孟加拉国动物和人结核病的分子流行病学
结核病(TB)是一种由革兰氏阳性抗酸杆菌属分枝杆菌引起的进行性肉芽肿性传染病。人类结核病主要由结核分枝杆菌引起，主要影响肺部，引起肺结核。它还可以影响肠道、脑膜、骨骼、关节、淋巴结、皮肤和身体的其他组织，导致肺外结核(ETB)。结核病也影响动物，如牛，水牛等，被称为牛结核病(BTB)，由结核分枝杆菌(MTBC)的一员引起。MTBC由引起人类和动物结核病的密切相关的物种组成。在孟加拉国总人口中，约85%的人从事农业，有患牛结核病的风险。牛结核病具有重要的经济意义和公共卫生意义。该研究旨在通过常规和分子技术确定结核病(分枝杆菌种)在人和动物中的流行情况。横断面描述性研究于2018年1月至2019年12月期间在Mymensingh、Sirajganj和Dhaka地区进行。目前正在通过从结核病嫌疑人(人类计算的最小样本量为369例，动物(特别是奶牛)为1530例)和相关标本的实验室调查结果(特别是人类和牛奶的痰液、血液、淋巴结抽吸物和动物组织)收集数据。 A total of 444 TB suspects were interviewed. Sputum from 443 patients were examined under LED microscope after auramin staining and 46 was found positive for tubercle bacilli. A case of extra-pulmonary TB was detected by Fine Needle Aspiration Cytology (FNAC) of cervical lymph node. Culture in liquid media was done with 42 Specimens of sputum. Thirty seven (37) of those showed growth while 5 did not. DNA was extracted from growth in liquid media by boiling method and was preserved accordingly in -200C. GeneXpert/RIF was done with 37 samples of sputum and 29 was found MTB positive and RIF sensitive while 4 were found MTB positive but RIF resistant. Conventional PCR showed 17 positive cases for Mycobacterium species. Multiplex PCR and gel electrophoresis were done and 10 were found positive for Mycobacterium tuberculosis. These Multiplex PCR products were used for DNA Sequencing. Results of DNA sequencing was submitted to GeneBank and the accession numbers were received. Strains of Mycobacterium Tuberculosis were isolated & showed similarity with the strains which are reported from other parts of the world. Overall incidence of TB in TB suspects was found 10.36%. A total of 470 BTB suspected animals were screened by CFT (Caudal Fold Tuberculin) test using bPPD (Bovine purified protein derivatives) where 101 (21.49%) were shown sensitive. CFT sensitive animals were tested by CCT (Comparative Cervical Tuberculin) using bPPD and aPPD (Avium purified protein derivatives) where 36 (7.66%) were shown BTB sensitive. On the other hand, a total of 570 BTB suspected animals were tested with Bovine antibody rapid test kid where 0.88% found positives for Mycobacterium bovis. One thirty eight samples (Milk, blood and tissue) were tested by Zeihl-Neelsen staining and light and inverted microscopy where 7 (7.97%) were positive. Conventional PCR was done for 214 samples (Milk, blood and tissue) and 06 (2.91%) found Mycobacterium spp positive from bovine tissue sample. Ending the TB epidemic by 2030 is one of the health targets of the newly adopted Sustainable Development Goals (SDGs). Understanding of Molecular epidemiology of tuberculosis is essential for its effective control in human as well as in animal.
MAHBUB ALAM博士
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