ABSTRACT
Multidrug-resistant tuberculosis (TB) (MDR-TB), or TB that is simultaneously resistant to both isoniazid (INH) and rifampicin (RIF), is a barrier to successful TB control and treatment. Stratified data on MDR-TB, particularly in the high-burden western Kenya region, remain unknown. This data is important to monitor the efficacy of TB control and treatment efforts. Herein, we determined the molecular epidemiology of drug-resistant TB and associated risk factors in western Kenya. This was a non-experimental, population-based, cross-sectional study conducted between January and August 2018. Morning sputum samples of individuals suspected of pulmonary TB were collected, processed, and screened for Mycobacterium tuberculosis (Mtb) and drug resistance using line probe assay (LPA) and Mycobacterium growth indicator tubes (MGIT) culture. MGIT-positive samples were cultured on brain heart infusion (BHII) agar media, and the presence of Mtb was validated using Immunochromatographic assay (ICA). Drug sensitivity was performed on MGIT and ICA-positive but BHI-negative samples. Statistical significance was set at P < 0.05. Of the 622 Mtb isolates, 536 (86.2%) were susceptible to RIF and INH. The rest, 86 (13.83%), were resistant to either drugs or both. A two-sample proportional equality test revealed that the MDR-TB prevalence in western Kenya (5%) did not vary significantly from the global MDR-TB estimate (3.9%) (P = 0.196). Men comprised the majority of susceptible and resistant TB (75.9% and 77.4%%, respectively). Also, compared with healthy individuals, the prevalence of HIV was significantly higher in MDR-TB patients (35.9% vs 5.6%). Finally, TB prevalence was highest in individuals aged 25-44 years, who accounted for 58.4% of the total TB cases. Evidently, the prevalence of MDRTB in western Kenya is high. Particular attention should be paid to men, young adults, and those with HIV, who bear the greatest burden of resistant TB. Overall, there is a need to refine TB control and treatment programs in the region to yield better outcomes.
ABSTRACT
Goats are among the most important small ruminants affected by Peste des Petits ruminants (PPR) and contagious caprine pleuropneumonia (CCPP) diseases, two of the most significant constraints worldwide to the production of small ruminant species. Herein, the competitive enzyme-linked immunosorbent assay (cELISA) and the latex agglutination test (LAT) were used to determine the coinfections of PPR and CCPP in goats in Kwale County on Kenya's South Coast. A total of 368 serum samples were collected from goats of various ages and sexes exhibiting respiratory distress in the four subcounties of Kwale County (Kinango, Lunga Lunga, Matuga, and Msambweni) and screened for PPR and CCPP antibodies. Of the 368 goats sampled, 259 (70.4%) were females and 109 (29.6%) were males, and 126 (34.2%), 71 (19.3%), 108 (29.3%), and 63 (17.1%) samples were collected from Kinango, Matuga, Lunga Lunga, and Msambweni, respectively. The overall PPR seropositivity rate was 48.6% (179/368); rates in Kinango, Lunga Lunga, Matuga, and Msambweni were 70.6%, 29.6%, 49.3%, and 36.5%, respectively. The overall CCPP seropositivity rate was 45.4% (167/368), while rates in Kinango, Lunga Lunga, Matuga, and Msambweni were 51.6%, 49.1%, 36.6%, and 36.5%, respectively. Notably, the seropositivity of PPR was higher in male (53.3%) than in female (46.72%) goats, though not statistically significant. In addition, the CCPP seropositivity rates were not significantly different between male (44.0%) and female (45.9%) goats. Regarding age, the PPR seropositivity rates were 45.9%, 55.8%, and 52.3% in adults, kids, and weaners, respectively. For CCPP, the seropositivity rates were 48.3%, 40.4%, and 42.3% in adults, kids, and weaners, respectively. The coinfection rate of PPR and CCPP was 22.3% (82/368). Despite the high coinfection, univariate analysis revealed no relationship between PPR and CCPP infections. However, given the high PPR and CCPP infection rates, as a result of separate or coinfection, there is a need to upscale or intensify vaccination in the county.
