Molecular epidemiology of bovine tuberculosis in Cameroon Franklyn Nkongho

Outline

• Background • Design • Results • Concluding remarks

Background

• WT funded project on the epidemiology of bTB in Cameroon – Describe the basic epidemiology – Estimate the performance of available diagnostic tests – Estimate the prevalence of bTB – Identify the strains circulating – Explore co-infection with liver fluke, paraTB, BVD – Estimate human zoonotic TB risk and strains

Mycobacterium bovis

• Poorly reported in Africa • Potential zoonotic PH problem – Infected raw milk or meat – Risk to herdsmen/slaughtermen • High TB burden linked to HIV – Zoonotic component poorly understood • Potential for cattle production loss • Control based on meat inspection

Design

B G M N • Three study components – Convenience sample of 4 abattoirs (Bamenda, Ngaoundere, Garoua, Maroua) – Population based cross sectional study in 2 areas – Human DTC based study in NW Region • Focus of talk is on the abattoir study

Sampling Design

Collection of blood sample for serological tests

Bamenda TB Lab

Sample Processing

GRINDING PASTE MADE Hain MTBC/CM/AS kits Spoligotyping/MIRU-VNTR (Genoscreen) Automated MGIT BACTEC 960 SYSTEM LJ Pyruvate LJ Glycerol WGS (ArkGenomics)

Buea Lab

Results abattoir

Bamenda

No. sampled 1129 No. with TB like lesions 45

Ngaoundere Garoua

935 160 106 38 Prev lesions 4.0% % lesions with

M bovis

68.9% 11.3% 67.9% 23.8% 89.5% Prev

M bovis

2.7% Prev bovigam 5.6% 7.7% 6.8% 21.3%

Maroua

122 18 14.8% 88.8% 13.1%

Results abattoir – proxy age

Abattoir lesions and M bovis

Lesion

pos neg

M bovis

pos 150 2 152 neg 51 177 228 201 179 380 NB. 380 animals had LN culture results All observed Random sample

Bovigam

pos neg

M bovis

pos 43 55 98 neg 15 200 215 58 255 313 NB. 67 had no bovigam results (mainly Garoua + Maroua)

Abattoir results – other

Mycobacteria

Abattoir

M tuberculosis M gordonae M phlei M fortuitum M mucogenicum M scrofulaecum M species

0 1 7

BAMENDA

1 2 9 2 1 0 4

NGAOUNDERE

0 0 1 1 0 1 1

GAROUA

0 0 0 1 0 0 1

MAROUA

0 0 0 0 Only 2 animals recorded mixed infections of M bovis and

M fortuitum

and an untyped

Mycobacterium

species

Results where were zoonotic cases 3 human cases or ~2% of human TB is zoonotic in the NW Region

Mycobacterium tuberculosis complex Species and Lineages

M. tuberculosis M. canetti M. africanum

M. bovis sub species

Spoligotyping

SB1026 SB0944 SB0953

Spoligotyping

SB0944 SB0953 SB1026

Spoligotyping

SB1026 SB0944 SB0953 SB0953 SB0953 SB0953 SB0953 SB0953 SB0953 SB0953 SB0944 SB0953 SB0953 SB0953 SB0953 SB0953 SB0953 SB0953 SB0953 SB0953 SB0953 SB0944

Spoligotyping

SB1026 SB0953 SB0944 Boyo Bui Menchum Mezam Momo Donga Mantung

Molecular work ongoing

• Data analysis still on going • Majority of spoligotype and MIRU-VNTR data still to come • WGS underway

Concluding remarks

• Relatively high prevalence of bTB • Range of other Mycobacteria in cattle – M tb and several NTMs • 3 human M bovis cases (yet to be typed) – Represents potential significant human burden • Complex epidemiological situation with transmission in both directions • Currently 3 spoligotypes in NWR – More diversity by MIRU-VNTR – Appear to be widely dispersed • Reinforce meat inspection and condemnation of infected carcasses • Public sensitization particularly around milk consumption • BUT DATA ANALYSIS STILL ON GOING

Questions?

Partners

• UoEdinburgh, UK – Mark Bronsvoort (PI) – Rob Kelly (RA/PhD) – Ian Handel – Adrian Muwonge • IRAD, Cameroon – Vincent Tanya (CoPI) • UoBuea, Cameroon – Lucy Ndip (CoPI) – Franklyn Nkongho (PhD) • Swiss TPH – Jakob Zinstaag (CoPI) • LRVZ de Farcha, Chad – Richard Ngondolo • GIZ/TBRL, Cameroon – Melissa Sander • UoGlasgow, UK – Roman Biek • UoLiverpool, UK – Kenton Morgan – Diana Williams • MINEPIA, Cameroon – Walters Andu • UoNgoundere, Cameroon - Dr Victor Ngwa - Jean Marc Babningom