Background. In Ethiopia the prevalence of all forms of TB is estimated at 261/100 000 population, leading to an annual mortality rate of 64/100 000 population. The incidence rate of smear-positive TB is 108/100 000 population. Objectives. To assess knowledge, attitudes, and practices regarding TB among pastoralists in Shinille district, Somali region, Ethiopia. Method. A community-based cross-sectional study was conducted among 821 pastoralists aged >18 years and above from February to May, 2011 using self-structured questionnaire. Results. Most (92.8%) of the study participants heard about TB, but only 10.1% knew about its causative agent. Weight loss as main symptom, transmittance through respiratory air droplets, and sputum examination for diagnosis were the answers of 34.3%, 29.9%, and 37.9% of pastoralists, respectively. The majority (98.3%) of respondents reported that TB could be cured, of which 93.3% believed with modern drugs. About 41.3% of participants mentioned covering the nose and mouth during sneezing and coughing as a preventive measure. The multivariate logistic regression analysis indicated that household income >300 Ethiopian Birr and Somali ethnicity were associated with high TB knowledge. Regarding health seeking behaviour practice only 48.0% of the respondents preferred to visit government hospital and discuss their problems with doctors/health care providers. Conclusion. This study observed familiarity with gaps and low overall knowledge on TB and revealed negative attitudes like discrimination intentions in the studied pastoral community. 1. Introduction Tuberculosis continues to be one of the most important global public health threats. About one-third of the world’s population is estimated to be infected with tubercle bacilli and hence at risk of developing active disease. TB is a leading killer of people with HIV. According to the World Health Organization Global TB Report [1], in 2010 there were approximately 8.8 million incident cases of TB globally, of which 1.1 million were among people living with HIV. The disease has been recognized as major public health problem in Ethiopia including Somali regional state and in 2010 there were estimated 220,000 (261/100,000) incident cases of TB, estimated 29,000 deaths (35/100,000) excluding HIV-related mortality [1]. As per Federal Ministry of Health (FMoH) data, TB in Ethiopia was one of the leading causes of morbidity, the fourth main cause of hospital admission, and the second largest cause of hospital deaths (after malaria) [2]. According to the Somali Regional Health Bureau
References
[1]
World Health Organization, Global Tuberculosis Control: WHO Report, WHO, Geneva, Switzerland, 2012.
[2]
Federal Ministry of Health (FMoH) Ethiopia, Guidelines for Prevention of Transmission of Tuberculosis in Health Care Facilities, Congregate and Community Setting, Federal Ministry of Health (FMoH) Ethiopia, Ist edition, 2009.
[3]
Somali Regional Health Bureau Report, “Personnel communication and data taken from unpublished report,” 2009.
[4]
World Health Organization, Global Tuberculosis Control, Epidemiology Strategy Financing, WHO, Geneva, Switzerland, 2009.
[5]
Government of India, TB India 2011, RNTCP Status Report, Central TB Division New Delhi: Ministry of Health and Family Welfare, Government of India, New Delhi, India.
[6]
D. Stephen, Vulnerable Livelihoods in Somali Region, Institute of Development Studies at the University of Sussex, Brighton, UK, 2006.
[7]
A. A. Gele, G. Bjune, and F. Abebe, “Pastoralism and delay in diagnosis of TB in Ethiopia,” BMC Public Health, vol. 9, article 5, 2009.
[8]
Central Statistical Agency, Population and Housing Census of Ethiopia: Results for Somali Region, vol. 1, Central Statistical Agency, 2005.
[9]
W. W. Daniel, Biostatistics: A Foundation for Analysis in the Health Science, pp. 658–659, Willey International, 8th edition, 2005.
[10]
L. Mengistu, A. Gobena, M. Gezahegne et al., “Knowledge and perception of pulmonary tuberculosis in pastoral communities in the middle and lower awash valley of afar region, Ethiopia,” BMC Public Health, vol. 10, article 187, 2010.
[11]
M. M. Mesfin, T. W. Tasew, I. G. Tareke, G. W. M. Mulugeta, and M. J. Richard, “Community knowledge, attitudes and practices on pulmonary tuberculosis and their choice of treatment supervisor in Tigray, northern Ethiopia,” Ethiopian Journal of Health Development, vol. 19, pp. 21–27, 2005.
[12]
Government of Nepal, “Knowledge, attitude and practices: Study on tuberculosis among community people,” Report of Mahottari District, Ministry of Health and Population and National Tuberculosis Centre, 2009, http://library.elibrary-mohp.gov.np/mohp/collect/mohpcoll/archives/mohp:199/4.dir/doc.pdf.
[13]
M. W. Dualeh, “Health situation of the drought-affected populations in the Somali National Regional State,” 2000, http://www.who.int/disasters/repo/5856.doc.
[14]
Austrian Development Cooperation, Ethiopia Subprogram Health 2004–2006, Federal Ministry for Foreign Affairs, Addis Ababa, Ethiopia, 2007.
[15]
Central Statistical Agency, “Census 2007,” 2008, http://www.etharc.org/resources/download/viewcategory/68.
[16]
B. Tessema, A. Muche, A. Bekele, D. Reissig, F. Emmrich, and U. Sack, “Treatment outcome of tuberculosis patients at Gondar University Teaching Hospital, Northwest Ethiopia: a five-year retrospective study,” BMC Public Health, vol. 9, article 371, 2009.
[17]
D. M. Nair, A. George, and K. T. Chacko, “Tuberculosis in Bombay: new insights from poor urban patients,” Health Policy and Planning, vol. 12, no. 1, pp. 77–85, 1997.
[18]
R. Liefooghe and J. B. Baliddawa, “From their own perspective. A Kenyan community's perception of tuberculosis,” Tropical Medicine and International Health, vol. 2, no. 8, pp. 809–821, 1997.
[19]
S. Mfinanga, O. M？rkve, R. R. Kazwala et al., “Tribal differences in perception of tuberculosis: a possible role in tuberculosis control in Arusha, Tanzania,” International Journal of Tuberculosis and Lung Disease, vol. 7, no. 10, pp. 933–941, 2003.
[20]
B. Venkatraju and S. Prasad, “Beliefs of patients about the causes of Tuberculosis in rural Andhra Pradesh,” International Journal of Nursing and Midwifery, vol. 2, no. 2, pp. 21–27, 2010.
[21]
M. Nichter, “Illness semantics and international health: the weak lungs/TB complex in the Philippines,” Social Science and Medicine, vol. 38, no. 5, pp. 649–663, 1994.
[22]
A. Sheik-Mohamed and J. P. Velema, “Where health care has no access: the nomadic populations of sub-Saharan Africa,” Tropical Medicine and International Health, vol. 4, no. 10, pp. 695–707, 1999.
[23]
United Nations Development Programme, “Between a rock and hard place: armed violence in African pastoral communities,” UNDP Report, 2007, http://www.genevadeclaration.org/fileadmin/docs/regional-publications/Armed-Violence-in-African-Pastoral-Communities.pdf.
