Cholera outbreak in some communities in North-East Nigeria, 2019: an unmatched case-control study.

BACKGROUND: Cholera, a diarrheal disease caused by the bacterium Vibrio cholerae, transmitted through fecal contamination of water or food remains an ever-present risk in many countries, especially where water supply, sanitation, food safety, and hygiene are inadequate. A cholera outbreak was reported in Bauchi State, North-eastern Nigeria. We investigated the outbreak to determine the extent and assess risk factors associated with the outbreak. METHODS: We conducted a descriptive analysis of suspected cholera cases to determine the fatality rate (CFR), attack rate (AR), and trends/patterns of the outbreak. We also conducted a 1:2 unmatched case-control study to assess risk factors amongst 110 confirmed cases and 220 uninfected individuals (controls). We defined a suspected case as any person > 5 years with acute watery diarrhea with/without vomiting; a confirmed case as any suspected case in which there was laboratory isolation of Vibrio cholerae O1 or O139 from the stool while control was any uninfected individual with close contact (same household) with a confirmed case. Children under 5 were not included in the case definition however, samples from this age group were collected where such symptoms had occurred and line-listed separately. Data were collected with an interviewer-administered questionnaire and analyzed using Epi-info and Microsoft excel for frequencies, proportions, bivariate and multivariate analysis at a 95% confidence interval. RESULTS: A total of 9725 cases were line-listed with a CFR of 0.3% in the state. Dass LGA had the highest CFR (14.3%) while Bauchi LGA recorded the highest AR of 1,830 cases per 100,000 persons. Factors significantly associated with cholera infection were attending social gatherings (aOR = 2.04, 95% CI = 1.16-3.59) and drinking unsafe water (aOR = 1.74, 95% CI = 1.07-2.83). CONCLUSION: Attending social gatherings and drinking unsafe water were risk factors for cholera infection. Public health actions included chlorination of wells and distribution of water guard (1% chlorine solution) bottles to households and public education on cholera prevention. We recommend the provision of safe drinking water by the government as well as improved sanitary and hygienic conditions for citizens of the state.

Quinolone-resistant Escherichia coli at the interface between humans, poultry and their shared environment- a potential public health risk.

BACKGROUND: Commensal Escherichia coli residing in the guts of humans and animals are reservoirs of multidrug resistance (MDR) genes, including quinolone resistance genes, in humans and poultry. This study aimed to characterize quinolones resistance in E. coli recovered from poultry workers, chickens, and poultry farm/market environments in Abuja, Nigeria. METHODS: This was a cross-sectional study conducted between December 2018 and April 2019 comprising poultry workers, chickens and their poultry farm/market environments. This study characterized E. coli isolates from stool, faecal and environmental samples using antimicrobial susceptibility testing and whole-genome sequencing methods. Core-genome multilocus sequences-based phylogeny was used to determine the relatedness between quinolone-resistant E. coli isolates. Data were analyzed using descriptive statistics. RESULTS: Of 110 E. coli isolates, quinolone-resistant phenotypes were observed in 68.2% (n = 75) isolates. Whole-genome sequencing detected plasmid-mediated quinolone resistance (PMQR) genes in 63.6% (n = 70) isolates. The most prevalent PMQR gene detected in 56 of these 70 E. coli isolates was qnrS1, followed by qnrB19 in 14 isolates and aac(6')-lb-cr in two isolates. Fifteen ciprofloxacin and 19 nalidixic acid-resistant isolates respectively showed double mutations in the quinolone-resistance determining regions (QRDRs) of gyrA, with single or double mutations in parC, and a single mutation in parE. The most prevalent amino-acid substitutions observed were S83L + D87N in gyrA (46.5%, n = 20), S80I in parC (51.2%, n = 22) and S458A in parE (14%, n = 6). About 2.9% (2/70) of PMQR isolates were extended-spectrum beta-lactamase (ESBL) producers while 2.9% (2/70) had plasmid-mediated colistin resistance (PMCR) genes. CONCLUSIONS: PMQR genes were prevalent in E. coli isolates recovered from healthy humans, chickens and poultry farm/market environments. PMCR genes (mcr-1.1) occurred in PMQR-positive isolates recovered from manure and drinking water originating from poultry farm/market environments. It was found that the gene encoding ESBL coexisted with qnrS-positive isolates of human and avian origin. Horizontal transfer of PMQR genes among E. coli isolates in the human-poultry-environment interface has public health implications for the spread of antimicrobial resistance. Relevant government agencies should enforce regulations to restrict the use of critically important antimicrobials in poultry production.

Prevalence and risk factors associated with SARS-CoV-2 infections among veterinary practitioners and dogs patients, June-August 2020, Lagos, Nigeria.

BACKGROUND: Lagos State is the epicenter of COVID-19 in Nigeria, having the highest number of cases and death. Veterinary practitioners play an important role in public health and risk exposure to SARS-CoV-2, the virus that causes COVID-19 while attending to animal patients and owners. We determined the prevalence of covid-19 among veterinary practitioners and their dog patients in Lagos, and the associated risk factors during the lockdown. METHODS: We administered questionnaires, reviewed clinical records and conducted serological test to determine the COVID-19 status of 112 veterinary practitioners and 154 dog patients and to assess the associated factors in nine veterinary clinics or hospitals between June to August 2020. Data were analyzed using descriptive statistics, bivariate and multivariate analyses at 5% significant level. RESULT: The mean age of participants was 37.5±10.5 and 66 (58.9%) were male. COVID-19 cases among the veterinary practitioners and dogs were 29 (25.9%) and 3 (2%), respectively. Predictors of COVID-19 cases among veterinary practitioners were contact with a SARS-CoV-2 infected dog (AOR: 25.42; CI 4.73-136.66); being a veterinary doctor working during the lockdown (AOR: 6.11; CI 1.56-24.00) and not disinfecting examination table after attending to dogs (AOR: 12.43; CI 1.39-110.99). CONCLUSION: Veterinary practitioners and dogs in Lagos were exposed to SARS-COV-2 virus during the COVID-19 lockdown. Contact with SARS-CoV-2 infected dogs, being a veterinary doctor working during the lockdown and not disinfecting examination tables after clinical examination were predictors of COVID-19 cases among veterinary practitioners in Lagos State. Strict Infection, Prevention and Control measures are recommended in veterinary practice.

Assessing the perceptions and practices of peri-urban dairy farmers regarding bovine mastitis management in North-Western Nigeria.

Peri-urban dairy farming is an emerging industry in sub-Saharan Africa that risks being undermined by diseases like bovine mastitis (BM) if farmers do not implement appropriate management programmes. However, little is currently known about farmer perceptions and practices towards BM due to challenges with accessing these herds for research. In this study, 49 intensive and 53 extensive peri-urban dairy farmers having ≥10 milking cows in Kaduna and Zaria metropolises, North-Western Nigeria were recruited through snowball sampling and on-farm interviews were conducted to collect information on herd demographics, milking procedures, and mastitis management. Descriptive statistics were provided for all study variables and statistical comparisons were made between intensive and extensive herds. The mean herd size was 33 milking cows (range: 11-62). A greater proportion of extensive herds contained only indigenous breeds of cattle (36/53; 68 %) compared with intensive herds (6/49; 12 %). Hand milking was the most common milking method across both herd types (93/102; 92 %). Intensive herds had better hand washing and udder cleaning practices, but there was no statistical difference between management systems with regards to floor, udder, and tail cleanliness. Only a small number of farms performed on-farm diagnosis of BM via strip cup test (4/102; 4%) or rapid mastitis test (3/102; 3%). Treatment of clinical mastitis was typically by intramuscular antibiotic injection (71/102; 70 %) or topically applied herbal preparations (14/102; 14 %). Dry cow intramammary therapy was only used by 6/46 intensive farms (13 %) and 1/53 extensive farms (2%). Most extensive herds (40/53; 76 %) reported milking cows with clinical mastitis after apparently healthy cows, however this practice was less common among intensive herds (5/49; 10 %). Extensive herds were less likely to request veterinary assistance for mastitis than intensive herds (17/53; 32 % versus 28/49; 57 %) and had higher perceived costs for treating BM cases. Intensive farmers reportedly received higher prices for milk than extensive farmers and perceived that BM was causing significantly more production losses in their herds. Only a small number of farmers (20/102; 20 %) kept mastitis treatment records for their herds. Overall, the study findings indicate that peri-urban dairy farmers may be lacking in awareness of BM impacts and access to basic resources to implement good practices such as hand washing between milking cows and antibiotic intramammary infusions.

Prioritization of zoonotic diseases of public health significance in Nigeria using the one-health approach.

Nigeria, with a population of over 190 million people, is rated among the 10 countries with the highest burden of infectious and zoonotic diseases globally. In Nigeria, there exist a sub-optimal surveillance system to monitor and track priority zoonoses. We therefore conducted a prioritization of zoonotic diseases for the first time in Nigeria to guide prevention and control efforts. Towards this, a two-day in-country consultative meeting involving experts from the human, animal, and environmental health backgrounds prioritized zoonotic diseases using a modified semi-quantitative One Health Zoonotic Disease Prioritization tool in July 2017. Overall, 36 of 52 previously selected zoonoses were identified for prioritization. Five selection criteria were used to arrive at the relative importance of prioritized diseases based on their weighted score. Overall, this zoonotic disease prioritization process marks the first major step of bringing together experts from the human-animal-environment health spectrum in Nigeria. Importantly, the country ranked rabies, avian influenza, Ebola Virus Disease, swine influenza and anthrax as the first five priority zoonoses in Nigeria. Finally, this One Health approach to prioritizing important zoonoses is a step that will help to guide future tracking and monitoring of diseases of grave public health importance in Nigeria.

Genetic relatedness of multidrug resistant Escherichia coli isolated from humans, chickens and poultry environments.

BACKGROUND: Inappropriate use of antimicrobial agents in animal production has led to the development of antimicrobial resistance (AMR) in foodborne pathogens. Transmission of AMR foodborne pathogens from reservoirs, particularly chickens to the human population does occur. Recently, we reported that occupational exposure was a risk factor for multidrug-resistant (MDR) Escherichia coli (E. coli) among poultry-workers. Here we determined the prevalence and genetic relatedness among MDR E. coli isolated from poultry-workers, chickens, and poultry environments in Abuja, Nigeria. This study was conducted to address the gaps identified by the Nigerian AMR situation analysis. METHODS: We conducted a cross-sectional study among poultry-workers, chickens, and poultry farm/live bird market (LBM) environments. The isolates were tested phenotypically for their antimicrobial susceptibility profiles, genotypically characterized using whole-genome sequencing (WGS) and in silico multilocus sequence types (MLST). We conducted a phylogenetic single nucleotide polymorphism (SNPs) analysis to determine relatedness and clonality among the isolates. RESULTS: A total of 115 (26.8%) out of 429 samples were positive for E. coli. Of these, 110 isolates were viable for phenotypic and genotypic characterization. The selection comprised 47 (42.7%) isolates from poultry-workers, 36 (32.7%) from chickens, and 27 (24.5%) from poultry-farm or LBM environments. Overall, 101 (91.8%) of the isolates were MDR conferring resistance to at least three drug classes. High frequency of resistance was observed for tetracycline (n = 102; 92.7%), trimethoprim/sulfamethoxazole (n = 93; 84.5%), streptomycin (n = 87; 79.1%) and ampicillin (n = 88; 80%). Two plasmid-mediated colistin genes-mcr-1.1 harboured on IncX4 plasmids were detected in environmental isolates. The most prevalent sequence types (ST) were ST-155 (n = 8), ST-48 (n = 8) and ST-10 (n = 6). Two isolates of human and environmental sources with a SNPs difference of 6161 originating from the same farm shared a novel ST. The isolates had similar AMR genes and plasmid replicons. CONCLUSION: MDR E.coli isolates were prevalent amongst poultry-workers, poultry, and the poultry farm/LBM environment. The emergence of MDR E. coli with novel ST in two isolates may be plasmid-mediated. Competent authorities should enforce AMR regulations to ensure prudent use of antimicrobials to limit the risk of transmission along the food chain.

Serological and molecular epidemiology of foot-and-mouth disease viruses in agro-pastoralist livestock herds in the kachia grazing reserve, Nigeria.

The Kachia Grazing Reserve (KGR) is located in Kaduna state in north-western Nigeria and consists of 6 contiguous blocks housing 744 defined households (HH), all engaged in livestock keeping. It is considered as a homogenous epidemiological unit and a defined study area. In 2012, all cattle and sheep of 40 selected HH were sampled to determine sero-prevalence of antibodies to foot-and-mouth disease virus (FMDV) and of FMDV. The overall sero-prevalence of antibodies to the non-structural 3ABC protein (NSP-3ABC ELISA) was 28.9% (380/1,315) (30.6% cattle; 16.3% sheep), and in 4.5% (62/1,380) (5% cattle; 0.6% sheep) of the examined sera FMD viral RNA could be detected by real-time RT-PCR (rRT-PCR). Additionally, in 2012 and 2014 serum, epithelium and probang samples were collected from cattle in reported FMD outbreaks and the causative FMDVs were molecularly characterized. Approximately half (28/59) of the outbreak sera reacted positive in NSP-3ABC ELISA, and 88% (52/59) of the outbreak sera contained detectable viral RNA. Overall, antibodies against five FMDV serotypes (O, A, SAT1, SAT2 and SAT3) were detected by solid phase competitive ELISA with combinations of two or more serotypes being common. Of the 21 FMDVs that could be isolated 19 were sequenced and 18 were confirmed as SAT2 (lineage VII) while one was characterized as serotype O (EA-3 topotype). Phylogenetic analysis revealed a close relationship between Nigerian FMDV strains and strains in this region and even with strains in North-Africa. Our findings indicate that FMD constitutes an endemic health problem to cattle rearing in the agro-pastoralist community in the KGR and that the KGR is not a closed epidemiological unit. Insight into the local FMDV epidemiology and in the circulating FMDV serotypes/strains is of support to the relevant authorities in Nigeria when considering the need for an FMD control policy to improve animal production in grazing reserves.

Serological prevalence of leptospirosis in cattle slaughtered in the Zango abattoir in Zaria, Kaduna State, Nigeria.

Leptospirosis is an occupational zoonosis caused by pathogenic leptospires. In this study, the presence and prevalence of antibodies specific to Leptospira spp. serovar Hardjo in 142 cattle slaughtered between June and July 2011 was investigated using the enzyme-linked immunosorbent assay (ELISA). Five (3.50%) of the 142 cattle sampled were seropositive for antibodies to Leptospira spp. serovar Hardjo. Despite the fact that there was no significant difference (p>0.05) in seropositivity between sexes and between breeds sampled, there was a significant difference (p<0.05) in sero-positivity between the different age groups examined. Leptospirosis is present in cattle slaughtered in the Zango abattoir; butchers and abattoir workers are exposed to infected animals and are at risk of being infected by Leptospira spp. serovar Hardjo.