Nontuberculous Mycobacteria in Humans, Animals, and Water in Zambia: A Systematic Review

Nontuberculous mycobacteria (NTM) are environmental opportunistic pathogens of humans and animals that are emerging with a serious public health impact particularly in individuals with Acquired Immunodeficiency Syndromes. Recent scientific evidence is shifting from NTMs being known as traditional environmental organisms to serious pathogenic organisms in both animals and humans. In humans, factors attributable to this rise have been linked mainly to Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome pandemic. In recent years there has been an increase in multidrug resistant Tuberculosis in Zambia and it is thought that NTMs could possibly be the cause. This study was therefore formulated to review available information on the prevalence of NTM in humans, animals and the environment, species distribution, zoonotic potential and public health importance in Zambia. This review was conducted in accordance with PRISMA guidelines. A literature search was done in PubMed and Google scholar using predefined search terms such as ‘nontuberculous mycobacteria’, ‘atypical mycobacteria’, ‘mycobacteria other than mycobacterium tuberculosis’ and ‘Zambia’, in combination with Boolean operators (AND, OR). This particular systematic review draws findings based on literature search between 2000 and 2020. Through literature search 243 papers were identified, 23 duplicates were identified and removed and 206 articles were excluded as they did not meet the inclusion criteria. The full text of the remaining 14 articles were considered for this review. The overall prevalence of NTM in humans was 24.39%, in water 21.5%, in animals 16.05% of which the prevalence in cattle was 14.81% and Kafue Lechwe 1.23%. Mycobacterium intracellulare was the most common isolated nontuberculous mycobacteria in humans and cattle while Mycobacterium gordonae was the most common in water, and Mycobacterium stomatepiae sp Nov in Kafue Lechwe. Nontuberculous mycobacteria are an emerging public health threat in Zambia both in humans and animals and this calls for the need for molecular information on the zoonotic transmission of nontuberculous mycobacteria. Increased awareness of nontuberculous mycobacteria diseases among clinicians and laboratory personnel is crucial for patient management and an essential step for facilitating the identification of nontuberculous mycobacteria species in laboratories.

Clustering and spatial heterogeneity of bovine tuberculosis at the livestock/wildlife interface areas in Namwala District of Zambia

Background and Aim: Bovine tuberculosis (bTB) remains a major public health issue in Zambia and has been exacerbated by human immunodeficiency virus prevalence and consumption of unpasteurized milk in the Southern Province of the country. The prevalence of bTB has been established to be linked to Kafue Lechwe, which act as reservoir hosts and share grazing fields with domestic cattle. No studies have so far used geographic information system (GIS) to investigate the relationship between the reservoir hosts (Kafue Lechwe) and domestic animals. This study, therefore, aimed to apply GIS to investigate the spatial distribution of bTB in Namwala District of the Southern Province of the country. Materials and Methods: To investigate the spatial distribution of bTB, geographical positioning system (GPS) coordinates representing 96 cattle herds across 20 independent villages were captured alongside risk factor data. The 96 herds were based on abattoir reports of condemned carcasses and a trace back. Positive herds were confirmed by cross-reference to purified protein derivative tests conducted by the District Veterinary Office. The GPS coordinates were transferred into ArcView 3.2 and laid on the map of Namwala District alongside physical features, including national parks, game management areas, and flood plains. Questionnaires were administered across 96 independent households to assess risk factors of bTB transmission. Results: The results revealed a "clustered" spatial distribution of the disease in cattle in Namwala District of Zambia, particularly significant in the eastern interface areas of the district (p=0.006 using Moran's I). Abattoir to production area trace back revealed a herd-level prevalence of 36.4% (95% CI=26.7-46.3%) among cattle herds in Namwala District, whereas individual animal prevalence ranged from 0% to 14% (95% CI=2.4-26.2%). Further, GPS data indicated that the majority of the positive herds were located at the livestock/wildlife interface area. Contacts with wildlife, coupled with sharing grazing, and watering points were found to be significant risk factors for bTB transmission. Conclusion: This study demonstrated the presence of bTB in cattle and associated spatial risk factors. In particular, bTB was observed to be a function of animal location within the livestock/wildlife interface area. GIS is thus an applicable and important tool in studying disease distribution.

Biometric analysis of testicles of the Kafue lechwe (Kobus leche kafuensis) and Bangweulu lechwe (Kobus leche smithemani) in Zambia

The Kafue lechwe (Kobus leche kafuensis) is a unique antelope found only in the Kafue basin of Zambia and is the main source of local income and protein. Its population has been dwindling over the years supposedly due to poaching and environmental pollution in the area and without mention of reproductive causes. The present study was a pilot study which determined biometric measurements of the testicles in adult lechwes as measures of reproductive ability and fertility. Testicles from 24 Kafue and 24 Bangweulu lechwes were examined from August to October 2009. The measurements were taken using Calipers, a ruler and string for testicular length, width, height, head size, body and tail of the epididymis. All testicular parameters were significantly higher in the Kafue than the Bangweulu lechwe. The study also found cases of cryptorchidism and abnormal epididymis in the Kafue and Bangweulu lechwes, respectively. The testicular parameters were measured during the non-breeding season thus influence of breeding on testicular biometry is expected. This was the first study of its kind and further studies on the reproductive physiology and biology are required to understand various causes of reductions in population and thereby aid the conservation of this species.

Detection of Parasites and Parasitic Infections of Free-Ranging Wildlife on a Game Ranch in Zambia: A Challenge for Disease Control

Ex-situconservancies are expanding alternatives to livestock production in Zambia albeit the lack of information on circulating infectious parasites from wildlife. Therefore, 12 wildlife species were examined on a game ranch were all species were found to be infected byRhipecephalusspp. Haemoparasite infections were estimated at 7.37% (n=95) withBabesiaspp. detected in bushbuck (Tragelaphus scriptus);Anaplasma marginalein impala (Aepyceros melampus) and puku (Kobus vardonii) for the first time in Zambia. The majority of worm species isolated from bovids were not detected in equids and,vice versa. Our findings intimate ecological and behavioural patterns of some animals as deterministic to exposure. Kafue lechwe (Kobus leche kafuensis) had the widest range of worm species with more infected organs than other animals suggesting their semi aquatic nature contributory to prolonged worm exposure compared to other animals. On the other hand, Kafue lechwe had the least tick infections attributable more to shorter attachment periods as they spend prolonged periods submerged in water. Our findings indicate the vital role that wildlife plays in the epidemiology of parasitic diseases. To reduce the infection burden, control measures should be focused on reducing transmission to highly susceptible animal species as described herein.

A Review of Bovine Tuberculosis in the Kafue Basin Ecosystem

The Kafue basin ecosystem is the only remaining natural habitat for the endangered Kafue lechwe antelope (Kobus leche Kafuensis). However, hydroelectricity power production, large-scale sugar plantations, commercial fishing and increasing livestock production are threatening its natural existence and sustainability. Further, increasing human settlements within and around the Kafue basin have resulted in decreased grazing grounds for the Kafue lechwe antelopes despite a corresponding increase in cattle population sharing the same pasture. Baseline epidemiological data have persistently reported findings of bovine tuberculosis (BTB) in both wild and domestic animals, although these have been deficient in terms of describing direct evidence in the role of either lechwe antelopes or cattle in the reported observations. Despite the current literature being deficient in establishing the casual role and transmission patterns of BTB, a bimodal route of infection at the livestock/wildlife interface has been postulated. Likewise, it is not known how much of (BTB) has the potential of causing disease in humans. This paper, seeks to underline those aspects that need further research and update available data on BTB in the Kafue basin with regards to the prevalence, distribution, risk factors, threats on wildlife conservation, livestock production, public health implications, and possible mitigatory measures.