Development and evaluation of a health education module for the prevention of respiratory tract infections among private hajj and umrah pilgrims

Hajj pilgrimage is usually associated with a regular occurrence of respiratory tract infection among pilgrims. Vaccination uptake and other preventive behaviours have generally been low among pilgrims across the globe. Despite this, there is presently no validated health theory-based health education module in Malaysia to guide the pilgrims on how to boost compliance with these preventive practices and increase their knowledge towards respiratory tract infection, preventive attitudes and practices towards prevention strategies. The general objective of this study is to develop and evaluate the effectiveness of health education modules against respiratory tract infections among Hajj pilgrims from Malaysia. This study was carried out in phases comprising of development and validation of questionnaire phase, development and validation of health education module for respiratory tract infection prevention phase, baseline characterization of pilgrims’ phase, intervention phase and evaluation phase. At the first phase of the study, a cross-sectional study was conducted for the development and validation of a measurement tool using the content, construct (items response theory, exploratory factor analysis and confirmatory factor analysis) validation and reliability. This phase is followed by the development and validation of new health education module via a smartphone application. For the intervention and the evaluation phase, a quasi-experimental study was utilized, where pre-post intervention data were analysed among 52 and 50 Hajj/Umrah pilgrims in the intervention or control group respectively. The intervention group was given health education module on the prevention of respiratory tract infections during Hajj and Umrah in the form of a smartphone application which was strictly guided by the health belief model. The control group received a smartphone application on normal Hajj and Umrah guidance from a different Hajj/Umrah travel company. Follow-up data were collected using the same questionnaire that was used during the pre-test data collection. Mixed design repeated measure ANOVA was used to analyse the effect of group, time, and group-time interaction on the dependent variables. There was a significant improvement in knowledge score and the main effect in the intervention group compared to the control group, based on time (p = 0.005, ηp2 = 0.075). Likewise, there was significant improvement in attitude score and main effect based on time (p = 0.035, ηp2 = 0.044). Similarly, there was a significant change in practice score and also main effect based on time (p = <0.001, ηp2 = 0.155) and interaction of group with time (p = 0.042, ηp2 = 0.041). Similarly, the occurrence of RTI in the intervention group is lower when compared to the control group. The new health educational intervention module developed was effective in improving the knowledge, attitude and practices toward prevention of RTI among Hajj pilgrims from Malaysia. Further studies are also needed to investigate the barriers and motivators to link the knowledge gap about the uptake of mandatory and recommended vaccine as well as the other components of the module. Therefore, Hajj agencies need to conduct health education before departure of pilgrims to prepare them against the common respiratory infections or in the event of outbreaks of infection during Hajj/Umrah

Dissemination of resistance and virulence determinants in methicillin-resistant Staphylococcus aureus during colonization and disease: a review

The successful in vivo horizontal transfer of mobile genetic elements carrying resistance and virulence determinants have contributed immensely to a global dissemination of virulent and multi-drug resistant pathogens. The pathogenesis of MRSA infection is enhanced via initial colonization of the skin through the component of the microbial surface antigen recognizing adhesive matrix molecules and by their ability to evade host immune response. Furthermore, it was also observed that the genetic diversity of pathogenic MRSA is due to its’ ability to rapidly acquire resistance and virulence determinants. A characteristic feature that made it one of the most important nosocomial pathogen worldwide. Similarly, the expression of virulence gene in MRSA has been observed to be regulated by the accessory gene regulator system (agr). These system is made up of a series of genes whose product build up quorum-sensing regulatory mechanisms that is growth dependent. At a certain growth stage, the agr systems triggers a pronounced changes in the expression of genes called the quorum sensing. The findings of this review affirmed the importance of horizontal gene transfer in the dissemination of resistance and virulence determinants and as well as the genetic diversity of MRSA

Antibiotic resistance profiles of Staphylococcus pseudintermedius isolated from dogs and cats

Aims: Antibiotic resistance in Staphylococcus pseudintermedius is increasing gradually towards those antibiotics that are frequently used leading to limited therapeutic options due to multidrug resistance. The objectives of the study were to investigate the antibiotic resistance profiles of S. pseudintermedius isolates from pet and stray dogs and cats in Selangor, Malaysia and to detect the resistance genes (mecA and BlaZ) within the isolates. Methodology and results: A total of 200 stray and pet dogs and cats were sampled. The samples were cultured onto Mannitol Salt agar and all the presumptive colonies were subcultured, then identified using biochemical tests and confirmed by PCR assay targeting the nuc gene. The isolates were subjected to antibiotic susceptibility test against 12 antibiotics. Twenty three isolates (11.5%) were positive to S. pseudintermedius (stray cats, 11/50; stray dogs, 9/50; pet dogs, 3/50 and pet cats, 0/50). One hundred percent (100%) of the S. pseudintermedius isolates were found to be resistant to penicillin, erythromycin and tetracycline while they showed 100% susceptible to oxacillin, amoxicillinclavulanic acid, gentamicin, chloramphenicol, vancomycin, ciprofloxacin, enrofloxacin, cephalexin and rifampicin. The blaZ gene which codes for β-lactamases production was found in all of the isolates that were resistant to penicillin but not to methicillin. Conclusion, significance and impact of study: A high number of S. pseudintermedius from dogs and cats developed antibiotic resistance which is a public health concern

Occurrence of Campylobacter in dogs and cats in Selangor Malaysia and the associated risk factors

Aims: Campylobacter is the most widely reported zoonotic bacterial agent that causes enteric disease in humans worldwide with millions of cases recorded far exceeding salmonellosis in Europe and United States. The objective of this study was to determine the occurrence of Campylobacter in dogs and cats and their associated risk factors. Methodology and results: A total of 101 rectal swabs were collected from both pets (n=40) and stray dogs (n=61) for the study. Similarly, a total of 86 rectal swabs were taken from stray cats (n=46) and pet cats (n=40) from client pets at a university veterinary hospital and from stray dogs and cats from animal shelters. Campylobacter were isolated by culture, identified by biochemical tests and confirmed and speciated, using mPCR assay. The result showed occurrence of Campylobacter in stray dogs and stray cats were 16.3% and 32.6% respectively, while in pet dogs and cats were 12.5 % each. Based on the mPCR assay, three species of Campylobacter were identified in dogs namely Campylobacter upsaliensis (66.6%), C. jejuni (6.7%) and C. heliviticus (20%), while C. upsaliensis (55%), C. helviticus (20%) and C. jejuni (6.7%) were identified in cats. The risk factors for the presence of Campylobacter in the animals were analysed but none was significantly associated, however the occurrence in cats was found higher in adults, females, those kept outdoors and residing in town areas, multipets household, cats with no history of being given antibiotics in past infections and being fed on raw meat and fish while the occurrence of Campylobacter was high in dogs of local breeds, females, of young age, being kept outdoors and fed raw meat and fish. Conclusion, significance and impact of study: These findings showed that Campylobacter were quite prevalent in both stray and pet dogs and cats which may contaminate other animals and spread in the environment as Campylobacters. It is of public health concern as humans can contract the disease if they do not practice proper hygiene after coming into contact with an infected animal or contaminated environment

Occurrence and antibiotic resistance of Campylobacter and Arcobacter spp. in dogs and cats

Campylobacter and Arcobacter are becoming more recognised because of their detection in a wide range of hosts and food of animal origin. Campylobacter is considered one of the most common causes while Arcobacter has emerged as a cause of gastro-enteritis in humans and both are of public health concern. They are gram negative, curved, spiral or S- shaped and are members of the order Campylobacterales, class Epsilon and phylum Proteobacteria. Several studies have been conducted in developed countries on their occurrence and characterisation in dogs and cats but such studies are lacking in most developing nations like Malaysia. Due to this present scenario, this study was conducted to determine the presence of Campylobacter and Arcobacter in dogs and cats and to also determine antibiotic resistance patterns of the isolates. The presence of these organisms was determined using conventional and molecular techniques. For Arcobacter, rectal and buccal swab samples were collected from owned dogs (40) and cats (40) presented to the University Veterinary Hospital (UVH), Universiti Putra Malaysia (UPM) and a private veterinary clinic within Kuala Lumpur, and stray dogs (61) and cats (46) from an animal shelter and Dewan Bandaraya Kuala Lumpur (DBKL) dog pound. Rectal swabs were also taken for the detection of Campylobacter in these animals. Suspected colonies of the two organisms were subcultured and subjected to biochemical tests which included catalase, oxidase, hippurate hydrolysis and indoxyl acetate hydrolysis tests. Multiplex polymerase chain reaction (mPCR) was employed for the confirmation of the suspected isolates and differentiation of species. Overall, the results showed carriage rates of 32.6% (15/46) and 12.5% (5/40) of Campylobacter in stray and client owned cats respectively, while Arcobacter was detected in 34.78% (16/46) and 45% (18/40) in stray and client owned cats respectively. In stray dogs, Campylobacter and Arcobacter were detected at 16.3% (10/61) and at 50% (31/61) respectively. Arcobacter butzleri was the only species that was isolated and © COPYRIGHT UPM ii Campylobacter upsaliensis (60%), C. helviticus (20%) and C. jejuni (11.4%) were the species of Campylobacter isolated. Risk factors for Campylobacter and Arcobacter infections in dogs and cats were determined through questionnaires filled by pet owners. Among the factors that were looked at included age, sex, breed category, single or multi-pet household, recent treatment with antibiotic, housing of the dogs and cats, source of drinking water, contact with other animals, consumption of raw meat and fish and place of residence of the owner. Factors found to significantly increase the risk for Arcobacter infections were multi-pets household type and source of drinking water in cats while none were significant in the case of dogs. None of the factors analyzed was significant in terms of the occurrence of Campylobacter in both dogs and cats. Antibiotic resistance pattern using minimum inhibitory concentration (M.I.C) and disc diffusion methods were carried out. Eighty nine (89) Arcobacter butzleri and 28 Campylobacter isolates were tested against 12 antibiotics using the disc diffusion method namely ciprofloxacin (Cip) 5µg; ampicillin (Amp), 10 µg; tetracycline (Te), 30 µg; erythromycin (E), 15 µg; gentamicin (CN), 10 µg; cefotaxime (CTX), 30 µg; penicillin G (P), µg; streptomycin (S), µg; nalidixic acid (NA), µg; enrofloxacin (Enr), µg; amoxicillin/clavulanic acid (AMC), µg and ceftazidine (CAZ), µg. Four antibiotics, namely ampicillin, tetracycline, erythromycin and ciprofloxacin were used against Campylobacter and Arcobacter butzleri isolates for the M.I.C. Overall, the isolates were found resistant to at least one antibiotic using both techniques. For Campylobacter isolates, the resistance to the antibiotics using the disc diffusion method was as follows: ciprofloxacin (17.8%), gentamycin (32.1%), cefotaxime (42.8%), penicillin G (53.5%), tetracycline (32.1%), ampicillin (42.8%), erythromycin (50%), streptomycin (42.8%), nalidixic acid (46.4%), amoxycillin/clavulanic acid (17.8%), ceftazidine (50%) and enrofloxacin (21.4%). Using the M.I.C.E. strip (Oxoid), Campylobacter and A. butzleri isolates showed exception in the resistance to ciprofloxacin. For Arcobacter isolates the resistance to antibiotics using the disc diffusion was as follows: ciprofloxacin (2.1%), gentamicin (63.1%), cefotaxime (69.4%), penicillin G and ampicillin (98.9%), tetracycline (33.6%), erythromycin (53.6%), streptomycin (85.2%), nalidixic acid (61.0%), amoxycillin/clavulanic acid (43.1% ), ceftazidine (3.6%) and enrofloxacin (31.5%). In comparison, the resistance rates between the disc diffusion and M.I.C. were not significantly different. The antibiotic resistance showed and 35 patterns for Campylobacter and Arcobacter isolates respectively. Campylobacter isolates were found resistant to nine (9) antibiotics while Arcobacter showed resistance to ten (10) antibiotics. Multi drug resistance (MDR) was reported among 50% and 78.9% of Campylobacter and Arcobacter isolates respectively. It can be concluded that the occurrence of Campylobacter and Arcobacter species in dogs and cats is of great public health significance as pets are in close contact with humans. Good management and controlling the population of stray dogs and cats are key factors in preventing the spread of Campylobacter and Arcobacter in these animal species. Antibiotic resistance in Campylobacter and Arcobacter not only increases the risk of treatment failure in both humans and animals but also spreads antibiotic resistance genes

Feline hemotropic mycoplasmosis concurrent with bacterial cystitis in a domestic shorthair cat

Objective: The main aim of this case report is to present a case of feline hemotropic mycoplasmosis that occurred concurrently with bacterial cystitis following the bite. Material and methods: A 3-year-old intact male domestic shorthair cat weighing 3.7 kg was referred to the Universiti Malaysia Kelantan Veterinary Clinic with clinical signs of hematuria and dysuria. History revealed that it was managed outdoor, fed with kibbles and wet food, but with no vaccination and deworming. Upon physical examination, the cat had a dull appearance, pale mucous membrane, normal respiratory rate, hypothermia, and bradycardia. Upon the examination of the urogenital system, there were urine burns at the anal region, necrotized penile tip, and presence of bite wound observed at the perineal region. Turgid and enlarged urinary bladder was identified upon palpation. Results: Diagnostic investigation revealed the hemotropic mycoplasmosis via microscopy, while urine culture was positive for Escherichia coli infection. The cat was successfully treated symptomatically. Conclusion: However, the prognosis of this cat was guarded given that the anemia was unresolved at the point of discharge. [J Adv Vet Anim Res 2018; 5(4.000): 490-495

A retrospective study of bovine tuberculosis at the municipal abattoir of Bauchi State, Northeastern Nigeria

Background and Aim: Bovine tuberculosis (bTB) still remains a major zoonotic bacterial disease affecting livestock and humans worldwide. The disease remains a poorly managed tropical disease in most developing countries of the world; where in addition to productivity losses and significance in international trade, it posed a major public health threat to both humans and animals. A retrospective study was designed to investigate the occurrence of bTB lesions at Bauchi municipal abattoir. Materials and Methods: The study utilized abattoir records spanning a period of 10 years (2004-2013). The records indicated that a total of 1,08,638 heads of cattle comprising n = 56,070 males and n = 52,570 females were slaughtered at the municipal abattoir during the study period. Results: Of these heads, n = 1230 (1.13%) (95% confidence interval [CI]: 1.07, 1.19) had tuberculous lesions. The annual occurrence during the study period varied significantly (p<0.001) from 0.53% (95% CI: 0.40, 0.67) to 1.87% (95% CI: 1.66, 2.10) in 2010 and 2012, respectively. Females had a significantly higher (p<0.001) prevalence of 2.10% (95% CI: 1.98, 2.23) compared with the males 0.23% (95% CI: 0.19, 0.27). The distribution of suspected gross bTB lesions in different organs showed 11.87% in the lungs, 5.93% in the liver, 1.14% in the heart, and 0.49% accounted for generalized bTB. However, none was observed on the lymph nodes and intestines. Conclusion: It can be concluded that bTB persists in Bauchi State with annual variations during the study period. This study highlights the importance of meat inspection as an important tool for detecting the presence of bTB lesions

Occurrence of bovine tuberculosis among cattle herds from nomadic peri-urban settlements and cattle slaughtered at the municipal abattoir of Bauchi, North-Eastern Nigeria

Objective: This study was designed to determine the prevalence of bovine tuberculosis (bTB) at the municipal abattoir and cattle herds in peri-urban nomadic settlements of Bauchi state of Northeastern Nigeria. Materials and Methods: A total of 2440 cattle slaughtered at the municipal abattoir from June to September were examined for lesions characteristic of bTB and eighty-six (n=86) cows selected from two cattle herds located at temporary nomadic settlements in Bauchi metropolis were also screened for bTB using purified protein derivative (PPD) tuberculin skin test. During the study period, total of 2,440 cattle were slaughtered comprising majority of females (n=1656) and males (n=784) as well as of different breeds including majority of White Fulani (n=1864) followed by Red Bororo (n=508) and Sokoto Gudali (n=68). Results: The results revealed that out of the 2,440 slaughtered cattle inspected for tuberculous-like lesions, 51 had lesions suspected to be lesions characteristic of tuberculosis, while 48 were positive for Ziehl-Neelsen. Prevalence rate of 1.96% based on microscopic examination and 2.0% based on suspected gross lesion were recorded. The prevalence was 0.77% for males, 1.2% females, 1.84% for adults, 0.12% for calves and 1.8% for white Fulani (Bunaji), 0.12% for Red Bororo (Rahaji) and 0.04% for Sokoto Gudali (Bokoloji). In addition, screening of 86 cows showed that 8.1% were positive for tuberculosis using tuberculin test. Conclusion: The outcome of this study showed that bTB is still endemic in Bauchi state and this can pose a significant public health challenge. Thus, it is recommended that the government should intensify the test-and-slaughter policy as well as put in place an effective monitoring and surveillance control programs for bTB to mitigate the risks posed to public health by this zoonotic disease in the study area. [J Adv Vet Anim Res 2018; 5(1.000): 53-59

Public health significance of companion animals in emergence and re-emergence of bacterial zoonoses

Companion animals especially cats and dogs can provide a bridge for transmission of emerging bacterial diseases that are zoonotic in nature. Zoonotic diseases had posed numerous risk to ownership of companion animals by human either through directed or indirect contact especially in recent years where livestock species are being used as pets. Furthermore, companion animals could play a significant role in zoonosis as a potential reservoirs of various infections. These diseases have impacted greatly to the definition of new paradigms posed by emerging and re-emerging infectious diseases particularly relating to biosecurity policies and broadly to the protection of public health. Multi-sectorial collaboration for disease containment should be emphasized towards curtailing and managing health risks regarding infectious zoonotic diseases. [J Adv Vet Anim Res 2018; 5(2.000): 101-109

Assessment of Knowledge, Attitude and Practice towards Prevention of Respiratory Tract Infections among Hajj and Umrah Pilgrims from Malaysia in 2018

Respiratory tract infection (RTI) is a major public health challenge during the Muslim pilgrimage to Makkah. This study aims to evaluate the knowledge, attitude, and practice of Malaysian Hajj and Umrah pilgrims towards the prevention of RTIs in 2018 and determine correlations among three domains. A cross-sectional study was conducted among 225 Umrah and Hajj pilgrims. Knowledge, attitude, and practice (KAP) towards RTI prevention was assessed by using a validated self-administered questionnaire among pilgrims attending a weekly orientation course organized by private Hajj/Umrah companies. Out of 225 participants, 65.9% of respondents were female with the mean (SD) age of 46.74 (13.38) years. The interquartile range (IQR) score for knowledge is 18.0 (6.0), the mean scores of attitude and practice are 32.65 (4.72) and 25.30 (4.9). respectively. Significant and negative linear correlations between knowledge and practice (r = &minus;0.232, p &lt; 0.001), and attitude and practice (r = 0.134, p = 0.045) were observed. Results from the current study showed good knowledge of RTIs among Malaysian pilgrims. However, a poor attitude was reflected in their preventive practice behaviors. This will further help in the prevention and management of RTIs during Hajj and Umrah. Therefore, an extensive educational health campaign should be provided to pilgrims to create awareness