Risk factors for rabid animal bites: a study in domestic ruminants in Mymensingh district, Bangladesh.

Rabies is endemic in Bangladesh. To identify risk factors, a case-control study was conducted based on hospital-reported rabid animal bite (RAB) cases in domestic ruminants, 2009 - 2018. RAB cases (n = 449) and three controls per case were selected. Dogs (87.8%) and jackals (12.2%) were most often identified as biting animals. In the final multivariable model, the risk of being a RAB case was significantly higher in cattle aged >0.5-2 years (odds ratio (OR) 2.89; 95% confidence interval (CI): 1.56-5.37), >2-5 years (OR 3.63; 95% CI: 1.97-6.67) and >5 years (OR 6.42; 95% CI: 3.39-12.17) compared to those aged <0.5 years. Crossbred cattle were at higher risk of being a RAB case (OR 5.48; 95% CI: 3.56-8.42) than indigenous. Similarly, female cattle were more likely to be a RAB case (OR 1.26; 95% CI: 1.15-2.29) than males. Cattle in rural areas (OR 39.48; 95% CI: 6.14-254.00) were at a much higher risk of being RAB cases than those in urban areas. Female, crossbred and older cattle, especially in rural areas should either be managed indoors during the dog breeding season (September and October) or vaccinated. A national rabies elimination program should prioritise rural dogs for mass vaccination. Jackals should also be immunised using oral bait vaccines. Prevention of rabies in rural dogs and jackals would also reduce rabies incidence in humans.

Bayesian evaluation of three serological tests for the diagnosis of bovine brucellosis in Bangladesh.

We evaluated the performance of three serological tests - an immunoglobulin G indirect enzyme linked immunosorbent assay (iELISA), a Rose Bengal test and a slow agglutination test (SAT) - for the diagnosis of bovine brucellosis in Bangladesh. Cattle sera (n = 1360) sourced from Mymensingh district (MD) and a Government owned dairy farm (GF) were tested in parallel. We used a Bayesian latent class model that adjusted for the conditional dependence among the three tests and assumed constant diagnostic accuracy of the three tests in both populations. The sensitivity and specificity of the three tests varied from 84.6% to 93.7%, respectively. The true prevalences of bovine brucellosis in MD and the GF were 0.6% and 20.4%, respectively. Parallel interpretation of iELISA and SAT yielded the highest negative predictive values: 99.9% in MD and 99.6% in the GF; whereas serial interpretation of both iELISA and SAT produced the highest positive predictive value (PPV): 99.9% in the GF and also high PPV (98.9%) in MD. We recommend the use of both iELISA and SAT together and serial interpretation for culling and parallel interpretation for import decisions. Removal of brucellosis positive cattle will contribute to the control of brucellosis as a public health risk in Bangladesh.

Investigation of methicillin-resistant Staphylococcus aureus among clinical isolates from humans and animals by culture methods and multiplex PCR.

BACKGROUND: Staphylococcus aureus is responsible for large numbers of hospital-related and community-acquired infections. In this study, we investigated the presence of S. aureus and methicillin-resistant S. aureus (MRSA) in 100 samples from animals (55 cattle, 36 dogs, and 9 cats) and 150 samples from hospitalized human patients. The samples were collected from healthy and diseased animals and from diseased humans and included milk, wound swab, pus, exudates, nasal swab and diabetic ulcer. Initially, S. aureus was isolated and identified by colony morphology, Gram staining, and biochemical tests (catalase and coagulase tests). The S. aureus-positive samples were examined by polymerase chain reaction (PCR) to determine their MRSA status. RESULTS: Of the 100 animal samples, 29 were positive for S. aureus. Four samples (13.8%) from dogs were MRSA-positive, but samples from cattle and cats were MRSA-negative. Of the 150 human samples we collected, 64 were S. aureus-positive and, of these, 34 (53.1%) were MRSA-positive. Most (28%) of the MRSA samples were isolated from surgical wound swabs, followed by the pus from skin infections (11%), exudates from diabetic ulcers (6%), exudates from burns (4%), and aural swabs (3%). By contrast, a low MRSA detection rate (n = 4) was seen in the non-human isolates, where all MRSA bacteria were isolated from nasal swabs from dogs. The antimicrobials susceptibility testing results showed that S. aureus isolates with mecA genes showed resistance to penicillin (100%), oxacillin (100%), erythromycin (73.5%), ciprofloxacin (70.6%), and gentamicin (67.7%). The lowest resistance was found against ceftazidime, and no vancomycin-resistant isolates were obtained. CONCLUSIONS: We detected S. aureus and MRSA in both human and canine specimens. Isolates were found to be resistant to some of the antimicrobials available locally. MRSA carriage in humans and animals appears to be a great threat to effective antimicrobials treatment. The prudent use of antimicrobials will reduce the antimicrobial resistance. Our findings will help to find the most appropriate treatment and to reduce antimicrobial resistance in the future by implementing prudent use of antimicrobials. Further studies are required to better understand the epidemiology of MRSA human-animal inter-species transmission in Bangladesh.

Brucella abortus is Prevalent in Both Humans and Animals in Bangladesh.

To determine the role of different Brucella (B.) spp. in Bangladesh, 62 animal samples and 500 human sera were tested. Animal samples from cattle, goats and sheep (including milk, bull semen, vaginal swabs and placentas) were cultured for Brucella spp. Three test-positive human sera and all animal samples were screened by Brucella genus-specific real-time PCR (RT-PCR), and positive samples were then tested by IS711 RT-PCR to detect B. abortus and B. melitensis DNA. Only B. abortus DNA was amplified from 13 human and six animal samples. This is the first report describing B. abortus as the aetiological agent of brucellosis in occupationally exposed humans in Bangladesh. Of note is failure to detect B. melitensis DNA, the species most often associated with human brucellosis worldwide. Further studies are required to explore the occurrence of Brucella melitensis in Bangladesh.

Peste des Petits Ruminants risk factors and space-time clusters in Mymensingh, Bangladesh.

Using a hospital-based case-control study design, our aim was to identify risk factors for-and space-time clusters of-Peste des Petits Ruminants (PPR) in Mymensingh, Bangladesh. Three hundred and eighty PPR cases diagnosed between January 2005 and December 2014 at the Bangladesh Agricultural University Veterinary Teaching Hospital (BAUVTH) were selected; three controls per case from BAUVTH were then selected (n = 1,048). From records, data extracted included information on date of report, location, age, breed, sex and body weight of goats. A mixed multivariable logistic regression model was built to identify risk factors. Location was included as a random effect and season and demographic variables as fixed effects. The approximate geographic coordinates of locations were collected, and the scan statistic (Bernoulli model) was used to identify space-time clusters of PPR. Compared with goats <4 months of age, the odds of PPR were 3 (95% confidence interval [CI]: 1.95-4.66), 1.9 (CI: 1.34-2.76) and 1.8 times (95% CI: 1.19-2.58) greater in goats aged 4-6, >6-12 and >12-24 months, respectively. The occurrence of PPR was also significantly higher (odds ratio [OR] 3.2; 95% CI: 1.15-8.59) in the Jamunapari breed than Black Bengals. Significantly higher odds of PPR were observed in winter (OR 1.6; 95% CI: 1.06-2.14) and the monsoon season (OR 1.5; 95% CI: 1.04-2.11) compared with the post-monsoon season. Two significant (p < .05) space-time clusters were identified between 2 December 2006 and 6 September 2007 (two locations) and 28 November 2006 and 13 February 2007 (five locations). Peste des Petits Ruminants is endemic in Bangladesh, but also occurs as discrete outbreaks. Control efforts-such as vaccination-should focus on high-risk groups (4-24 months of age, Jamunapari breed), prior to the onset of winter and the monsoon season so as to increase immunity during high-risk periods, and focus on disease hotspots.

Latent class evaluation of three serological tests for the diagnosis of human brucellosis in Bangladesh.

BACKGROUND: A Bayesian latent class evaluation was used to estimate the true prevalence of brucellosis in livestock farmers and patients with prolonged pyrexia (PP) and to validate three conditionally dependent serological tests: indirect ELISA (iELISA), Rose Bengal Test (RBT), and standard tube agglutination (STAT). A total of 335 sera from livestock farmers and 300 sera from PP patients were investigated. RESULTS: The true prevalence of brucellosis in livestock farmers and PP patients was estimated to be 1.1 % (95 % credibility interval (CrI) 0.1-2.8) and 1.7 % (95 % CrI 0.2-4.1), respectively. Specificities of all tests investigated were higher than 97.8 % (95 % CrI 96.1-99.9). The sensitivities varied from 68.1 % (95 % CrI 54.5-80.7) to 80.6 % (95 % CrI 63.6-93.8). The negative predictive value of all the three tests in both populations was very high and more than 99.5 % (95 % CrI 98.6-99.9). The positive predictive value (PPV) of all three tests varied from 27.9 % (95 % CrI 3.6-62.0) to 36.3 % (95 % CrI 5.6-70.5) in livestock farmers and 39.8 % (95 % CrI 6.0-75.2) to 42.7 % (95 % CrI 6.4-83.2) in patients with PP. The highest PPV were 36.3 % for iELISA and 42.7 % for RBT in livestock farmers and pyrexic patients, respectively. CONCLUSIONS: In such a low prevalence scenario, serology alone does not help in diagnosis and thereby therapeutic decision-making. Applying a second test with high specificity and/or testing patients having history of exposure with known risk factors and/or testing patients having some clinical signs and symptoms of brucellosis may increase the positive predictive value of the serologic tests.