Human and bovine tuberculosis knowledge, attitude and practice (KAP) among cattle owners in Ethiopia

Systematic review of knowledge, attitudes, and practices of dairy farmers and consumers towards bovine tuberculosis in low- and middle-income countries

Bovine Tuberculosis (bTB), caused by Mycobacterium bovis, is a neglected zoonotic disease primarily associated with cattle. The incidence of bTB is highest in low-income settings with high cattle density and unpasteurised dairy consumption. Smallholder dairy farming has steadily grown in low- and middle-income countries (LMICs) with limited professional support for adequate bTB surveillance and risk mitigation. Several studies have explored the knowledge, attitudes, and practices (KAP) of milk value chain stakeholders towards bTB in LMICs, but this evidence has not been collated and synthesised. We conducted a systematic review to determine what is known, believed, and done in relation to bTB among dairy producers and consumers in LMICs. We performed a systematic search of studies in OVID Medline, Scopus and CABI on 11 September 2023. KAP data were summarised using narrative synthesis and forest plots. We retrieved 2763 articles, retaining 51 for the review. Only studies from Africa (n = 38) and Asia (n = 13) met the eligibility criteria. Most populations reported awareness of human tuberculosis and knew it could be treated, but there was limited awareness of bTB and its zoonotic potential. Knowledge of bTB transmission routes and bTB mitigation varied across populations, and risky practices were also variable. Inconsistencies in study design and survey tools suggest some results may have a mid- to high-risk of bias. Awareness of bTB is surprisingly low among African and Asian populations with high bTB exposure risk, possibly due to the long-standing divide between animal and human health messages that has obscured the One Health implications of bTB. Addressing bTB in LMICs requires a structural One Health approach and standard KAP survey tools to adequately explore the socio-cultural, political, and economic processes and drivers favouring bTB spread and persistence.

Knowledge, attitude, and perception towards COVID-19 vaccinations among the adults in Rwanda: a cross-sectional study

BACKGROUND

Multiple vaccinations have received approval for the prevention of the coronavirus illness. Nevertheless, the sluggish vaccination rate is mostly attributed to the general population's limited understanding and unwillingness to accept the use of vaccinations. Thus, it is important to investigate the Rwandan population's knowledge, attitudes, and perceptions toward COVID-19 vaccines.

METHODS

A cross-sectional survey was conducted among 370 participants from 11th to 17th February 2023. Demographic information was gathered, and knowledge, attitudes, and perceptions of COVID-19 vaccinations were assessed. A binary logistic regression analysis was undertaken to determine the parameters that determine the perception of COVID-19 vaccinations.

RESULTS

This study included 370 participants. Among them, 85% had good knowledge about COVID-19 vaccines, and 84% had a positive attitude towards them. Additionally, the study had a diverse group, with half of the participants being female and nearly half falling between the ages of 30 and 39. Several key findings emerged through logistic regression analysis. Those aged 30-39 had 1.39 times higher odds of positive perception than 18-28 (OR = 1.39, 95% CI = 1.08-3.24). Participants with a university education were twice as likely to have a positive perception compared to those without an education level (OR = 2.43, 95% CI = 1.30-6.20). Additionally, single individuals were three times more likely to have a positive perception than their married counterparts (OR = 3.39, 95% CI = 1.28-9.09). Vaccinated individuals had twice the odds of positive perception than non-vaccinated individuals (OR = 2.89, 95% CI = 1.01-8.89). Those receiving information from government health institutions were three times more likely to have a positive perception than those who received the information from friends (OR = 3.19, 95% CI = 1.02-12.7). Moreover, employed participants were four times more likely to have a positive perception non-employed individuals (OR = 4.21, 95% CI = 1.48-13.6). Besides, gender and COVID-19 diagnosis did not significantly correlate with positive COVID-19 vaccine perception.

CONCLUSION

The results indicate that the general public in Rwanda has good knowledge, positive attitudes, and a positive perception toward the COVID-19 vaccination, however, some of the participants had some misconceptions towards COVID-19. The findings of this study will be valuable for policymakers and healthcare authorities working to improve vaccination rates.

Unveiling insights into bovine tuberculosis: A comprehensive review

The frequent zoonotic disease known as "bovine tuberculosis" is brought on by the Mycobacterium bovis bacteria, which can infect both people and animals. The aim of this review article is to provide an explanation of the etiology, history, epidemiology, pathogenesis, clinical symptoms, diagnosis, transmission, risk factors, public health importance, economic impact, treatment, and control of bovine tuberculosis. Primarily, bovine tuberculosis affects cattle, but other animals may also be affected. Bovine tuberculosis is present throughout the world, with the exception of Antarctica. Cattle that contract bovine tuberculosis might suffer from a persistent, crippling illness. In the early stages of the disease, there are no symptoms. The tuberculin test is the primary method for detecting bovine tuberculosis in cows. Depending on its localized site in the infected animal, M. bovis can be found in respiratory secretions, milk, urine, feces, vaginal secretions, semen, feces, and exudates from lesions (such as lymph node drainage and some skin lesions). This illness generally lowers cattle productivity and could have a negative financial impact on the livestock business, particularly the dairy industry. The most effective first-line anti-tuberculosis chemotherapy consists of isoniazid, ethambutol, rifampin, and streptomycin. Second-line drugs used against bovine tuberculosis include ethionamide, capreomycin, thioacetazone, and cycloserine. To successfully control and eradicate bovine tuberculosis, developed nations have implemented routine testing and culling of infected animals under national mandatory programs.

Prevalence and risk factors of bovine tuberculosis in cattle in selected districts of Fafan pastoral settings, Eastern Ethiopia

Cross-sectional study was conducted from October 2021 to August 2022 to investigate the prevalence and associated risk factors of bovine tuberculosis in cattle in selected districts of the pastoral settings of Fafan zone, Somali region, eastern Ethiopia. A comparative intradermal tuberculin test was performed using purified protein derivatives. Animal-related characteristics, and the owner's knowledge on the importance of BTB were collected using a structured questionnaire. The prevalence was 11.24 % (95 % CI, 8.61-14.35) and 43.3 % (95 % CI, 33.27-53.75) at the individual and herd levels, respectively. There were statistically significant differences in the proportions of positive reactor animals according to body condition score (P = 0.000), age (P = 0.048), seasonal migration (P = 0.038), parity number (P = 0.005), and reproductive status (P = 0.037). Animals with poor body condition scores had a significantly higher likelihood of testing positive, with their odds being 11.4 times greater (COR = 11.408, CI = 3.43-37.94, P < 0.001). In multivariate logistic regression, poor body condition score remained significantly associated with the odds of a positive reaction to tuberculosis (AOR = 0.137, CI = 0.053-0.356, P < 0.001). Similarly, the analysis showed that seasonal migration (AOR = 2.882, CI = 1.155-7.191, P = 0.023) and parity number (AOR = 11.64, CI = 1.818-74.464, P = 0.010) were significant predictors of bovine tuberculosis infection in cattle. According to the questionnaire, 14.2 % (17 of 120) and 13.3 % (16 of 120) of the respondents were knowledgeable about bovine tuberculosis and its transmission from animals to humans, and vice versa, respectively. The general judgment of herders' understanding of bovine tuberculosis transmission methods to humans was very low. The study findings showed a high prevalence of bovine tuberculosis in the study area, emphasizing the need for an effective control and prevention strategy.

Effects of a lymphedema prevention program based on the theory of knowledge-attitude-practice on postoperative breast cancer patients: A randomized clinical trial

BACKGROUND

Breast cancer-related lymphedema (BCRL) is one of the common postoperative complications that severely affects the functions of the arm and quality of life. Since lymphedema is difficult to treat and prone to recurrence, early prevention of lymphedema is crucial.

METHODS

Patient diagnosed with breast cancer (N = 108) were randomized to the intervention (n = 52) or control group (n = 56). In the intervention group, patients were provided the lymphedema prevention program based on the theory of knowledge-attitude-practice during the perioperative period and the first three chemotherapy sessions (mainly includes health education, seminars, knowledge manuals, sports guidance, peer education, and WeChat group).The limb volume, handgrip strength, arm function, and quality of life were measured in all patients at the baseline, 9 weeks (T1), and 18 weeks (T2) after surgery.

RESULTS

The incidence of lymphedema in the Intervention group was numerically lower than in the control group after implementing the lymphedema prevention program, but the difference was not statistically significant (T1: 1.9% vs. 3.8%, p = 1.000; T2: 3.6% vs. 7.1%, p = 0.744). However, compared with the control group, the intervention group showed there was less deterioration in handgrip strength (T1 [t = -2.512, p < 0.05] and T2 [t = -2.538, p < 0.05]), improved postoperative upper limb dysfunction (T1 [t = 3.087, p < 0.05] and T2 [t = 5.399, p < 0.05]) and less deterioration in quality of life (T1 [p < 0.05] and T2 [p < 0.05]).

CONCLUSION

Although the investigated lymphedema prevention program improved arm function and quality of life, it did not reduce the incidence of lymphedema in postoperative breast cancer patients.

Assessment of Knowledge, Attitudes, and Practices (KAP): Public Health and Economic Burden of Tuberculosis in Jarso District of West Wollega Zone, Oromia, Western Ethiopia

Tuberculosis is a communicable mycobacterial disease of humans and animals caused by members of Mycobacterium tuberculosis complex, highly impacting the public health and economy of the country in endemic areas. Retrospective and cross-sectional study was conducted between March and August 2021. For knowledge, attitude, and practices study, five villages were randomly selected using simple random sampling. To quantify the public health burden, one-year data were collected from Jarso Health Center, and unregistered patients were identified using snowball method, and the estimation was based on disability-adjusted life years. Younger age groups (18-40 years) had shown 105.8 times more odds of knowledge towards tuberculosis than the older (>60 years). Moreover, tertiary levels of education had 9395.1 times more odds of knowledge towards tuberculosis compared to illiterates. The estimated economic burden was 7,731.25US$. Of the 51 tuberculosis patients, two died from the disease, resulting in 45.03 disability-adjusted life years. Communities of the study district were heard about tuberculosis, however, unaware of the cause and sources of the infection. Therefore, further strategic and continuous community-based health education and awareness should be given for effective control and prevention of tuberculosis in the study area.