喀麦隆北部贝努埃地区山羊的结核病:流行率、皮内结核菌素皮肤试验的诊断性能和人畜共患风险因素

A. Julius, A. Emmanuel, N. Victor, Tchedele Achille Olivier, Mouliom Mouiche Mohamed Moctar, Kilekoung Mingoas Jean-Pierre, Zoli André Pagnah
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引用次数: 1

摘要

由牛分枝杆菌引起的结核病是一种具有严重公共卫生意义的动物消耗性疾病。尽管在牛中得到了广泛的诊断,并且在不同的环境条件下进行结核菌素皮肤试验(TST),在不同的截止点进行了比较,但喀麦隆山羊中结核病的信息缺乏。这项研究基于TST对检测结核样病变和抗酸杆菌作为金试验的效果,估计了喀麦隆Benuoe地区山羊中牛结核病的患病率。山羊结核检出率为结核样病变(27.87%)、抗酸杆菌(3.29%);单次皮内比较宫颈结核菌素(SICCT)≥2mm、≥3mm和≥4mm的阳性反应分别为(12.28%,95%CI: 9.19-15.95)、(8.95%,95%CI: 6.31-12.23)和(5.37%,95%CI: 3.36-8.09),单次皮内比较宫颈结核菌素(SICCT)≥2mm、≥3mm和≥4mm的阳性反应分别为(2.30%,95%CI: 1.06-4.32)、(1.79%,95%CI: 0.72-3.65)和(1.02%,95%CI: 0.28 - 2.60)。SICT和SICCT检测结核样病变的敏感性(11.76%)显著低于检测抗酸杆菌的敏感性(100%)[Kappa=0.161],与检测抗酸杆菌的敏感性(100%)和完全一致[Kappa=1.00]。贝叶斯模型显示,使用SICT的山羊结核病患病率为18.41% (95%CI: 11.73-27.00),使用SICCT的山羊结核病患病率为4.28% (95%CI: 1.26-8.60),在≥2mm的截止点上,SICT的性能特征高于SICCT。然而,双图ROC (TG-ROC)分析显示,SICCT诊断山羊结核病的最佳分界点为≥2mm。许多山羊处理者意识到人畜共患结核的健康危害,但对山羊结核及其可能传播给人类的人畜共患结核一无所知。该研究报告了对喀麦隆北部Benoue地区山羊进行的第一次结核菌素皮肤比较试验,并证实人畜共患结核病是喀麦隆山羊被忽视的健康和生产问题,需要进一步调查。
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Tuberculosis in goats in Benoue area of North Cameroon: Prevalence, diagnostic performance of intradermal tuberculin skin test and zoonotic risk factors
Tuberculosis (TB) due to Mycobacterium bovis is a wasting disease of animals with severe public health significance. Though widely diagnosed in cattle and the performance of Tuberculin Skin Test (TST) at different cut-off points compared in various environmental conditions, there is dearth of information with respect to TB in goats in Cameroon. This study estimated the prevalence of bovine TB in goats in Benuoe area of Cameroon, based on the performance of TST against detection of tuberculous-like lesions and acid-fast bacilli as gold tests. The study detected goat TB based on tuberculous-like lesions (27.87%), acid-fast bacilli (3.29%); and bovine TB positive reactions (12.28%, 95%CI: 9.19–15.95), (8.95%, 95%CI: 6.31–12.23) and (5.37%, 95%CI: 3.36–8.09) at Single intradermal cervical tuberculin (SICT) ≥2.5mm, ≥3mm, and ≥4mm and (2.30%, 95%CI: 1.06–4.32), (1.79%, 95%CI: 0.72–3.65) and (1.02%, 95%CI: 0.28– 2.60) at Single intradermal comparative cervical tuberculin (SICCT) ≥2mm, ≥3mm, and ≥4mm cut-off points, respectively. SICT and SICCT sensitivity (11.76%) against detection of tuberculous-like lesions was significantly lower [p<0.05] with slight agreements [Kappa=0.161] compared to sensitivity (100%) and perfect agreements [Kappa=1.00] against detection of acid-fast bacilli at these cut-offs. The Bayesian model revealed a goat TB prevalence of 18.41% (95%CI: 11.73–27.00) using SICT and 4.28 (95%CI: 1.26–8.60) using SICCT with the performance characteristic being higher for SICT than SICCT at ≥2mm cut-off. However, two-graph ROC (TG-ROC) analysis revealed that the optimal goat TB diagnosis with SICCT was at ≥2mm cut-off point. Many goat handlers were aware of health hazards of zoonotic TB but ignorant about goat TB and its possible zoonotic transmission to humans. The study reports the first comparative tuberculin skin test of goats in Benoue area of North-Cameroon and confirmed that zoonotic TB is a neglected health and production problem of goats in Cameroon that needs further investigated.
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