Identifying high-risk profile patients for zoonotic tuberculosis in Mubende district, Uganda

Background: Zoonotic Tuberculosis (ZTB) in humans caused by Mycobacterium bovis (M.<br/>bovis), the causal agent of bovine TB, remains an important challenge in terms of diagnosis.<br/>Recently (2017), a novel lateral flow immunochromatographic device (LFD) antibody test was<br/>developed and evaluated for the specific detection of M. bovis in veterinary samples. The<br/>objectives of this study were to: 1) use the LFD to screen a group of human samples from TB<br/>suspect patients in Mubende district, and 2) assess sociocultural practices from patients<br/>testing positive to M. bovis by the LFD assay.<br/>Methods: 125 patients having a cough for at least two weeks and a smear positive sputum test<br/>were interviewed between August 30 , 2016 and June 29, 2017 at the Mubende Regional<br/>Referral Hospital, Kasambya, Kiganda, Kassanda, Bukuya health centers. Sputum samples<br/>were collected by qualified and experienced medical personnel, cultured and then tested using<br/>the LFD test.<br/>Results: The LFD assay detected 22 (17.6%, 95% CI: 11-25%) M. bovis positive sputum<br/>cultures among all TB suspect patients. More than half (56%) of these patients reported<br/>eating/drinking unpasteurized dairy products, and 78% reported eating uncooked meat. Finally,<br/>19 of these LFD positive patients (82.6%) worked in proximity to animals (all of them as<br/>farmers). All but one of the 22 LFD positive patients (21 (95.4%), 95% CI: 77 - 99%) were<br/>confirmed as Mycobacterium tuberculosis complex positive by the HAIN test.<br/>Conclusions: The results using the novel LFD assay agree with previous results published for<br/>rural areas in Africa with similar socio-cultural eating practices, and therefore, this study<br/>highlights the importance to further investigate the use of appropriate tools and methods to<br/>correctly identify M. bovis as the potential cause of human TB among patients in such high-risk<br/>communities.