Haemoparasite infection kinetics and the population structure of Theileria parva on a single farm in Uganda.

The development of sensitive PCR-based species-specific diagnostics and parasite genotyping methods offer the opportunity to provide important and detailed information on the infection dynamics of tick-borne disease. In this study we have exploited such tools to investigate the infection kinetics and parasite diversity within Theileria parva in a single farm in Uganda. Initial analysis of a sample of cattle showed high levels of infection with three Theileria species and Ehrlichia bovis, with most animals being infected with more than one pathogen. To study the infection dynamics, newborn calves were sampled longitudinally and it was shown that all animals became infected with T. parva, T. mutans, T. velifera and E. bovis with the average time to first infection being 53, 74, 116 and 109 days, respectively. However, the majority of these calves cleared the infections with T. parva and E. bovis but remained infected with the other two species of Theileria. In order to investigate the diversity of infecting genotypes of T. parva, samples from six calves were genotyped with a single mini-satellite marker at time points over a nine-month period. Each animal was infected with multiple different sets of genotypes and these were lost over different periods of time, implying that immunity is induced against particular infecting strains. To undertake a higher resolution analysis of parasite genotypes, samples from 30 calves were genotyped with a full panel of 12 micro- and mini-satellite markers but, due to the presence of mixed infections, only 16 samples could be used to generate parasite multi-locus genotypes (MLGs). A high degree of diversity of T. parva was seen on the farm, although some MLGs occurred more than once. Similarity analysis demonstrated a level of sub-structuring and the T. parva population was found to be in linkage disequilibrium. The basis for this high diversity coupled with apparent sub-structuring is discussed in relation to the possible causes.

Genetic diversity of Mycobacterium tuberculosis in Mbarara, South Western Uganda.

BACKGROUND: We determined the genetic diversity of mycobacteria isolated from tuberculosis patients in Mbarara Uganda, using region of difference (RD) analysis and spacer oligonucleotide typing (spoligotyping). METHODS: Sputum samples were cultured on Lowenstein Jensen media. The isolates were characterized using RD analysis and spoligotyping. RESULTS: The majority (92.8%) of the patients were new cases, 60% were males and 44% were HIV positive with a mean age of 33.7 years. All the 125 isolates were identified as M.tuberculosis sensu stricto. Most (92.8%) of the isolates were modern strains. Spoligotyping revealed 79 spoligotype patterns, with an overall diversity of 63.2%. Sixty (48%) isolates formed 16 clusters each consisting of 2-15 isolates. Mst (59.2 %) of the isolates were Uganda genotype strains. The major shared spoligotypes in our sample were SIT 135 (T2-Uganda) with 12 isolates and SIT 128 (T2) with 5 isolates. Sixty nine (87%) patterns had not yet been defined in the SpolDB4.0.database. CONCLUSION: The TB epidemic in Mbarara is caused mainly by modern M.tuberculosis strains of the Uganda genotype. The wide diversity of strains may indicate that the majority of the TB cases are reactivation rather than re-infection. However this needs to be ascertained with more discriminative finger printing techniques.

Molecular characterisation of Mycobacterium bovis isolates from cattle carcases at a city slaughterhouse in Uganda.

During a period of eight months, the carcases of 16,800 slaughter cattle were inspected at a city abattoir in Uganda. Eighty-seven of them had tuberculosis-like lesions and tissue samples were cultured. Only 17 cultures yielded acid-fast bacilli; 11 of them were confirmed as Mycobacterium bovis and six as non-tuberculous mycobacteria (NTM). GenoType Mycobacterium assays on the six NTM identified two as Mycobacterium fortuitum and one as Mycobacterium intracellulare, but three were unidentified. Characterisation of the M bovis isolates by spoligotyping and IS6110 restriction fragment length polymorphism (RFLP) revealed that five of the six spoligotype patterns observed in the 11 strains had not been previously reported, and seven of the nine isolates typed by RFLP had multicopy number IS6110 patterns. Six of the 11 infected carcases had multiple sites of infection, but none was condemned as unfit for human consumption.

Mycobacterium tuberculosis Uganda genotype is the predominant cause of TB in Kampala, Uganda.

SETTING: Rubaga Division, Kampala, Uganda. OBJECTIVE: To use polymerase chain reaction (PCR) based regions of difference (RD) analysis to study the species diversity of Mycobacterium tuberculosis complex isolates from a community-based sample of tuberculosis (TB) patients from Rubaga and to perform long sequence polymorphism (LSP) analysis to further characterise the M. tuberculosis Uganda genotype, a group of strains previously recognised by their characteristic spoligotype patterns. DESIGN: For the present study, 344 consecutive TB patients attending clinics in Rubaga Division were enrolled. Sample processing and culture were performed at the National Tuberculosis and Reference Laboratory and molecular assays at Makerere Medical School. Species identification was achieved by determining the RDs, while spoligotyping and LSP analysis were performed to characterise the M. tuberculosis Uganda genotype. RESULTS: Of the 344 isolates, 343 (99.7%) were M. tuberculosis sensu stricto, while one was classical M. bovis. The Uganda genotype strains characteristically lacked RD724, a locus that defines one of the major sub-lineages of M. tuberculosis, which suggested that this geographically constrained lineage is specifically adapted to a central African human host population. CONCLUSION: M. tuberculosis is the most prevalent species of the M. tuberculosis complex in Kampala, and the Uganda genotype is the predominant strain.

Theileria parva live vaccination: parasite transmission, persistence and heterologous challenge in the field.

The 'Muguga cocktail' live vaccine, delivered by an infection and treatment protocol, has been widely deployed in Eastern, Central and Southern Africa to protect cattle against East Coast fever, caused by Theileria parva. The vaccine contains 3 component stocks (Muguga, Serengeti-transformed and Kiambu 5). In a previous study, parasites from vaccinated and unvaccinated animals were genotyped with a panel of micro- and minisatellite markers (Oura et al. 2004a) and it was shown that only the Kiambu 5 stock establishes a long-term carrier state but there was no evidence for the transmission of this stock. Also parasite genotypes different from the 3 component vaccine stocks were identified in vaccinated animals. We now report a follow-up study on the same farm, some 4 years after the initial vaccination, aimed at establishing the source of the novel parasite genotypes identified in vaccinated cattle, determining the longevity of the carrier state established by the Kiambu 5 vaccine stock and re-examining whether vaccine transmission can occur over a longer time-scale. To do this, samples were taken from vaccinated and unvaccinated cattle and the parasites were genotyped with a series of micro- and minisatellite markers. The data indicate that the vaccine stabilates contain at least 6 parasite genotypes, the Kiambu 5 stock can be detected in many but not all vaccinated cattle for up to 4 years and can be transmitted to unvaccinated cattle which share grazing and that some of the vaccinated animals become infected with local genotypes without causing overt disease.

Introduction of an in-house PCR for routine identification of M. tuberculosis in a low-income country.

SETTING: National Tuberculosis (TB) Treatment Centre, Makerere University Medical School and Joint Clinical Research Centre, Kampala, Uganda. OBJECTIVE: To evaluate the introduction of a polymerase chain reaction (PCR) based assay for identification of the Mycobacterium tuberculosis complex (MTC) into routine practice. DESIGN: Routine diagnostic specimens were processed and inoculated into Bactec 12B vials and monitored daily. At a growth index (GI) > or =10, 0.5 ml of the 12B broth was removed and assayed with PCR. The same 12B vial was analyzed using the Bactec NAP method at GI > or =500. Vials at various levels of GI were included. Recurrent cost and time required to perform PCR and NAP were compared. RESULTS: Initially, 71 specimens were analyzed; of these, 68 were NAP-positive while 69 were PCR-positive for MTC. PCR resulted in a 75% reduction in cost for a single test compared with Bactec NAP. PCR has been successfully incorporated into routine practice, and 432 samples have been analyzed. In addition, isolates from solid media were also well identified by PCR. With PCR, more samples can be analyzed at a time, it is faster and is less labor intensive. CONCLUSION: PCR is a reliable and cheaper alternative for the identification of MTC.

Population genetic analysis and sub-structuring of Theileria parva in Uganda.

In recent years the population structures of many apicomplexan parasites including Plasmodium spp., Toxoplasma gondii and Cryptospordium parvum have been elucidated. These species show a considerable diversity of population structure suggesting different strategies for transmission and survival in mammalian hosts. We have undertaken a population genetic analysis of another apicomplexan species (Theileria parva) to investigate the levels of diversity of this parasite and the role of genetic exchange in three geographically separate populations. The principal hindrance to carrying out such a study on field isolates was the high proportion of blood samples that contain multiple genotypes, making it impossible to determine the genotypes of the parasites directly. This problem was overcome by sampling only young indigenous calves between 3 and 9 months of age in which approximately 60% of the T. parva infected calves contained a single/predominant allele at each locus, making it possible to undertake population genetic analyses. Blood samples were collected from calves in three geographically distinct regions of Uganda and were analysed using 12 polymorphic mini and microsatellite markers that were evenly dispersed across the four chromosomes. We have identified 84 multilocus genotypes (MLG) from these samples, indicating high levels of diversity in the parasite. Analysis of linkage disequilibrium between pairs of loci provides evidence that the population in Lira district had an epidemic structure. The population in Mbarara was substructured containing two genetically distinct sub-groups and the larger sub-group also had an epidemic population structure. The population from Kayunga was in linkage disequilibrium. Genetic distances and Wrights fixation index (F(ST)) indicate that there is evidence for geographical sub-structuring between the Lira and the Kayunga populations.