Objectives (please quantify your objectives in case of Applied research)

Introduction

Tuberculosis is a worldwide problem and Pakistan is ranked No. 8 in the world in having the load of human tuberculosis (WHO, 2009). Pakistan is not behind in bovine tuberculosis either. M. bovis is the causative agent of bovine tuberculosis and is classified as a Risk 3 pathogen for public health and is a trade barrier (OIE, 2008). Tuberculosis caused by M. bovis in humans is a very old story which is just recently unfolded. The main source (M. bovis) of human transmission of this disease agent is the infected milk or meat (Cotter et al., 1996). The risk of human infection has been linked through the use of unpasteurised, unboiled milk or using raw milk for producing cream, butter or curd (Cotter et al., 1996). The link between M. bovis and human infection has been reported from almost all over the world, and where from it is not reported it does not mean that this link does not exist. M. bovis has been linked with 25% cases of human TB in developed countries in the late 19th and early 20th centuries (O’Reilly and Daborn, 1995). A significant rise in M. bovis cases were found compared with decrease in M. tuberculosis cases in United States. Patients with M. bovis are 2.5 times more likely to die during the treatment than those with M. tuberculosis (Rodwell et al., 2008). Different studies in Pakistan on bovine tuberculosis in cattle, buffalo, sheep and goat have reported its presence in animals which in general vary from 5-10% (Jalil et al., 2003; Javed et al., 2006; Khan et al., 2008). The presence of greater than 5% prevalence in animals is a concern and it should be addressed seriously and 10% or greater is a much significant problem and needs serious strategic planning to control it. The disease in Pakistan in animals is consistently present and is on the increase. The recent attention towards Livestock by the Government by which the Livestock farming is on the increase that has threatened the Livestock owners as there will be speculated increase in the prevalence of disease in animals in Pakistan in near future.

The present study is focused on to assess the situation of M. bovis as cause of human tuberculosis in Pakistan. As the disease by M. bovis in humans is on the increase, especially in countries where pasteurized milk is not being used for human consumption. Pakistan is a developing country and the general public cannot purchase the expensive pasteurized milk. Therefore, most of the people buy milk from open market or from Dodhi. Thus the chances of spread of this disease in local community are very much there. A Pubmed search with keywords “M. bovis and human”, and keywords: “Pakistan and tuberculosis” resulted in no report on M. bovis infecting human in Pakistan. Similarly, search on Pakmedinet with keywords: “M. bovis” showed no report from Pakistan. This reflects poor reporting of the disease in humans in Pakistan. However, there may have been some reports but those are not accessible through internet.

As there is gap in information about tuberculosis caused by Mycobacterium bovis in human in Pakistan, main sources of transmission of this agent and the target population in which the disease is more prevalent. Therefore, the study is planned to investigate the molecular epidemiology of M. bovis causing human disease in Pakistan, sources of spread of disease and the major community that is contracting this disease more than others. It is hoped that the study will help to generate useful data which eventually will help the researchers and policy makers to formulate future strategies to control/eradicate this disease from the country in both humans and animals.