Type

Journal Article

Authors

Abraham Aseffa
Stephen V. Gordon
Lawrence Yamuah
Glyn Hewinson
Rea Tschopp
Brian D Robertson
Sebastien Gagneux
Gobena Ameni
Jakob Zinsstag
Yohannes Derese
and 13 others

Subjects

Microbiology

Topics
single high rate transmission zoonotic tuberculosis health facilities mycobacterium tuberculosis mycobacterium bovis infection

Investigation of the high rates of extrapulmonary tuberculosis in Ethiopia reveals no single driving factor and minimal evidence for zoonotic transmission of Mycobacterium bovis infection. (2014)

Abstract Ethiopia, a high tuberculosis (TB) burden country, reports one of the highest incidence rates of extra-pulmonary TB dominated by cervical lymphadenitis (TBLN). Infection with Mycobacterium bovis has previously been excluded as the main reason for the high rate of extrapulmonary TB in Ethiopia. Here we examined demographic and clinical characteristics of 953 pulmonary (PTB) and 1198 TBLN patients visiting 11 health facilities in distinct geographic areas of Ethiopia. Clinical characteristics were also correlated with genotypes of the causative agent, Mycobacterium tuberculosis. No major patient or bacterial strain factor could be identified as being responsible for the high rate of TBLN, and there was no association with HIV infection. However, analysis of the demographic data of involved patients showed that having regular and direct contact with live animals was more associated with TBLN than with PTB, although no M. bovis was isolated from patients with TBLN. Among PTB patients, those infected with Lineage 4 reported "contact with other TB patient" more often than patients infected with Lineage 3 did (OR = 1.6, CI 95% 1.0-2.7; p = 0.064). High fever, in contrast to low and moderate fever, was significantly associated with Lineage 4 (OR = 2.3; p = 0.024). On the other hand, TBLN cases infected with Lineage 4 tended to get milder symptoms overall for the constitutional symptoms than those infected with Lineage 3. The study suggests a complex role for multiple interacting factors in the epidemiology of extrapulmonary TB in Ethiopia, including factors that can only be derived from population-based studies, which may prove to be significant for TB control in Ethiopia.
Collections Ireland -> University College Dublin -> PubMed

Full list of authors on original publication

Abraham Aseffa, Stephen V. Gordon, Lawrence Yamuah, Glyn Hewinson, Rea Tschopp, Brian D Robertson, Sebastien Gagneux, Gobena Ameni, Jakob Zinsstag, Yohannes Derese and 13 others

Experts in our system

1
Stephen V. Gordon
University College Dublin
Total Publications: 40