Zoonotic Tuberculosis

14.4.1 Policy

As is the case in many other African countries, occupational health and safety issues are largely disregarded in Ethiopia. The ministerial occupational health and safety directives make no provision for dealing with BTB, and the Ethiopian Occupational Health Team under the Ministry of Labor and Social Affairs (MOLSA) focuses on more immediate health crises such as childhood mortality, malaria, waterborne illnesses, and HIV/AIDS.

14.4.2 High-Risk Cultural Practices

The government’s attitude about the control of TB is surprising given that M. bovis was isolated from 17 to 30% of human TB patients in rural Tanzania, Uganda, and Ethiopia (Kidane et al. 2002; Kazwala et al. 2001) Because pastoralists in Ethiopia drink large amounts of raw milk (Regassa et al. 2009), consume undercooked meat (Kazwala et al. 2001; Neill et al. 1989), and live in very close contact with their animals, they are more likely then to contract zoonotic TB. Abattoir and animal health workers, herdsmen, dairy farmers, and dairy farm workers are similarly at a higher risk of contracting the disease because of its high prevalence in the national herd and their intimate contact with tuberculous cattle and their products (Biet et al. 2005). Zoonotic TB is often overlooked or misdiagnosed because of poor healthcare and treatment services, inadequate diagnostic facilities, health monitoring and sur­veillance, and public awareness programs.

14.4.3 Public Awareness of the Risk of Contracting BTB

The high prevalence of BTB in slaughtered cattle in Ethiopia should be of concern given the lack of awareness of its importance by the population at risk. In central Ethiopia, only 32% of the population interviewed was aware that humans could become infected by M.

14.4.4 The Role of HIV-AIDS and Malnutrition

in Zoonotic TB

The large number of immune-deficient inhabitants, attributable to chronic malnutri­tion and HIV/AIDS, makes the Ethiopian population highly susceptible to M. bovis infection. Elsewhere, M. bovis in HIV-infected patients according to some estimates may account for 20-50% of all forms of TB in immune-deficient (including HIV-positive) patients (Hlavsa et al. 2008; Cicero et al. 2009).

The number of M. bovis infections in humans in Ethiopia has been reported to be low. The actual numbers of zoonotic M. bovis cases in Ethiopia, however, are likely to be more substantial because of the high prevalence of the diseases in livestock, the lack of BTB control and prevention, and the application of inadequate food safety measures.

14.5