testing records, abattoir records and laboratory records. We integrated all information to quantify the bTB tests applied, bTB positive farms and animals, meat inspection and laboratory findings. Test coverage was highest among dairy cattle in Central Division (~73%), where bTB was highly prevalent with 7.8% of dairy cattle and 61.7% of dairy farms found to be positive between 2015 and 2020. There was no visible downward trend in the apparent prevalence of bTB over the 6-year period. During 2019 and 2020, only 21.3% (51/239) of the tested dairy farms maintained their clear status, another 8.4% (20/239) reverted to infected status after 1 year or more of being bTB clear, and most farms remained infected during these 2 years. Factors observed to be contributing to this situation were persistent infections, related in part to the significant number of untested animals, uncontrolled animal movements, and larger farm size. Similar to other developing countries, bTB remains a serious concern and further strengthening of the program targeting the main contributors to bTB persistence, along with maintenance of a comprehensive reporting and traceability system, industry awareness and government support are needed. Control of bTB in Fiji is a long-term objective that must have multiple stakeholder engagement and regular review to measure success.
RESUMO
Bovine tuberculosis (bTB) is globally significant due to its impacts on cattle production. A Brucellosis and Tuberculosis Eradication and Control (BTEC) program commenced in Fiji during the 1980's and has since been sustained by government funding and industry cooperation. A retrospective study of bTB data obtained during the Fiji BTEC program from 1999 to 2014 was undertaken at the University of Sydney with support from the Government of Fiji. It confirmed that bTB is well-established in dairy cattle farms in Naitasiri and Tailevu provinces of Central Division on the main island of Viti Levu, and suggested that the disease is present among cattle on farms in all or most provinces across three (Central, Northern, Western) of the four divisions in the country. It was evident that despite sustained efforts, disease reduction and containment was not being achieved. Reasons contributing to this situation included the appropriateness of the protocol for conduct of the single intradermal test (SID) in cattle, absence of regular quality assurance training of BTEC field staff, lack of standard procedures for bTB data collation and evaluation, unregulated cattle movements and the presence of stray cattle. The Fiji Ministry of Agriculture responded proactively to these findings by implementing revision to the use of the SID in cattle and refresher training for staff along with the Biosecurity Authority of Fiji who implemented cattle movement restriction. A subsequent apparent outbreak of bTB in some farms due to increased detection by the new test protocol raised concerns for the local dairy industry. To clarify the status and extent of bTB infection and the challenges faced by the industry, a stakeholder forum was held in May 2017, and a new BTEC strategy was formulated and endorsed by stakeholders. bTB remains a focus for cattle disease control by the government of Fiji. This case study highlights the challenges for bTB control in Fiji and underlines the importance of technical and social considerations to achieve success in disease control.