Mansur ud Din Ahmad

Zoonotic tuberculosis in occupationally exposed groups in Pakistan

BACKGROUND Bovine tuberculosis (bTB) remains a public health threat in low-income countries. Data on human tuberculosis (TB) due to Mycobacterium bovis are poorly documented in developing countries. AIMS To determine the occurrence of active pulmonary TB due to M. bovis in abattoir workers, butchers, livestock farmers and veterinarians and to document their knowledge and practices regarding bTB. METHODS A cross-sectional study of abattoir workers, butchers, livestock farmers, veterinary doctors and veterinary assistants, which obtained data on socio-demographic conditions, knowledge and practices regarding TB. Sputum samples were collected from respondents with a chronic cough. The chi-squared test was used for statistical analysis. RESULTS A total of 141 abattoir workers, 317 butchers, 50 livestock farmers, five veterinary doctors and three veterinary assistants took part. Four out of 16 abattoir workers and 1 out of 50 livestock farmers were positive for M. bovis by PCR analysis. Duration of work as an abattoir worker was significantly associated (P < 0.05) with prevalence of zoonotic TB. The knowledge of abattoir workers, butchers, livestock farmers and veterinary assistants regarding transmission of bTB from animals to humans and the symptoms of TB in humans was very poor. Most of these workers did not use protective equipment and appropriate safe working techniques and were considered at high risk of acquiring zoonotic TB. CONCLUSIONS Zoonotic TB is a significant public health issue among professionally exposed groups in Peshawar, Pakistan and suggests a need for further detailed investigations of the disease in this and similar areas.

Prevalence and molecular diagnosis of Trypanosoma evansi in Nili-Ravi buffalo (Bubalus bubalis) in different districts of Punjab (Pakistan)

The prevalence of Trypanosoma evansi was investigated in 1,250 Nili-Ravi buffaloes of mixed age and sex by polymerase chain reaction (PCR) for the first time in Pakistan. DNA of the trypanosomes was isolated with TRIREAGENT®. The assay was employed using primers ESAG 6/7, specific for a 237-bp fragment from T. evansi genomic DNA. The samples were screened for the presence of T. evansi also by stained thin smear. Forty-four (3.5%) samples were positive by microscopy, while 97 (7.7%) samples were identified by PCR, indicating the high sensitivity of PCR for surveying the disease in epidemiological studies.

Molecular Epidemiology of a novel re-assorted epidemic strain of equine influenza virus in Pakistan in 2015–16

BACKGROUND A widespread epidemic of equine influenza (EI) occurred in nonvaccinated equine population across multiple districts in Khyber Pakhtunkhwa Province of Pakistan during 2015-2016. OBJECTIVES AND METHODS An epidemiological surveillance study was conducted from Oct 2015 to April 2016 to investigate the outbreak. EI virus strains were isolated in embryonated eggs from suspected equines swab samples and were subjected to genome sequencing using M13 tagged segment specific primers. Phylogenetic analyses of the nucleotide sequences were concluded using Geneious. Haemagglutinin (HA), Neuraminidase (NA), Matrix (M) and nucleoprotein (NP) genes nucleotide and amino acid sequences of the isolated viruses were aligned with those of OIE recommended, FC-1, FC-2, and contemporary isolates of influenza A viruses from other species. RESULTS HA and NA genes amino acid sequences were very similar to Tennessee/14 and Malaysia/15 of FC-1 and clustered with the contemporary isolates recently reported in the USA. Phylogenetic analysis showed that these viruses were mostly identical (with 99.6% and 97.4% nucleotide homology) to, and were reassortants containing chicken/Pakistan/14 (H7N3) and Canine/Beijing/10 (H3N2) like M and NP genes. Genetic analysis indicated that A/equine/Pakistan/16 viruses were most probably the result of several re-assortments between the co-circulating avian and equine viruses, and were genetically unlike the other equine viruses due to the presence of H7N3 or H3N2 like M and NP genes. CONCLUSION Epidemiological data analysis indicated the potential chance of mixed, and management such as mixed farming system by keeping equine, canine and backyard poultry together in confined premises as the greater risk factors responsible for the re-assortments. Other factors might have contributed to the spread of the epidemic, including low awareness level, poor control of equine movements, and absence of border control disease strategies.

Assessment of knowledge, attitude and practice towards post exposure prophylaxis for HIV among health care professionals in Lahore

HIV infections in health care workers have become a major health problem especially in developing countries in these days. Most in poor resource setting HCWs dealing with large number of HIV infected patients. This situation raises the need for post exposure prophylaxis (PEP) for HIV exposed group really important. Considering this a cross sectional survey was conducted in general and governmental hospitals of district Lahore Pakistan to asses Knowledge, attitude and practice of HCWs regarding PEP for HIV. Response regarding Knowledge, attitude and practice of 609 HCWs were entered on a predesigned self explanatory questionnaire. Descriptive analysis of the data showed that almost half of the HCWs have never heard about PEP. 68% of HCWs were of the opinion that PEP guidelines should not be listed in the working area or they responded with no idea regarding PEP. A good number of HCWs almost 47.2% believed PEP non protective against HIV or either did not have knowledge about it. Significant proportion (>50%) of the respondents were found having in adequate knowledge and improper attitude towards PEP. 35.3% of the respondents were placed on PEP after exposure while rest of the HCWs were not or either did not have idea about PEP. It was concluded that knowledge and attitude of HCWs about HIV for PEP was just satisfactory, consequently formal training for HCWs about PEP for HIV is recommended.

Investigating the epidemiology of EI epidemic spread in the Province of Khyber Pakhtunkhwa, Pakistan in 2015–16

EI in non-vaccinated population causes disruption and economic losses. To identify the risk factors associated with the EI epidemics in equids in Pakistan, a 1:1 matched case control study was conducted during 2015-2016. Including a total of 197 laboratory confirmed cases and negative controls, matched on the basis of geography, time of sampling, specie and age. A piloted questionnaire was used to collect data regarding risk factors associated with the occurrence of EI in face to face interviews. Conditional logistic regression was performed to analyze the data. A total of 16 out of 23 variables were found associated as risk factors in Univariable conditional logistic regression analysis. Multivariable conditional logistic-regression analysis was also performed. Monthly removal of manure doubles the risk of EI (EI) compared to its daily removal. Due to lack of vaccination; the spread of disease was favored by high equine density. Investigating the index-case it was recorded that infected cases were imported from Afghanistan. Most of these risk factors related to biosecurity and management were due to low awareness level regarding EI amongst the respondents. These findings are in line with the results of many other studies identifying similar risk factors for EI infection in various countries. Adopting protective practices, vaccination and controlling the risk factors identified in the present study could reduce the spread and future outbreaks of EI in Pakistan.

An epidemiological investigation of associated risk factors with equine influenza (H3N8) epidemic 2015–16 in Pakistan

Infection with equine influenza viruses in unvaccinated population could cause large-scale morbidity leading to huge economic losses compromising equine welfare in developing countries. Here we conducted a matched case-control study to identify the potential risk factors responsible for the EI epidemic in Pakistan in the year 2015-16. Total of 197 laboratory-confirmed matched pairs of cases and controls were included in the study. A predesigned questionnaire-based epidemiological data was collected for this purpose from all the matched pairs respondents. Conditional logistic regression analysis was conducted analyzing the data. Multivariable regression analysis identified local equine density and frequency of manure removal as potential risk factors for the incidence of EI. Due to lack of vaccination, the spread of EI was favored supported by many infected equine population free movements. The first case of this epidemic was imported from Afghanistan which was considered as a source case for the epidemic. Management and biosecurity practices compliance was very low due to lack of awareness amongst the respondents. These findings agree with the previous findings in various developing countries. Strategic control of infected equines free movement and vaccination of the equine population are suggested in future to control such epidemics.

Occurrence of Campylobacter in retail meat in Lahore, Pakistan

Campylobacter, one of the emerging zoonotic pathogens, is worldwide in distribution. This thermo-tolerant pathogen is one of the leading causes of diarrhea and gastroenteritis in humans. The main sources of infection are contaminated meat and meat products. A cross-sectional study was conducted to estimate the prevalence of Campylobacter species in retail meat in the Lahore district of Pakistan from September 2014 to January 2015. A total of 600 samples (200 samples each of beef, mutton, and chicken) were collected from retail shops through convenience sampling and preceded for Campylobacter contamination using the ISO 10272-1:2006 (E) method. Campylobacter was present in all three types of meat; the highest prevalence being recorded in chicken meat (29%) followed by mutton (18%) and beef (15.5%). Campylobacters were isolated from 125 (20.8%) samples out of the 600 meat samples. Campylobacter jejuni was more common (74.4%) than C. coli (25.6%). The highest number of Campylobacters were isolated in September (25/125) and November (23/125) while low numbers were isolated in October and December with isolates rate of (17/125) and (19/125), respectively. The highest prevalence was seen in the oldest and overpopulated town of Data Gunj Bakhsh 16% (20/125) while lowest prevalence was seen in a newer and least populated town of Gulburg (7/125). These results indicate that Campylobacter species are circulating in various meat sources in Lahore and that it may pose a threat to public health.

Occurrence of zoonotic tuberculosis in occupationally exposed high-risk groups in Peshawar, Pakistan

Objective/background: To determine the occurrence of active pulmonary tuberculosis (TB) due to Mycobacterium bovis in abattoir workers, butchers, livestock farmers, and veterinarians and to document their knowledge and practices regarding bovine TB (bTB). Methods: A cross-sectional study was conducted among abattoir workers, butchers, livestock farmers, veterinary doctors, and veterinary assistants. Sputum samples were collected from the respondents with a chronic cough and data on sociodemographic conditions, knowledge, and practices regarding TB were obtained. The chi-square test was used for statistical analysis. Results: A total of 141 abattoir workers, 317 butchers, 50 livestock farmers, five veterinary doctors, and three veterinary assistants took part. Four of 16 coughing abattoir workers and one of 50 coughing livestock farmers were positive for M. bovis by polymerase chain reaction analysis. Duration of work as an abattoir worker was significantly associated (p <0.05) with prevalence of zoonotic TB. Age, education, and type of work carried out by workers were not significantly associated with zoonotic TB. None of the abattoir workers, butchers, and livestock farmers had undergone any sort of formal training related to their work. The knowledge of abattoir workers, butchers, livestock farmers, and veterinary assistants regarding transmission of bTB from animals to humans and the symptoms of TB in humans was very poor. Most of these workers did not use protective equipment and appropriate safe working techniques and were considered at high risk of acquiring zoonotic TB. Conclusion: Zoonotic TB is a significant public health issue among professionally exposed groups in Peshawar, Pakistan, and suggests a need for further detailed investigations of the disease in this and similar areas.

CERTAIN INTEGRALS INVOLVING LOGARITHMIC AND EXPONENTIAL FUNCTIONS

In this paper we have evaluated the integrals∫0∞xn−1lnxexp(−ax−bx−1)dxand∫0∞xn−2(ax2−b)(lnx)2exp(−ax−bx−1)dxfor all n=1,2,3,…. Some applications of the results are discussed and an open problem is posed.