Prevalence of Zoonotic Diseases (T.B and Brucellosis) in Animals Domesticated in Pishin District

Research Report submitted to

&

For the complete fulfillment of the requirements for the degree of

MASTER OF SCIENCE (MS)

In

BIOTECHNOLOGY AND INFORMATICS

By

AEMAL TAREEN

Supervisor
Dr. DOST MUHAMMAD BALOCH
Faculty of Biotechnology and Informatics, BUITEMS, Quetta

Co-Supervisor
PROFESSOR Dr. MUHAMMAD AZAM KHAN KAKAR
Faculty of Biotechnology and Informatics, BUITEMS, Quetta

PREVALENCE OF ZOONOTIC DISEASES (TUBERCULOSIS AND BRUCELLOSIS) IN ANIMALS DOMOISTICATED IN PISHIN DISTRICT (BALOCHISTAN)

Abstract
This report presents a combined epidemiological and economic framework for assessing zoonoses using a ‘‘one health’’ concept. The framework allows for an understanding of the cross-sector economic influence of zoonoses using improved risk analysis and listing a range of analytical tools. The goal of the framework is to link the check outputs of animal and human disease transmission models, economic influence models and assessment of risk management options to gain improved understanding of factors affecting the acceptance of risk management plans so that investment planning includes the most promising interventions (or sets of interventions in an integrated fashion). A more complete understanding of the costs of the disease and the costs and benefits of control measures would promote broader application of the most efficient and effective control measures, contributing to improved animal and human health, better livelihood outcomes for the poor and macroeconomic growth.
Keywords: Zoonoses, Tuberculosis, Brucellosis
Acknowledgements / Foreword
IN THE NAME OF ALLAH, THE BENEFICENT, THE MERCIFUL
I would like to express my sincere gratefulness to Relief International for financial support and giving us the chance of working on this project and contribution towards betterment of humans and livestock. I am very grateful to my project supervisor Dr. Dost Muhammad Baloch, co-supervisor Dr. Muhammad Azam Khan Kakar, Dr. Ejaz of RI, Dr Abdul. Rehman, the lab in charge of DI lab Quetta and all my fellows & friends for their kind co-operation and encouragement for completing this Project Successfully. I also express my gratitude to Department of Biotechnology and Informatics for providing the necessary requirement for Completion of Work.

Table of Contents
Abstract ii
Acknowledgements / Foreword iii
Table of Contents iv
List of Figures v
List of Tables vi
Terminology / Notation vii
Acronyms / Abbreviations vii
1 Introduction 1
1.1 Statement of the Problem: 2
1.2 Research Hypotheses: 4
1.3 Significance of the Study: 4
1.4 Purpose of the Research: 4
2 Literature Review 5
3 Materials & Methods 10
4 Results / Discussion 12
5 Conclusions 15
References 16
List of Figures Figure 1: Cycle of M. Bovis Transmission between cattle and humans. The thickness of the arrows Suggests level of probability 1 Figure 2: Spread of Brucellosis between cattle& Humans 2

List of Tables

Table 1: Animal Count Pishin Dist. (2005) 10

Terminology / Notation

Acronyms / Abbreviations

Spp Species DLS Department of Livestock services T.B Tuberculosis L.U Livestock Unit

Introduction
The usage Zoonoses, or Zoonotic diseases, are caused by infectious agents that are transmissible under natural conditions from animals to humans. Zoonoses may rise from wild or domestic animals or from products of animal source. A number of infectious diseases, including viruses, bacteria, and parasites, can be transmitted from animals to people through a variety of infection routes, including animal bites, vectors (i.e., insects), and animal-to-human contact (i.e., inhalation of respiratory droplets or skin-to-skin contact). Some examples of common Zoonotic diseases include lyme disease, rabies, ringworm, and plague. . Zoonoses have been known since early historical spells. There are holy references to infection, a bacterial zoonoses mainly transmitted to humans by fleas; and some historians contend that a disease first described by Thucydides during the Plague of Athens (430–425 B.C.E.) was typhus, a louse-borne zoonoses. ). Certain zoonoses, such as yellow fever, malaria, and rabies, are well known to the general public, but a vast number of lesser-known zoonoses exist in limited cycles in different parts of the world. There are undoubtedly many zoonoses waiting in nature that have the potential to cause serious public health consequences if introduced into humans.

Figure 1: Cycle of M. Bovis Transmission between cattle and humans. The thickness of the arrows Suggests level of probability *

Figure 2: Spread of Brucellosis between cattle& Humans *
Statement of the Problem:

The Department of Livestock services (DLS) has made several efforts to implement the regulation in Pishin district of Baluchistan. In spite of such efforts are in place, consumers are forced to use unhygienic and inadequate meat and milk; they are bound to live with the risk of meat borne diseases; and various cases of frauds precipitate from time to time The demand of meat and meat products are higher than the existing supply for which meat industry depends on import of live animals from different areas. The demand for meat is greater than the supply from domestic sources. In this vein, fewer literatures maintain that the prevailing supply deficit is not only due to deficit number of food animals in Pishin but also due to non-acceptance of locally produced meat by the residents. There is lack of research activities on meat borne diseases; it is occasional and isolated in nature, and the results of most of them remain as undocumented findings. Some of the Literatures report the prevalence of bacterial, viral and parasitic diseases as meat borne zoonoses in district Pishin. Some of them are brucellosis, tuberculosis & many other Zoonotic diseases. Few literatures argue that the effect of zoonoses might be little through meat consumption in Pishin due to superior cooking style – frying the meat and then cooking in the pressure cooker – nevertheless, it does not rule out the absence of the spore forming pathogens and possibly their in-built toxins in the cooked meat. Regarding the presence of pathogenic microorganisms, Gautam 2005 cited in Sankhi (2006:110) has detected Salmonella Spp in buffalo meat, mutton and chicken; and Escherichia coli has been reported as the predominant bacteria followed by Staphylococcus and Salmonella Spp, and other bacteria of Entero-bacteriaceae family in raw meat obtained from buffalo, goat, cow, sheep and poultry in Pishin. Some of these reported bacteria are potent producers of toxins which causes death of humans. Given these situations, it is apparent that the meat and milk products procured, processed and marketed in the area is unsafe for human consumption posing potential public health hazards. A similar major concern of meat sector in Pishin is pollution of environment due to the waste products of meat emitted from slaughtering and dressing operation. The slaughter sites are lacking proper drainage channels as well as waste disposal system; waste materials are disposed into municipality waste tank, streets and open areas.
Infectious diseases * Major cause of deaths in humans * Major economic losses in domestic animals * Major cause of wildlife destruction * Major impact on developing countries and poverty
Issues includes * What is the current status of these infectious diseases?(T.B & Brucellosis) * Do we know what really cause these diseases? * What would we need to know to predict the emergence and re-emergence of a disease?

Research Hypotheses:

This Awareness among meat occupational and consumers helps implementation of the Slaughterhouse and Meat Inspection Act in Pishin district. Provision of sufficient regulatory infrastructures supports the implementation of Slaughterhouse and Meat Inspection Act in.

Significance of the Study: The present study finds a great opportunity to carry out research in the area of meat and milk business in Pishin with particular emphasis to ascertain the implementation status of Slaughterhouse and Meat Inspection Act in. Various findings of this study are helpful in bridging the knowledge gap existing in the available literatures related to execution of meat legislation in the area. Besides, the study opens up various dimensions for the research activities regarding policy implementation process in meat sector in the country. The government authority can have the opportunity to bring necessary adjustments in its existing policies, strategies, and programmes and activities based on the various findings of the present research study. Purpose of the Research: * To see the animals infected with Zoonotic diseases (Tuberculosis & Brucellosis) in Pishin district. * To screen out carrier animals in the area thus to develop strategies to prevent Brucellosis and tuberculosis in the area.
Literature Review

Zoonotic diseases are caused by many different pathogenic agents. In most cases, humans are accidental or ‘‘spill-over’’ hosts of a disease-ecological cycle maintained by animal hosts, including insects (Kayali et al. 2003; Schelling et al. 2003). Because of the circulation of Zoonotic agents between animals, humans, and the environment, the cost of a disease affects human activity and health in addition to other economic sectors. According to the Institute of Medicine (2009), Zoonotic pathogens caused more than 65% of emerging infectious disease events in the past six decades. The direct cost of Zoonotic diseases over the last decade has been estimated to be more than $20 billion with over $200 billion indirect losses to affected economies as a whole (World Bank 2010). In the last 60 years, many industrialized countries have successfully controlled or eliminated Zoonotic diseases through costly public investment facilitating coordinated interventions, including ‘‘test and slaughter,’’ feed bans, mass vaccination of domestic animals and wildlife, health education and milk pasteurization.

These are highly effective methods of eliminating Zoonotic diseases which require important operational, legal, and financial collaterals (Keusch et al. 2009). In most developing countries, surveillance of Zoonotic diseases is not recognized as ‘‘one-health’’ collaboration between veterinary medicine and human medicine. In addition, many countries lack diagnostic capacity and health infrastructure. In livestock populations efforts have primarily focused on implementing prevention and eradication measures with much less emphasis on the effect of mitigation (transmission control) strategies, taking into consideration economic and development impacts at the macro (national economy, environment) or micro (health, livelihoods, food security of smallholder farmers) levels. Many industrialized countries are able to control or reduce the risk of Zoonotic diseases through public investment in preventative measures such as surveillance and compensation of farmers for culled stock in the event of an outbreak.

In April 2001, the British government slaughtered and destroyed more than 2 million animals in England to stop the spread of foot-and-mouth disease (Sobrino and Domingo 2001). Such interventions are not feasible in many developing countries because of poor surveillance programs, limited institutional capacity, and, without donor assistance, lack of funds for livestock holder and compensation (Zinsstag et al. 2007).

This issue is illustrated by the limited effectiveness of the response following the HPAI outbreak in 2006–2008. Education programs to increase producer level bio-security measures were implemented in developing countries without careful consideration of how to alter behaviour of small scale producers sustainably, despite high level ministerial support (Narrod et al. 2011). Successful investment in zoonoses control requires assessment of the cost of disease and the cost-effectiveness of proposed interventions, in addition to adaptation of the interventions to the local context. Given that 70% of the world’s rural poor depend on livestock and working animals for their livelihoods, animals cannot be left out of the solutions (LID 1999; FAO 2002).

Economic impacts exist beyond the cost of control, including direct decreases in household income due to reduction in livestock/product sales, consumption impacts due to reduced food security, increased household vulnerability where livestock is used as a risk-coping mechanism and effects on household wealth which influence savings and gender equality (Birol et al. 2010). In addition there are impacts at the sector level, such as the feed and input sector or the broader economy which includes other analyzable input and output sectors (see You and Diao 2007; Diao et al. 2009). These associated costs may influence behavioural change at different levels (household, practitioners, policy) which is important to the decision-making process.

A ‘‘one health’’ approach demonstrates closer cooperation between human and animal health resulting in benefits that are not achieved through the two medicines working independently. ‘‘One health’’ evolved from ‘‘one medicine,’’ a term coined by veterinary epidemiologist Calvin Schwabe in the 1960s to demonstrate that there is no paradigm difference between human and veterinary medicine thus allowing for integrated work (Schwabe 1984).

To date, there have been limited efforts to conduct integrated analyses considering both the social and ecological systems, although this approach is not conceptually new having been successfully applied in an ‘‘ecosystem approach to health’’ or ‘‘Eco health’’ (Forget and Label 2001). We suggest that such an approach has enormous potential to improve public and animal health and provide cost savings in the public and private sectors. Sampling humans and animals simultaneously in an integrated study design decreases detection time for zoonotic disease (Schelling et al. 2003; Zinsstag et al. 2009a). Through integrated analysis, the full societal cost of disease can be estimated linking an animal– human transmission model to cross-sector economic analysis to show the full societal cost (Roth et al. 2003, Zinsstag et al. 2005a).

The cost of livestock mass vaccination is often much higher than the public health benefit savings. Singularly from a public health perspective, such interventions are not cost-effective. An example is brucellosis control in Mongolia, where the intervention costs are less than a third of the overall cost of disease, when the private and agricultural sectors are included, with a societal benefit-cost ratio of 3.2 (Roth et al. 2003). Assessing the cost of zoonoses in multiple sectors facilitates identification of cost-sharing options such as a separable cost method.

Although brucellosis control by livestock mass vaccination is not cost-effective from a public health sector perspective, it becomes highly cost-effective when costs are shared between the public health and agricultural sectors in proportion to their benefits (Roth et al. 2003). Integrated assessments are hence crucial for Zoonotic disease control in resource poor countries (Zinsstag et al. 2007). The goal of the framework is to link the analysis outputs of animal safety at a given cost. At best, mitigation is negotiated with all stakeholders, communities, authorities, and scientists in participatory trans disciplinary processes (Schelling 2008; Zinsstag 2007).

Risk managers can choose strategies depending on the risk preferences for affected stakeholders and comparative advantages in implementing risk-reduction options. It is difficult to compare strategies which consider risk reductions and others evaluating costs and benefits. Despite good intentions, decisions can lead to losses in social welfare through unexpected outcomes and consequences. Decision makers would be aided by a framework which structures complex information and accounts for implications of the intricacy. Materials & Methods | Number | Cattle | 202611 | Sheep/Goats | 4,40,637 | Draught Animals | 5232 | Camels | 305 | Livestock Unit (LU) | 2,45,016 |

Table 1: Animal Count Pishin Dist. (2005)
Draught animals are horses, mules, donkeys
A livestock unit (LU) is a comparative unit, based on its fodder requirements, through which all livestock can be summarised; e.g. a cow, bull, camel and horse are defined as 1 LU, while a sheep; goat and donkey are defined as 0.5 LU.

The grazing capacity of an area is defined in the same way as the carrying capacity: For our purpose it is defined that one livestock unit can optimally survive on one hectare of are under fodder and range land (range land being forest area and area under pastures).
The grazing capacity = Rangeland + area under fodder / livestock units

Pishin district lies between 30° 04’ to 31° 17’ north latitudes and 66° 13’ to 67° 50’ east longitudes..The district Pishin was a part of Quetta. In 1975 it was separated from Quetta for administrative reasons. It derives its name from the locality Pishin. Pishin is a modernised form of ‘Pushang’, which is Old Persian for the Arabic Fushang. The population of Pishin District was estimated to be over 500,000 in (2005), with 99.9% of the population being Pashtun.

We use the following methods for the sample collection of Tuberculosis and Brucellosis in district Pishin. The methods are

1. Tuberculosis * Tuberculin Test * Nasal secretion samples were taken 2. Brucellosis * For brucellosis blood samples and aborted foetus were taken Results / Discussion

A randomized research was conducted of five hundred (n=500) samples of domesticated animals in Pishin district for Tuberculosis & Brucellosis. Animals include a random ratio of sheep, goat, cow and buffaloes. I had found 3 positive samples out of 500. The name of the villages where I found positive samples is 1. Ajram 2. Daman
During survey of the meat and milk occupational, observations of their meat and milk establishments were also carried out. The unmanaged disposal of wastes has several implications i.e. the environment of the city contains high level of microbes in the form of dusts and droplets leading to aerosol mode of transmission of meat and milk borne Zoonotic diseases. The overall effect of the study can reduce the control of disease outbreak very difficult.

In Pishin district, the proportion of people relying on live- stock for some or all of their livelihoods is high, ranging from 20% to over 60%, depending on the livestock production system and region.
In both pastoral and mixed agricultural/rural systems, people live closely with livestock populations that have a high prevalence of brucellosis, & Tuberculosis making these individuals at higher risk of infection. Brucellosis is known to have a great impact on economic development, both in terms of direct losses (morbidity, mortality) and indirect losses, including costs associated with ineffective control measures.

However, this is the first study to evaluate quality of life of patients with brucellosis compared to a control population. In the current study, the General Health domain had the lowest mean value in the group of patients with brucellosis and Tuberculosis.
The General Health domain reflects an individual’s perceptions of his or her general health status. Disease, such as brucellosis, can result in poor physical activity, an increasingly sedentary lifestyle, depression, and dependency on others. When these factors are combined with poor socioeconomic status and lack of insurance, this can result in an even more negative perception of current and future health.

In Pishin, brucellosis continues to be a problem due to certain traditions and customs associated with food preparation and a lack of health programs designed to teach people about the safety concerns associated with living and working closely with livestock. Much of the rural population of Pishin has a low economic status, with many families now relying on funds sent from family members who have immigrated to other areas, Differences in quality of life between rural and urban area patients are most likely due to the additional socio-economic hardships that the rural population must endure.

The results of this study indicate that brucellosis does appear to negatively impact the welfare and quality of life of patients and that this disease has the largest impact on those least equipped to handle additional stress and poor health. The data presented here reinforce the hypothesis that socioeconomics can impact quality of life associated with a certain disease or condition and that those most affected are often times individuals living in territories that are behind in their development of health and disease prevention strategies. This necessitates the need for better education and public health programs aimed at these high risk populations.

Conclusions

Animal and human health is inseparably linked and food animals, especially cattle serve as a reservoir of diseases of public health importance.

The safety of food of animal origin with regard to infection by M. Bovis & Brucella spp is worth giving consideration, taking into knowledge the current tuberculosis& Brucellosis wrecking the world. Though animals with these diseases pose risk to humans, this risk is extremely remote in developed countries due to introduction of milk pasteurisation and effective bovine tuberculosis control programmes (Shitaye et al., 2006).
In contrast, spread from animals to humans in developing countries remains a very real danger, mostly from infected milk. This seems to be a danger, which is being entirely ignored (Davies, 2006). The animal and public health consequences of M. Bovis & Brucella are grave.

Disease surveillance programmes in animals and humans should be considered a priority, especially in areas where risk factors are present. Other recommendations made by the WHO (1994) in its message on Zoonotic diseases include: Training of personnel at all levels of control programmes and the urgent need for further research on the diagnosis and control, immunological, epidemiological and socioeconomic aspects of these diseases.

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