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Tuberculosis control in animals and humans alike requires early detection of Mycobacterium tuberculosis complex as well as current knowledge about the transmission patterns of the disease in the respective populations. These two building blocks provide the foundation on which the disease control programs can build their policies to expediate control efforts. In this thesis we amalgamate molecular epidemiology, genomics, and proteomics. We studied the transmission pattern of M. tuberculosis and its evolution within a marginalized population. The patterns led to the identification of gaps in TB control policies in marginalized populations with little access to healthcare. Similarly, we studied the genomewide polymorphisms in a naturally attenuated strain - M. bovis strain Ravenel to elucidate possible mechanisms for its reduced virulence and pathogenicity. Insights gained from genome sequence analysis in conjunction with pathogenesis study for M. bovis Ravenel paved the pathway to defining the complex and multi-faceted reasons for attenuation of the oldest bacteria of the world. Next, pathogen-specific biomarkers were evaluated to assist in unambiguous disease detection across multiple host species. Discovery and validation of biomarkers work facilitated the field diagnostic applications for TB in animals and humans. This three-pronged approach developed in this study, understanding the genomic basis of attenuation, and enhanced field TB diagnostics in the animal-human interface.
Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
This book recounts the biology of M. bovis, followed by the status of bovine Tuberculosis (bTB) in African countries, primarily based on zoonotic and epidemiological field reports. Since the accumulation of data is valueless unless it led to practicable control measures, emphasis is put on locally adapted protocols for future control of the disease. In order to systematically evaluate the knowledge base of bTB, Epidemiologic Problem Oriented Approach (EPOA) methodology was used. The methodology is composed of two triads: i) the problem identification/characterization triad, which is mainly descriptive in nature, and ii) the problem management/solution/mitigation triad, which is mainly geared toward problem management/solution (see figure). The first triad comprises three pillars: i) agent ii) host, and iii) environment and the second one: i) therapeutics/treatment, ii) prevention/control, and iii) health maintenance/promotion. The two triads are linked together by the diagnostic procedure linkage. The systematic and detailed studies of the ‘Host-Agent-Environment’ interactions are the building blocks to the understanding of agent transmission pathways and disease spread. These may include data about the disease status of the country, the nature of the disease agent and its hosts, the modes of transmission, the wildlife reservoirs in nature, persistence of infection, and agent survival in animal products and the environment. The problem identification and characterization triad identifies these interactions. Once a problem has been identified and well understood, the next step is to minimize the risk of transmission and spread of a disease. This area, referred to as problem solution/management triad, consists of problem management alternatives that rely upon prevention/control, and health maintenance/promotion of the disease in livestock, wildlife, and humans with the emphasis on resource-poor, developing countries in Africa.
Tuberculosis (TB), which is caused by the infectious agent Mycobacterium tuberculosis (MTB), is a major global public health problem that infects one third of the world’s population. This book provides an overview of the molecular epidemiology pattern, transmission dynamics, host response, evolution, and pathogenesis mechanisms of TB. Chapters explore such topics as mechanisms associated with increasing trends of drug-resistant TB, the development of anti-mycobacterial drugs, genotyping tools, diagnosis and treatment of latent tuberculosis infection, and more.
Until about 10 years ago, the general view in the field was that Mycobacterium tuberculosis, the causative agent of human tuberculosis was a “clone” with insufficient natural sequence variation between clinical strains to be considered biologically and epidemiologically “relevant”. This view has now changed quite dramatically thanks to the –omics revolution, particularly the advent of next generation DNA sequencing. Large-scale comparative genomic studies over the last few years have revealed that M. tuberculosis clinical strains are more genetically diverse than appreciated previously. Moreover, an increasing number of experimental and epidemiological studies are showing that this genetic diversity also translates into important phenotypic variation. Taken together, these findings have led to a paradigm shift, such that currently phylogenetic diversity among M. tuberculosis clinical strains is being considered in the development of new tools to combat tuberculosis. The purpose of this book is to bring together a series of contributions from some of the most influential groups working on various aspects of M. tuberculosis diversity, and which through their work have contributed to the this paradigm shift. This includes authors focusing on the evolution of M. tuberculosis in relation to other members of the M. tuberculosis complex adapted to animals, the co-evolution between M. tuberculosis and humans, the phenotypic consequences of strains diversity both from an experimental and epidemiological point of view, the ecology and evolution of drug resistant tuberculosis, the diversity and evolution of the BCG vaccine strains, and the use of mathematical modelling to study strain diversity and drug resistance in human tuberculosis. No such book has ever been published, and given the paradigm shift described above, this book will be a valuable resource both for established researchers as well as new scientists, clinicians and public health officials joining the growing field of tuberculosis research.
Zoonotic Tuberculosis: Mycobacterium bovis and Other Pathogenic Mycobacteria, Third Edition is a comprehensive review of the state of the art in the control and elimination of infections caused by Mycobacterium tuberculosis complex in animals and humans. This update to the most complete and current reference available on Mycobacterium bovis includes new coverage of the latest molecular techniques; more information on human infection and One Health; updates to the information on the International Union Against Tuberculosis and Lung Disease (IUATLD), the World Health Organization (WHO), Pan American Health Organization (PAHO), and the United States Department of Agriculture’s (USDA) National Tuberculosis Eradication Program; and coverage of additional African countries. The Third Edition upholds the book’s reputation as a truly global resource on M. bovis. Written by an international list of tuberculosis experts, chapters cover the status of tuberculosis in many regions throughout the world and deal with issues related to the detection, spread, and control of Mycobacterium bovis, as well as the economic impact of outbreaks. Zoonotic Tuberculosis: Mycobacterium bovis and Other Pathogenic Mycobacteria offers valuable information for public health officials, medical doctors, state and federal regulatory veterinarians, veterinary practitioners, and animal caretakers.
Johne's Disease is a chronic, progressive intestinal disease caused by infection with Mycobacterium avium subspecies paratuberculosis (Map) that affects primarily ruminant animals. In recent decades there has been growing concern over the lack of effective control of this disease and questions have arisen regarding the possibility that Map infection could be a cause of some cases of Crohn's disease in humans. This report presents a broad outline of the steps that should be taken to control Johne's disease, reduce the spread of Map, and minimize effects of the disease in animals. The report also describes the weaknesses of our current research agenda and provides recommendations for a new research strategy to resolve the question of whether there is a link between Johne's and Crohn's diseases.
Genetics and Evolution of Infectious Diseases, Third Edition discusses the evolving field of infectious diseases and their continued impact on the health of populations, especially in resource-limited areas of the world where they must confront the dual burden of death and disability due to infectious and chronic illnesses. Although substantial gains have been made in public health interventions for the treatment, prevention, and control of infectious diseases, in recent decades the world has witnessed the emergence of the human immunodeficiency virus (HIV) and the COVID-19 pandemic, increasing antimicrobial resistance, and the emergence of many new bacterial, fungal, parasitic, and viral pathogens. Fully updated and revised, this new edition presents the consequences of such diseases, the evolution of infectious diseases, the genetics of host-pathogen relationship, and the control and prevention strategies that are, or can be, developed. This book offers valuable information to biomedical researchers, clinicians, public health practitioners, decisions-makers, and students and postgraduates studying infectious diseases, microbiology, medicine, and public health that is relevant to the control and prevention of neglected and emerging worldwide diseases. - Takes an integrated approach to infectious diseases - Provides the latest developments in the field of infectious diseases - Focuses on the contribution of evolutionary and genomic studies for the study and control of transmissible diseases - Includes updated and revised contributions from leading authorities, along with six new chapters
First edition published in 2002. Second edition published in 2008.
Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.