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Cross-Sectional Study on Swine Tuberculosis Prevalence in Gansu Province, China from February to June 2021 | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 31 January 2024 V1 Latest version Share on Cross-Sectional Study on Swine Tuberculosis Prevalence in Gansu Province, China from February to June 2021 Authors : Liang Sun , Yao Xi , Jiaxin Huang , Jifei Yang , zengjun Lu , Pu Sun , and Qiaoying Zeng [email protected] Authors Info & Affiliations https://doi.org/10.22541/au.170669807.72146902/v1 280 views 150 downloads Contents Abstract Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Summary: Tuberculosis (TB), caused by the Mycobacterium tuberculosis complex (MTBC), poses a major global threat to the health of humans and animals. The Suidae family is highly susceptible to TB and is used as screening sentinels for testing the presence of MTBC in the environment, but swine TB (STB) tends to be neglected worldwide. China has the largest pig population in the world, but epidemiological information on STB is scarce. In this study, 1379 serum samples were randomly collected from 45 herds of Gansu province, China from February to June 2021 and tested with PPD-B-ELISA. The STB prevalence at individual level was 0.22% (95% CI: 0.04%, 0.63%) and varied from 0.00% to 2.20% in different cities. The prevalence at herd level was 4.44% (95% CI: 0.54%, 15.15%) and varied from 0.00% to 33.33% in different cities. The STB prevalence in intensively raised three-crossbred pigs (0.23%, 95% CI: 0.05%, 0.68%) was higher than that in free-range raised Tibetan pigs (0.00%, 95% CI: 0.00%, 3.85%) ( p = 0.81). Besides, 180 serum samples were collected from Guangxi province, China, and STB prevalence in Guangxi province (1.67%, 95% CI: 0.35%, 4.79%) was significantly higher than that in Gansu province ( p < 0.05). These latest STB prevalence data are strongly suggested to conduct a randomized nationwide cross-sectional study on a regular basis for the development of an effective national program for STB surveillance and control. Cross-Sectional Study on Swine Tuberculosis Prevalence in Gansu Province, China from February to June 2021 Liang Sun 1 , Yao Xi 1 , Jiaxin Huang 1 , Jifei Yang 2 , Zengjun Lu 2 , Pu Sun 1, 2* , Qiaoying Zeng 1 11 * Co-corresponding authors: Pu sun, Email: [email protected] ; Qiaoying Zeng, Email: [email protected] . 1 Laboratory of Veterinary Microbiology, College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, 730070, China. 2 State Key Laboratory of Veterinary Etiological Biology, National Foot and Mouth Disease Reference Laboratory, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730070, China. Running title: Cross-Sectional Survey on Seroprevalence of Swine Tuberculosis in Gansu Province, China Corresponding authors: Qiaoying Zeng, Laboratory of Veterinary Microbiology, College of Veterinary Medicine, Gansu Agricultural University, Lanzhou, 730070, China, Tel: +8613893316398, Email: [email protected] (Q.Z); Pu Sun, State Key Laboratory of Veterinary Etiological Biology, National Foot and Mouth Disease Reference Laboratory, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730070, China, Tel: +8609318378501; Email: [email protected] (P.S.). Summary: Tuberculosis (TB), caused by the Mycobacterium tuberculosis complex (MTBC), poses a major global threat to the health of humans and animals. The Suidae family is highly susceptible to TB and is used as screening sentinels for testing the presence of MTBC in the environment, but swine TB (STB) tends to be neglected worldwide. China has the largest pig population in the world, but epidemiological information on STB is scarce. In this study, 1379 serum samples were randomly collected from 45 herds of Gansu province, China from February to June 2021 and tested with PPD-B-ELISA. The STB prevalence at individual level was 0.22% (95% CI: 0.04%, 0.63%) and varied from 0.00% to 2.20% in different cities. The prevalence at herd level was 4.44% (95% CI: 0.54%, 15.15%) and varied from 0.00% to 33.33% in different cities. The STB prevalence in intensively raised three-crossbred pigs (0.23%, 95% CI: 0.05%, 0.68%) was higher than that in free-range raised Tibetan pigs (0.00%, 95% CI: 0.00%, 3.85%) ( p = 0.81). Besides, 180 serum samples were collected from Guangxi province, China, and STB prevalence in Guangxi province (1.67%, 95% CI: 0.35%, 4.79%) was significantly higher than that in Gansu province ( p < 0.05). These latest STB prevalence data are strongly suggested to conduct a randomized nationwide cross-sectional study on a regular basis for the development of an effective national program for STB surveillance and control. Keywords : Swine tuberculosis, Gansu province, China, Cross-sectional survey, Seroprevalence, Serology Introduction Tuberculosis (TB) is known as an important zoonotic infectious disease since humans and animals can be cross-infected by the Mycobacterium tuberculosis complex (MTBC). According to the Global Tuberculosis Report in 2021 by the World Health Organization, there were about 5.8 million new Human TB (hTB) cases and 1.5 million new deaths in 2020 (Global Tuberculosis Report in 2021). Although hTB is mainly caused by Mycobacterium tuberculosis ( M. tb ), 17.0%, 26.1%, 5.3%, and 6.5% of hTB cases have been reported to be caused by Mycobacterium bovis ( M. bovis ) in Ethiopia, Tanzania, Turkey, and the west bank of Palestine, respectively (Bayraktar et al., 2011; Ereqat et al., 2012; Fetene et al., 2011; Kazwala et al., 2001; Mfinanga et al., 2004; Shitaye et al., 2007). M. bovis has an extraordinary host range, including humans, cattle, pigs, and a variety of domesticated and wild animals (Cousins et al., 2005). In May 2014, the World Health Assembly passed a resolution of the post-2015 End TB Strategy with its ambitious targets to be fully realized in 2035 (Sun et al., 2021). However, MTBC infection in the multi-host system is a great barrier to achieving this goal worldwide. The Suidae family has been reported to be highly susceptible to TB, and the detection of severe typical tubercles in pigs and wild boars suggests that those species may act as maintenance hosts rather than dead-end hosts (Di Marco et al., 2012; Naranjo et al., 2008). Due to the high susceptibility to MTBC, domestic pigs and feral swine are used as screening sentinels for testing the presence of MTBC in the environment (Bailey et al., 2013; L. A. Corner et al., 2015). Swine TB (STB) is a worldwide disease that is often neglected (Tbran et al., 2019). Therefore, as a reservoir for MTBC especially for M. bovis , swine might transmit MTBC to humans, especially in TB-endemic areas (Bollo et al., 2000; Nugent et al., 2015). STB has also been reported in other Suidae families such as bush pigs ( Potamochoerus porcus ) in South Africa (Hlokwe et al., 2014), warthogs ( Phacochoerus africanus ) in Africa (Miller et al., 2016), and collared peccaries ( Tayassu tajacu ) in South America (Mayer et al., 2012). Proper identification of STB, followed by implementation of suitable management strategies, is important for control of STB (Csivincsik et al., 2016). However, there are limited STB diagnosis tests available. Mycobacterial culture remains the gold standard method for infection confirmation, but it is quite difficult due to several factors including the chronic process of TB, a high proportion of persistent infection, the slow growth of MTBC, low efficiency of isolation of MTBC, and the biosafety requirement for MTBC culture, etc (Boadella et al., 2011; L. A. L. Corner et al., 2012). Standard in vivo diagnosis methods including tuberculin skin tests and interferon-gamma release assays are mainly developed and calibrated in bovine TB, but these methods also have some limitations including multiple handling events required or time constraints since blood samples must be handled in the laboratory within 24 hours after collection (Buddle et al., 2009; Schiller et al., 2010). Alternatively, antibody-based diagnosis has been widely used for STB diagnosis owing to its convenience and good performance (Boadella et al., 2011; Gil et al., 2010; Pedersen et al., 2017; Perez de Val et al., 2017). Unlike many other animals, swine appear to produce detectable humoral responses soon after M. bovis infection, and the responses are maintained during the development of the disease (Garrido et al., 2011; Roos et al., 2016). This allows rapid detection of STB by serological assays (Boadella et al., 2011). China has the largest pig population in the world, and the pig production industry is an important driver of the China economy. Sufficient data on STB prevalence are needed for the development of an effective STB surveillance and control program, but epidemiological information on STB in China is very scarce. Therefore, a cross-sectional study was conducted for assessing the STB prevalence in Gansu province in China with PPD-B-ELISA (de Val Perez et al., 2011; Garcia-Bocanegra et al., 2012; Gil et al., 2010). Materials and Methods Study area Gansu province (located in Northwestern China) lies between 32°11′-42°57′ north latitude and 92°13′-108°46′ east longitude with a total area of 425,800 square kilometers (Figure 1). Gansu has 12 prefecture cities and 2 autonomous prefectures. Ethics Statement The protocols regarding animal sampling were performed following the management guidelines of the Gansu Ethical Review Committee (license no. SYXK-89 GAN-2014-003). The study was explained to all the farm owners and oral consent of farms was obtained before sampling. Animals and sampling According to the data published by the Gansu Province Bureau of Statistics, there were 6.89 million swine in 2020 (Table 1). To obtain a sample size representative of the Gansu swine population, the number of pigs to be tested was calculated with EPITOOLS ( https://epitools.ausvet.com.au/oneproportion ). The minimum sample size was calculated to be 664 with an assumed STB prevalence of 50%, a confidence level of 99%, and desired precision of 5%. According to the ratio of the number of swine in each city to the number of swine in the province, the sample size was calculated and presented in Table 1. Then, a cross‐sectional multistage sampling strategy was used for selecting the study population. Firstly, scaled pig farm (intensively raised three-crossbred pig number ≥ 200) was the primary sampling unit, and at least three farms were randomly selected in each city. It is worth noting that the pigs raised in Gannan Tibetan autonomous prefectures are free-range Tibetan pigs. Secondly, swine were the secondary sampling units, and at least 30 swine were randomly selected from each selected farm. Pigs were selected using systematic sampling, in which the first pig was randomly selected, and subsequent pigs were selected with a fixed sampling interval. In addition, there were 180 serum samples collected from Guangxi province. Serological analysis All the serum samples were tested in duplicate with PPD-B-ELISA as previously described (de Val Perez et al., 2011; Garcia-Bocanegra et al., 2012; Perez de Val et al., 2017). The 96-well plate was coated with 100 μL bovine PPD (PPD-B, Harbin Pharmaceutical Group Bio-vaccine Co. Ltd., China) which was prediluted with carbonate/bicarbonate buffer to a final concentration of 2 μg/mL and incubated overnight at 4°C. After 45-min blockade at 37°C with PBS containing 0.05% Tween 20 (PBST) and 0.5% casein, serum samples (diluted at 1/200 in PBST containing 1% casein) were added into 96-well plate in duplicate and incubated for 1 h at 37°C. Then, 96-well plate was added with protein A and protein G conjugated peroxidase (Sigma, America) and incubated for 1 h at 37°C. The protein A and protein G conjugated peroxidases were prediluted in PBST containing 1% casein to final concentrations of 50 ng/mL and 100 ng/mL, respectively. The plate was washed six times with PBST after each step during this procedure. Afterward, the plate was added with 100 μL TMB substrate (Beyotime, China) and incubated for 20 min in the dark, and then the reaction was stopped with 100 μL 1 N HCl. After incubation, the Optical Density at 450 nm (OD 450 ) was calculated as the sample OD 450 value minus the background OD 450 value (nonspecific absorbance in wells with no antigen added). A sample was defined as positive when the average OD 450 value was higher than the cut-off value (calculated as the mean of the background OD 450 plus 3 folds of standard deviation). All the positive sera and 20 randomly selected negative sera were further tested with PPD-A-ELISA which was the same as PPD-B-ELISA but coated with avian PPD (PPD-A, Harbin Pharmaceutical Group Bio-vaccine Co. Ltd., China). Statistical analyses The farm was defined as positive if at least one swine was detected as positive. Individual prevalence was calculated as the ratio of the number of positive swine to the total number of swine. Similarly, herd prevalence was calculated as the number of positive farms to the total number of farms examined. The prevalence and the 95% confidence intervals were determined using the binomial distribution with Microsoft Excel 2016 (Microsoft Corporation, USA). OR and Fisher’s exact test in SPSS 25 (International Business Machines Corporation, America) were used to determine the difference in positive and negative results between groups. p < 0.05 was considered as significantly different, and p < 0.01 as extremely significantly different. Results In total, 1379 serum samples from 45 herds were collected from February to June 2021 in Gansu province. On average, 98.5 serum samples (ranging from 90 to 150) were selected randomly from each city (Table 1). The overall STB prevalence at the individual level was 0.22% (95% CI: 0.04%, 0.63%) and varied from 0.00% to 2.20% in different cities (Table 1) (Figure 2). The prevalence at the individual level was 2.20% (95% CI: 0.27%, 7.71%) in Zhangye city, and that in Wuwei city was 1.11% (95% CI: 0.03%, 6.04%). The overall STB prevalence at the herd level was 4.44% (95% CI: 0.54%, 15.15%) and varied from 0.00% to 33.33% in different cities (Table 1). Both Wuwei city and Zhangye city had one positive herd with a prevalence of 33.33% (95% CI: 0.84%, 90.57%) at the herd level. The STB prevalence in intensively raised three-crossbred pigs (0.23%, 95% CI: 0.05%, 0.68%) was higher than that in free-range raised Tibetan pigs (0.00%, 95% CI: 0.00%, 3.85%), but the difference between them was not significant ( p = 0.81). In addition, the STB prevalence in Guangxi province (1.67%, 3/180, 95% CI: 0.35%, 4.79%) was higher than that in Gansu province, and the difference between them was significant ( p < 0.05) with odds ratio (OR) of 7.77 (95% CI: 1.56, 38.81). Discussion Although STB has not been subjected to the official investigation, there is a strong body of evidence that TB can be actively present in the pig population. Either in Spanish wild boars (Naranjo et al. 2008) or Nebrodi Black Pigs in Sicily (Di Marco et al., 2012), the high rates of reported granulomatous lesions related to TB suggest that suids can act as maintenance hosts. Furthermore, a novel strain of M. bovis was isolated from Nebrodi Black Pigs, arousing the concern of transmission of M. bovis genotypes in the porcine species (Amato et al., 2018; Di Marco et al., 2012). This implies that the control of STB should be mandatory if the presence of pigs poses an epidemiological risk. The carcass inspection at the slaughterhouse, which is regulated by legislation, is not the best approach for STB prevention and control. It has been reported that the isolation of M. bovis does not necessarily correspond to visually detectable lesions at the abattoir (Garcia-Jimenez et al., 2013; Martin-Hernando et al., 2007). Besides, the organs from which M. bovis is most frequently isolated in swine are mandibular lymph nodes and tonsils, but these organs tend not to be examined during swine carcasses official inspection (Gortazar et al., 2011). Although, identification of specific members of MTBC is desired to provide proper treatment or control measures in STB. But it is quite difficult currently and time-consuming, and may produce false-negative results. Since swine appear to produce humoral responses soon after M. bovis infection, and these humoral responses are maintained during the development of disease, antibody diagnostic technique is suitable for STB prevention and control (Garrido et al., 2011; Roos et al., 2016). PPD-B-ELISA is an ideal choice to identify the risk of STB transmission due to its advantages of simple, easy, rapid, and high-throughput screening. In addition, the 6 positive sera and 20 randomly collected negative sera were tested with PPD-A-ELISA and the results were negative, which means PPD-B-ELISA had an excellent analytical specificity and the seropositive swine were infected with MTBC other than environmental mycobacteria. To our knowledge, this is the first cross-sectional survey of STB in China. Our data indicated that the STB prevalence in Gansu province, China was 0.22% (95% CI: 0.04%, 0.63%), which was lower than that in Egypt (8.90%) (Mohamed et al., 2009), Ethiopia (5.83%) (Arega et al., 2013), Uganda 3.1% (Muwonge et al., 2010), and Spain (2.3%) (Cano-Terriza et al., 2018). STB prevalence in Gansu province, China was the same as that in Czech Republic (0.22%) which has been included amongst the states declared free from bovine tuberculosis within the European Union on February 31, 2004 (Pavlik et al., 2005). The lower STB prevalence in Gansu province might be associated with the preventive measures adopted by China since the Ministry of Agriculture and Rural Affairs of the People’s Republic of China launched the control and eradication project on bovine TB in 2012 (Shufang et al., 2015). In June 2017, the Ministry of Agriculture and Rural Affairs of the People’s Republic of China issued the National Guidelines for Controlling bovine TB (2017–2020), which adopted comprehensive prevention and control measures such as quarantine culling, risk assessment, movement control, and strengthening health management (The Ministry of Agriculture and Rural Affairs of the People’s Republic of China., 2017). The World Organization for Animal Health, the World Health Organization, the Food and Agriculture Organization, and the International Union Against Tuberculosis and Lung Disease also jointly launched the first-ever roadmap to tackle zoonotic TB in 2017. The STB prevalence in Guangxi province, China (1.67%, 95% CI: 0.35%, 4.79%) was significantly higher than that in Gansu province, China ( p < 0.05) with OR of 7.77 (95% CI: 1.56, 38.81). The relatively higher bTB prevalence in Guangxi province might be due to the fact that the cold and humid environment in the winter in this region was more suitable for MTBC survival (Fine et al., 2011; Santos et al., 2015; Tanner et al., 1999). Wild or free-range swine usually exhibit higher STB prevalence than intensively raised swine. However, in this study, the STB prevalence in intensively raised pigs (0.23%, 95% CI: 0.05%, 0.68%) was higher than that in free-range Tibetan pigs (0.00%, 95% CI: 0.00%, 3.85%), but the difference between them was not significant ( p = 0.81). The reason for this might be the limited serum samples of Tibetan pigs used in this study. Future investigations are suggested to collect more serum samples, especially from free-range Tibetan pigs to elucidate the epidemiological status of STB. Acknowledgments This work was funded by the National Natural Science Foundation of China (31260616), Herbivorous Livestock Technology System in Gansu Province, and Integrated Experimental Demonstration Project of Disease Prevention and Control and Biosafety Technology for Healthy Pig Breeding (20201007-2). We thank all staff members from Gansu Agricultural University and Lanzhou Veterinary Research Institute who provided support for this study. Great gratitude goes to linguistics Prof. Ping Liu from Huazhong Agriculture University, Wuhan, China for her work at English editing and language polishing. Conflict of Interest Statement The authors declare no conflict of interest. References Amato, B., Lo Presti, V. D., Gerace, E., Capucchio, M. T., Vitale, M., Zanghi, P., . . . Boniotti, M. B. (2018). 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Table 1 Cross-sectional study of STB in Gansu province, China No. of positive No. of tested Prevalence% (95% CI: lower, upper) No. of positive No. of tested Prevalence% (95% CI: lower, upper) Lanzhou 0.43 41.44 0 90 0.00 (0.00, 4.02) 0 3 0.00 (0.00, 70.76) Jiayuguan 0.04 3.85 0 150 0.00 (0.00, 2.43) 0 5 0.00 (0.00, 52.18) Jinchang 0.05 4.82 0 90 0.00 (0.00, 4.02) 0 3 0.00 (0.00, 70.76) Baiyin 0.84 80.95 0 90 0.00 (0.00, 4.02) 0 3 0.00 (0.00, 70.76) Tianshui 0.65 62.64 0 96 0.00 (0.00, 3.77) 0 3 0.00 (0.00, 70.76) Wuwei 1.49 143.59 1 90 1.11 (0.03, 6.04) 1 3 33.33 (0.84, 90.57) Zhangye 0.65 62.64 2 91 2.20 (0.27, 7.71) 1 3 33.33 (0.84, 90.57) Pingliang 0.44 42.40 0 100 0.00 (0.00, 3.62) 0 3 0.00 (0.00, 70.76) Jiuquan 0.27 26.02 0 122 0.00 (0.00, 2.98) 0 4 0.00 (0.00, 60.24) Qingyang 0.46 44.33 0 90 0.00 (0.00, 4.02) 0 3 0.00 (0.00, 70.76) Dingxi 0.52 50.11 0 90 0.00 (0.00, 4.02) 0 3 0.00 (0.00, 70.76) Longnan 0.61 58.79 0 90 0.00 ( 0.00, 4.02) 0 3 0.00 (0.00, 70.76) Linxia 0.21 20.24 0 96 0.00 (0.00, 3.77) 0 3 0.00 (0.00, 70.76) Gannan 0.23 22.17 0 94 0.00 (0.00, 3.85) 0 3 0.00 (0.00, 70.76) In total 6.89 664 3 1379 0.22 (0.04, 0.63) 2 45 4.44 (0.54, 15.15) FIGURE 1. Gansu province in the Chinese map FIGURE 2. STB prevalence in Gansu province, China at individual level Information & Authors Information Version history V1 Version 1 31 January 2024 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords china cross-sectional survey gansu province serology seroprevalence swine tuberculosis Authors Affiliations Liang Sun Gansu Agricultural University View all articles by this author Yao Xi Gansu Agricultural University View all articles by this author Jiaxin Huang Gansu Agricultural University View all articles by this author Jifei Yang Lanzhou Veterinary Research Institute View all articles by this author zengjun Lu Lanzhou Veterinary Research Institute View all articles by this author Pu Sun Gansu Agricultural University View all articles by this author Qiaoying Zeng [email protected] Gansu Agricultural University View all articles by this author Metrics & Citations Metrics Article Usage 280 views 150 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Liang Sun, Yao Xi, Jiaxin Huang, et al. Cross-Sectional Study on Swine Tuberculosis Prevalence in Gansu Province, China from February to June 2021. Authorea . 31 January 2024. 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