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‘One Health´ approach to end zoonotic TB

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Mycobacterium bovis has a wide host range causing TB in animals, both in wildlife and cattle (bovine TB bTB), and in humans (zoonotic TB zTB). The real burden of bovine and zoonotic TB (b/zTB) remains unknown due to diagnostic challenges. Although progress has been made to reduce the burden of TB, b/zTB has been neglected in low- and middle-income countries (LMICs) with little improvement in prevention, diagnosis or treatment. Using Tanzania as a case study, because of its high TB burden, large wildlife diversity and wide reliance on livestock, we developed an approach to comprehensively estimate the burden and implement multidisciplinary actions against b/zTB. We performed a review of the literature on b/zTB, but there is a lack of available data on the b/zTB burden in Tanzania and, notably, on epidemiological indicators other than incidence. We propose a five-action programme to address b/zTB in Tanzania, and we believe our proposed approach could benefit other LMICs as it operates by implementing and strengthening surveillance and health delivery. The resulting knowledge and system organisation could further prevent and mitigate the effects of such conditions on human and animal health, livestock production, population livelihood and the economy.

Keywords: epidemiology; one health; tuberculosis; zoonosis

Document Type: Review Article

Affiliations: 1: Centre for Multidisciplinary Research in Health Science, University of Milan, Milan, Italy 2: Division of Infectious Diseases and International Health, Duke University, Durham, NC, USA 3: Division of Infectious Diseases and International Health, Duke University, Durham, NC, USA, Duke Global Health Institute, Duke University, Durham, NC, USA, Kilimanjaro Christian Medical University College, Moshi, Tanzania 4: Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK 5: Kilimanjaro Christian Medical University College, Moshi, Tanzania, Kibong´oto Infectious Diseases Hospital, Moshi, Tanzania 6: Humanitas University, Milan, Italy 7: National Institute for Medical Research – Muhimbili Centre, Dar es Salaam, Tanzania, Liverpool School Tropical Medicine, Liverpool, UK 8: Kilimanjaro Christian Medical University College, Moshi, Tanzania, Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania 9: Division of Infectious Diseases and International Health, Duke University, Durham, NC, USA, Duke Global Health Institute, Duke University, Durham, NC, USA, Kilimanjaro Christian Medical University College, Moshi, Tanzania, Centre for International Health, University of Otago, Dunedin, New Zealand

Publication date: February 1, 2023

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