Occurrence of tuberculosis among people exposed to cattle in Bangladesh.

BACKGROUND: Tuberculosis (TB) has been an important public health concern in Bangladesh. The most common cause of human TB is Mycobacterium tuberculosis, while bovine TB is caused by Mycobacterium bovis. OBJECTIVE: The objective of this study was to determine the frequency of TB in individuals with occupational exposure to cattle and to detect Mycobacterium bovis among cattle in slaughterhouses in Bangladesh. METHODS: Between August 2014 and September 2015, an observational study was conducted in two government chest disease hospitals, one cattle market, and two slaughterhouses. [Correction added on 27 June 2023, after first online publication: In the preceding sentence, the year "2014" has been added after the word "August".] Sputum samples were collected from individuals who met the criteria for suspected TB and had been exposed to cattle. Tissue samples were collected from cattle that had low body condition score(s). Both humans and cattle samples were screened for acid-fast bacilli (AFB) by Ziehl-Neelsen (Z-N) staining and cultured for Mycobacterium tuberculosis complex (MTC). Region of difference (RD) 9-based polymerase chain reaction (PCR) was also performed to identify Mycobacterium spp. We also conducted Spoligotyping to identify the specific strain of Mycobacterium spp. RESULTS: Sputum was collected from a total of 412 humans. The median age of human participants was 35 (IQR: 25-50) years. Twenty-five (6%) human sputum specimens were positive for AFB, and 44 (11%) were positive for MTC by subsequent culture. All (N = 44) culture-positive isolates were confirmed as Mycobacterium tuberculosis by RD9 PCR. Besides, 10% of cattle workers were infected with Mycobacterium tuberculosis in the cattle market. Of all TB (caused by Mycobacterium tuberculosis) infected individuals, 6.8% of individuals were resistant to one or two anti-TB drugs. The majority of the sampled cattle (67%) were indigenous breeds. No Mycobacterium bovis was detected in cattle. CONCLUSIONS: We did not detect any TB cases caused by Mycobacterium bovis in humans during the study. However, we detected TB cases caused by Mycobacterium tuberculosis in all humans, including cattle market workers.

The Epidemiology of Melioidosis and Its Association with Diabetes Mellitus: A Systematic Review and Meta-Analysis.

Melioidosis is an under-recognized fatal disease in humans, caused by the Gram-negative bacterium Burkholderia pseudomallei. Globally, more than 35,000 human melioidosis cases have been reported since 1911. Soil acts as the natural reservoir of B. pseudomallei. Humans may become infected by this pathogen through direct contact with contaminated soil and/or water. Melioidosis commonly occurs in patients with diabetes mellitus, who increase the occurrence of melioidosis in a population. We carried out a systematic review and meta-analysis to investigate to what extent diabetes mellitus affects the patient in getting melioidosis. We selected 39 articles for meta-analysis. This extensive review also provided the latest updates on the global distribution, clinical manifestation, preexisting underlying diseases, and risk factors of melioidosis. Diabetes mellitus was identified as the predominant predisposing factor for melioidosis in humans. The overall proportion of melioidosis cases having diabetes was 45.68% (95% CI: 44.8-46.57, p < 0.001). Patients with diabetes mellitus were three times more likely to develop melioidosis than patients with no diabetes (RR 3.40, 95% CI: 2.92-3.87, p < 0.001). The other potential risk factors included old age, exposure to soil and water, preexisting underlying diseases (chronic kidney disease, lung disease, heart disease, and thalassemia), and agricultural activities. Evidence-based clinical practice guidelines for melioidosis in patients with diabetes mellitus may be developed and shared with healthcare professionals of melioidosis endemic countries to reduce morbidity.

Human exposures to by-products from animals suspected to have died of anthrax in Bangladesh: An exploratory study.

Anthrax is a zoonotic disease caused by the bacterium Bacillus anthracis that is considered endemic in Bangladesh, where cases among animals and people have been reported almost annually since 2009. Contaminated by-products from animals are suspected to play a role in transmission to people, but minimal information is known on the supply chain of these potentially contaminated products. Between April 2013 and May 2016, we conducted a qualitative study in 17 villages located in five districts in Bangladesh, which had experienced suspected anthrax outbreaks. The study explored how by-products from suspected animal cases were collected, discarded, processed, distributed and used by people. We conducted open-ended interviews, group discussions and unstructured observations of people's exposure to animal by-products. The practice of slaughtering acutely ill domestic ruminants before they died was common. Respondents reported that moribund animals were typically butchered, and the waste products were discarded in nearby rivers, ditches, bamboo bushes, or on privately owned land. Regardless of health status before death, very few carcasses were buried, and none were incinerated or burned. The hides were reportedly used to make wallets, belts, shoes, balls and clothing. Discarded bones were often ground into granular and powder forms to produce bone meal and fertilizer. Therefore, given anthrax is endemic in the study region, livestock with acute onset of fatal disease or found dead with no known cause of death may be an anthrax case and subsequently pose a health risk to those involved in the collection and processing of the carcass, as well as the end-user of these products. Improved bio-security practices and safe carcass disposal measures could reduce the risk of human exposure, but resource and other constraints make implementation a challenge. Therefore, targeting at-risk animal populations for vaccination may be the most effective strategy to reduce anthrax outbreaks, protect the supply chain and reduce the risk of exposure to B. anthracis.

Epidemiology and genotypes of group A rotaviruses in cattle and goats of Bangladesh, 2009-2010.

Group A rotavirus (RVA) is recognized as a major cause of severe gastroenteritis in newborn calves and goat kids. We estimated the proportion of ruminants infected with rotavirus and identified the circulating genotypes in cattle and goats in Bangladesh. Between May 2009 and August 2010, fecal samples were collected from 520 cattle and goats presenting with diarrhea at three government veterinary hospitals in three districts of Bangladesh. All samples were screened for RVA RNA using real-time, one-step, reverse transcription polymerase chain reaction (qRT-PCR). Of the 520 animals tested, 11.7% (61) were positive for RVA RNA, with 6.2% (15/241) and 16.5% (46/279) positivity in cattle and goats, respectively. RVA positive samples were further characterized by nucleotide sequence analysis of two structural protein gene fragments, VP7 (G genotype), and VP4 (P genotype). Among 17 successfully sequenced strains, G8 (17.9%) was the most prevalent G-genotype followed by G10 (8%) and G6 (1.6%). P[1] (11.3%) was the most frequently detected P-genotype followed by P[11] (3.2%) and P[15] (1.6%). The most common VP7/VP4 combinations for cattle were G10P[11], G10P[15], and G6P[11], and for goat, G8P[1], and G10P[1]. Phylogenetic analysis of the RVA strains showed clustering with bovine and caprine strains from neighboring India. The study adds to our understanding of the genetic diversity of bovine and caprine rotavirus strains in Bangladesh. Our findings highlight the importance of rotavirus surveillance in cattle and goat populations, which may serve as a potential source for genetic reassortment and zoonotic transmission.

The Pattern of Highly Pathogenic Avian Influenza H5N1 Outbreaks in South Asia.

Highly pathogenic avian influenza (HPAI) H5N1 has caused severe illnesses in poultry and in humans. More than 15,000 outbreaks in domestic birds from 2005 to 2018 and 861 human cases from 2003 to 2019 were reported across the world to OIE (Office International des Epizooties) and WHO (World Health Organization), respectively. We reviewed and summarized the spatial and temporal distribution of HPAI outbreaks in South Asia. During January 2006 to June 2019, a total of 1063 H5N1 outbreaks in birds and 12 human cases for H5N1 infection were reported to OIE and WHO, respectively. H5N1 outbreaks were detected more in the winter season than the summer season (RR 5.11, 95% CI: 4.28-6.1). Commercial poultry were three times more likely to be infected with H5N1 than backyard poultry (RR 3.47, 95% CI: 2.99-4.01). The highest number of H5N1 outbreaks was reported in 2008, and the smallest numbers were reported in 2014 and 2015. Multiple subtypes of avian influenza viruses and multiple clades of H5N1 virus were detected. Early detection and reporting of HPAI viruses are needed to control and eliminate HPAI in South Asia.

Determination of hematological and serum biochemical reference values for indigenous sheep (Ovies aries) in Dhaka and Chittagong Districts of Bangladesh.

AIM: The study was aimed to determine the reference values of most commonly used hematological and biochemical parameters of indigenous sheep, reared under semi-intensive backyard farms in Dhaka and Chittagong district, Bangladesh. MATERIALS AND METHODS: A total of 41 blood samples were collected from indigenous sheep (Ovis aries) from June to December 2016 from Dhaka and Chittagong Districts of Bangladesh. Hematological and serum biochemical parameters such as hemoglobin (Hb), packed cell volume (PCV), erythrocyte sedimentation rate (ESR), total erythrocyte count (TEC), total leukocyte count (TLC), neutrophil, eosinophil, basophil, monocyte, lymphocyte, urea, triglyceride, cholesterol, glucose, albumin, total protein (TP), alanine aminotransferase (ALT), and aspartate transaminase (AST) were determined by biochemical analyzer. 90% reference intervals were calculated for all parameters. RESULTS: The hematologica and serum biochemical profiles of indigenous sheep showed wide range and variation. The results were categorized according to sex and age of the sheep for comparison. Young sheep had significantly higher PCV, eosinophil, triglyceride, and TP level than that of adult (p<0.05), whereas the urea and albumin level was higher in adult than that of juvenile (p<0.05). Most of the values of the parameters are close to each other for both male and female except TEC, urea, cholesterol, triglyceride, glucose, and AST. However, a significant difference was found only for albumin and basophil level between male and female sheep. CONCLUSION: Hematological and biochemical parameters in Bangladeshi indigenous sheep showed a wide range and variation implicating future study for the prophylaxis of ovine diseases.

Hematological reference values for healthy fat-tailed sheep (Dhumba) in Bangladesh.

OBJECTIVE: There is scarce literature regarding hematology profile of fat-tailed sheep (Dhumba). The study was conducted to determine reference intervals for their hematology profile in the context of Bangladesh. MATERIALS AND METHODS: Blood samples were collected from 32 healthy fat-tailed sheep from Dhaka, Bangladesh, during September-October, 2015. Hemoglobin (Hb), packed cell volume (PCV), erythrocyte sedimentation rate (ESR), total leukocyte count (TLC), total erythrocyte count (TEC), lymphocyte, monocyte, eosinophil, basophil, and neutrophil counts were measured. RESULTS: The levels showed a wide range and variation based on age and sex. Adult sheep had significantly (p = 0.01) higher Hb level than that of juvenile (<6 months of age). Other parameter values were almost similar for both adult and juvenile. The only two hematological parameters, showing noteworthy differences between male and female, were TLC and Basophil level (p < 0.05) in blood. CONCLUSION: The study sets baseline for future research and diagnosis of diseases in fat-tailed sheep. It also helps for profitable production of fat-tailed sheep in Bangladesh.