肺与呼吸系统医学

Human Presumptive Tuberculosis Cases: Syndromes and Animal Ownership in the Rural Communities of North-Western and North-Eastern Parts of Amhara Regional State, Ethiopia

Abstract

Araya Mengistu, Seleshe Nigatu, Tadesse Guadu, Elias Kebede, Bimrew Admasu, Basaznew Bogale, Atnaf Alebe, Samuel Sebsbie, Adugna Burju, Wendweson Kumlachew, Mezgebu Asmiro and Wubegzier Mekonnen

Objective: Human tuberculosis is a global public health problem where considerable numbers are infected by Mycobacterium tuberculosis and are at a risk of developing active tuberculosis. Tuberculosis is a problem for the livestock’s as well. Tuberculosis in humans should be considered early in the evaluation of patients with chronic cough and risk factors like HIV/AIDS are diagnosed. The aim of this study was to know the status of the clinical signs that could be noticed by presumptive TB cases and look livestock ownership with the existence of chronic cough in their animals.

Methodology: The study was cross-sectional and conducted in purposefully selected ten districts encompassing 26 peasant associations. The study populations were individuals or households who suffered from a chronic cough for more than two weeks. Pretested questionnaire was used to collect the required information and the data were collected by health extension workers. The data were checked and entered into excel spreadsheet and exported to SPSS version 20.0 software. The data were cleaned and checked before analysis. Descriptive statistics used to analyze the data and graphs as well as tables used to present the findings. The ethical clearance was obtained from the University of Gondar Ethical Review Board and permission obtained from respective health departments.

Results: In this study 681 individuals were found to have chronic cough/presumptive tuberculosis cases. More than half (nearly 53%) of them lives in the high altitudes and 49% reported a cough duration of >2 weeks to 4 weeks, while 18.7% coughed for more than one year. Among the cases 63.7%, 73.6% and 19.2%, showed productive cough, tried getting treatments and used home remedies, respectively. Three fourth of the participants reported the presence of fever, night sweat and fatigue while a quarter of them claimed blood in the sputum. Eighty three point seven percent of them own livestock and 38.4% of their animals were suffering from chronic cough. Of the coughing animals 21.4% received modern treatment, of which only 7.4% responded to the treatment. Likewise, 63.5% of livestock owners shared house with their animals.

Conclusion and Recommendations: Presumptive tuberculosis cases could be characterized by having an indicator clinical signs for tuberculosis. In this study three fourth of the participants reported the presence of fever, fatigue and night sweating while a quarter of them claimed the presence of hemoptysis. Of the owned animals 38.4% showed chronic cough and among the treated animals for the cough only 7.4% responded to the treatment. The practice of house sharing with animals was 63.5%. The presence of chronic cough in animals and less treatment response with a significant proportion of house sharing practice might play a role in the tuberculosis disease epidemiological dynamics. Therefore, identification of causes of chronic cough, early diagnosis of presumptive tuberculosis cases, providing better attention to animal health and avoiding of common house utilization with animals is suggested.