Abstract
BackgroundInfection with Mycobacterium bovis (Mb) predominantly causes cervical TB lymphadenitis (TBL). Raw milk is considered the main source of Mb infection and raw milk is a major food source for Afar pastoralists. The aim of this study was to assess Afar pastoralists' knowledge concerning cervical TBL and its treatment.MethodsA community-based cross-sectional survey involving 818 interviewees was conducted in two districts of the Afar Region, Ethiopia. In addition, two focus group discussions (FGDs) were conducted in each of the study areas, one with men and the other with women.ResultsOf the 818 interviewees [357 (43.6%) females and 461 (56.4%) males], 742 (90.7%) reported that they had knowledge of cervical TBL, mentioning that swelling(s) on the neck resulting in a lesion and scar are common symptoms. However, only 11 (1.5%) individuals mentioned that bacteria or germs are the causative agents of TBL. Three interviewees and a male discussant mentioned drinking raw milk as the cause of TBL. A considerable proportion (34.2%) of the interviewees and almost all the discussants suggested herbal medicine as an effective treatment. Male study participants were 1.82 times more likely to have overall knowledge of TBL than female study participants (adjusted OR, 1.82; 95% CI, 1.32 to 2.51, p < 0.001).ConclusionThe pastoral community members in the study areas had little biomedical knowledge of the cause, the source of infection and the transmission route of cervical TBL. Furthermore, most community members believed that herbal medicines are the most effective treatment for TBL. Therefore, TB control programs in the Afar Region require the incorporation of public health education introducing current biomedical knowledge of the disease. In addition, further studies are important to elucidate which medicinal plants are used by Afar pastoralists to treat TBL.
Highlights
Infection with Mycobacterium bovis (Mb) predominantly causes cervical TB lymphadenitis (TBL)
Epidemiological data reveal a conservative magnitude of Pulmonary Tuberculosis (PTB) and Extra-pulmonary tuberculosis (EPTB) in the Afar region, but case records concerning TB over a seven year period (20012007) obtained from the Afar Regional Health Bureau indicate that approximately 28% of cases were due to EPTB; TBL is the most common form of EPTB in the region
The present findings revealed that male study participants have a relatively greater biomedical knowledge of TBL than females, supporting the findings of other studies concerning PTB [16,15]
Summary
Infection with Mycobacterium bovis (Mb) predominantly causes cervical TB lymphadenitis (TBL). Pulmonary Tuberculosis (PTB) is a major health problem in developing countries [1], caused by exposure to Mycobacterium tuberculosis (Mtb). Extra-pulmonary tuberculosis (EPTB) has made a profound contribution to the burden of TB, since the emergence of the human immunodeficiency virus (HIV) [2], and TB lymphadenitis (TBL) is the most common form of EPTB [2,3,4]. Studies indicate that infection with Mycobacterium bovis (Mb) predominantly causes EPTB, . Epidemiological data reveal a conservative magnitude of PTB and EPTB in the Afar region, but case records concerning TB over a seven year period (20012007) obtained from the Afar Regional Health Bureau indicate that approximately 28% of cases were due to EPTB; TBL is the most common form of EPTB in the region
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