A One Health Approach to the Suspected Zoonosis of Mycobacterium avium subspecies paratuberculosis: A systematic review of reviews Pubblico

Abstract

Mycobacterium avium subspecies paratuberculosis (MAP) has long been suspected as a zoonotic pathogen because of the similarity between Johne's disease, a chronic diarrheal wasting disease in animals caused by MAP, and Crohn's disease, a chronic inflammatory bowel disease in humans with unknown etiology. Studies in humans investigating MAP in Crohn's have found an association with presence of the bacteria, but pathogenicity of MAP in humans has never been conclusively proven. A new approach is required to determine if MAP is a zoonotic pathogen in humans. The present umbrella review of systematic reviews and meta-analyses evaluated health impacts, risk factors, and prevalence of MAP in domestic and wild animals. This systematic evaluation of the review articles is the first step in determining how the animal literature can guide future research evaluating the possible role of MAP in human illness. This review of reviews identified several new mechanisms and risk factors for MAP that have not been considered in human MAP research to date. Further research and a One Health approach to synthesize data across disciplines, including human, animal, and environmental health, are needed to determine if MAP is zoonotic and elucidate its impact on public health.

Table of Contents

Table of Contents

SECTION PAGE

CHAPTER 1: Introduction......................................................................................................................................................... 1

Introduction and Rationale........................................................................................................................................ 1

Problem Statement....................................................................................................................................................... 3

Purpose Statement........................................................................................................................................................ 4

Research Question........................................................................................................................................................ 4

Significance Statement ............................................................................................................................................... 5

CHAPTER 2: Literature Review.............................................................................................................................................. 6

CHAPTER 3: Methods & Results.......................................................................................................................................... 10

Methods......................................................................................................................................................................... 10

Results............................................................................................................................................................................ 12

Health impact of MAP.............................................................................................................................. 13

Risk factors for MAP infection............................................................................................................... 15

Prevalence of MAP ................................................................................................................................... 18

CHAPTER 4: Discussion.......................................................................................................................................................... 20

REFERENCES.............................................................................................................................................................................. 24

FIGURES

Figure 1:......................................................................................................................................................................... 32

TABLES

Table 1. Systematic Review Data Extraction for Health Impact Studies.................................................. 33

Table 2. Systematic Review Data Extraction for Risk Factors Studies...................................................... 35

Table 3. Systematic Review Data Extraction for Prevalence Studies........................................................ 38

Table 4. Studies Excluded After Full-text Review........................................................................................... 41

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Biology, Veterinary Science
Parola chiave	zoonosis paratuberculosis One Health
Committee Chair / Thesis Advisor	Vidal Graniel, Jorge, Emory University
Committee Members	Goodman, Michael, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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