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Social and environmental factors affect tuberculosis related mortality in wild meerkats.

ABSTRACT: Tuberculosis (TB) is an important and widespread disease of wildlife, livestock and humans world-wide, but long-term empirical datasets describing this condition are rare. A population of meerkats (Suricata suricatta) in South Africa's Kalahari Desert have been diagnosed with Mycobacterium suricattae, a novel strain of TB, causing fatal disease in this group-living species. This study aimed to find characteristics associated with clinical TB in meerkats. These characteristics could subsequently be used to identify 'at-risk' animals within a population, and target these individuals for control measures. We conducted a retrospective study based on a unique, long-term life-history dataset of over 2000 individually identified animals covering a 14-year period after the first confirmatory diagnosis of TB in this population in 2001. Individual- and group-level risk factors were analysed using time-dependent Cox regression to examine their potential influence on the time to development of end-stage TB. Cases of disease involved 144 individuals in 27 of 73 social groups, across 12 of 14 years (an incidence rate of 3·78 cases/100 study years). At the individual level, increasing age had the greatest effect on risk of disease with a hazard ratio of 4·70 (95% CI: 1·92-11·53, P < 0·01) for meerkats aged 24-48 months, and a hazard ratio of 9·36 (3·34-26·25, P < 0·001) for animals aged over 48 months (both age categories compared with animals aged below 24 months). Previous group history of TB increased the hazard by a factor of 4·29 (2·00-9·17, P < 0·01), and an interaction was found between this variable and age. At a group level, immigrations of new group members in the previous year increased hazard by a factor of 3·00 (1·23-7·34, P = 0·016). There was weaker evidence of an environmental effect with a hazard ratio for a low rainfall (<200 mm) year of 2·28 (0·91-5·72, P = 0·079). Our findings identify potential individual characteristics on which to base targeted control measures such as vaccination. Additional data on the dynamics of the infection status of individuals and how this changes over time would complement these findings by enhancing understanding of disease progression and transmission, and thus the implications of potential management measures.

SUBMITTER: Patterson S

PROVIDER: S-EPMC5413830 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

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Social and environmental factors affect tuberculosis related mortality in wild meerkats.

Patterson Stuart S Drewe Julian A JA Pfeiffer Dirk U DU Clutton-Brock Tim H TH

The Journal of animal ecology 20170403 3

Tuberculosis (TB) is an important and widespread disease of wildlife, livestock and humans world-wide, but long-term empirical datasets describing this condition are rare. A population of meerkats (Suricata suricatta) in South Africa's Kalahari Desert have been diagnosed with Mycobacterium suricattae, a novel strain of TB, causing fatal disease in this group-living species. This study aimed to find characteristics associated with clinical TB in meerkats. These characteristics could subsequently ...[more]

PMID: 28186336

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Project description:The aim of our study was to evaluate the seasonal variations and whether short-term exposure to environmental risk factors, such as climate and air pollution, is associated with PTB-related hospital admissions in human immunodeficiency virus (HIV)-infected patients in Spain during the era of combined antiretroviral therapy (cART). A retrospective study was carried out using data from the Minimum Basic Data Set (MBDS) and the State Meteorological Agency (AEMET) of Spain. The primary outcome variable was hospital admissions with PTB diagnosis. The environmental risk factors evaluated were season, temperature, humidity, NO2, SO2, O3, PM10, and CO. Overall, HIV-infected patients had a lower frequency of PTB-related hospital admissions in summer (22.8%) and autumn (22.4%), but higher values in winter (26.6%) and spring (28.2%). Using a Bayesian temporal model, PTB-related hospital admissions were less frequent in summer-autumn and more abundant in winter-spring during the first years of follow-up. During the later years of follow-up, the seasonal trends continued resulting in the lowest values in autumn and the highest in spring. When considering short-term exposure to environmental risk factors, lower temperatures at 1 week (odds ratio (OR) = 1.03; p = 0.008), 1.5 weeks (OR = 1.03; p<0.001), 2 weeks (OR = 1.04; p<0.001), and 3 weeks (OR = 1.03; p<0.001) prior to PTB admission. In addition, higher concentration of NO2 at the time of admission were significantly associated with higher likelihoods of PTB-related hospital admission in HIV-infected patients when 1.5 weeks (OR = 1.1; p = 0.044) and 2 weeks (OR = 1.21; p<0.001) were used as controls. Finally, higher concentration of SO2 at 1.5 weeks prior to PTB admission was significantly associated with a higher likelihood of PTB-related hospital admissions (OR = 0.92; p = 0.029). In conclusion, our data suggest an apparent seasonal variation in hospital admissions of HIV-infected patients with a PTB diagnosis (summer/autumn vs. winter/spring), as well as a link to short-term exposure to environmental risk factors, such as temperature and ambient NO2 and SO2.

Project description:BACKGROUND:While most child deaths are caused by highly preventable and treatable diseases such as pneumonia, diarrhea, and malaria, several sociodemographic, cultural and health system factors work against children surviving from these diseases. METHODS:A retrospective verbal/social autopsy survey was conducted in 2012 to measure the biological causes and social determinants of under-five years old deaths from 2007 to 2010 in Doume, Nguelemendouka, and Abong-Mbang health districts in the Eastern Region of Cameroon. The present study sought to identify important sociodemographic and household characteristics of the 1-59 month old deaths, including the coverage of key preventive indicators of normal child care, and illness recognition and care-seeking for the children along the Pathway to Survival model. FINDINGS:Of the 635 deceased children with a completed interview, just 26.8% and 11.2% lived in households with an improved source of drinking water and sanitation, respectively. Almost all of the households (96.1%) used firewood for cooking, and 79.2% (n?=?187) of the 236 mothers who cooked inside their home usually had their children beside them when they cooked. When 614 of the children became fatally ill, the majority (83.7%) of caregivers sought or tried to seek formal health care, but with a median delay of 2 days from illness onset to the decision to seek formal care. As a result, many (n?=?111) children were taken for care only after their illness progressed from mild or moderate to severe. The main barriers to accessing the formal health system were the expenses for transportation, health care and other related costs. CONCLUSIONS:The most common social factors that contributed to the deaths of 1-59-month old children in the study setting included poor living conditions, prevailing customs that led to exposure to indoor smoke, and health-related behaviors such as delaying the decision to seek care. Increasing caregivers' ability to recognize the danger signs of childhood illnesses and to facilitate timely and appropriate health care-seeking, and improving standards of living such that parents or caregivers can overcome the economic obstacles, are measures that could make a difference in the survival of the ill children in the study area.

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Social and environmental factors affect tuberculosis related mortality in wild meerkats.

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Social and environmental factors affect tuberculosis related mortality in wild meerkats.

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