Date Published: June 11, 2018
Publisher: Public Library of Science
Author(s): Hezekiah Kehinde Adesokan, Victor Oluwatoyin Akinseye, Mutolib Abiodun Sulaimon, Seyed Ehtesham Hasnain.
Zoonotic tuberculosis (TB) is a significant public health disease, but has long been neglected. Information on knowledge and practices of its prevention and influencing factors amongst occupationally exposed individuals is required for designing all-inclusive, informed control programmes. We investigated knowledge and practices related to zoonotic TB prevention and associated determinants amongst herdsmen and abattoir workers in south-western, south-eastern and north-western Nigeria using semi-structured questionnaire. Data were analysed with STATA 12. A total of 510 respondents (196 herdsmen; 314 abattoir workers) participated in the survey, of which 58.6% and 46.9% respectively were knowledgeable and demonstrated good practices about zoonotic TB prevention. Almost 60% knew that zoonotic TB transmission was preventable and 49.8% knew transmission could be through consumption of infected animal products. However, only 16.7% knew the disease could be transmitted by aerosol. Just 49.4% sought medical check-up when ill, 37.8% used protective clothing and only 29.2% usually condemned TB infected cattle. Respondents with post-primary education were about three times more likely to be knowledgeable (OR = 2.70, 95%CI: 1.68–4.33) and two times more likely to demonstrate good practice (OR = 2.23, 95%CI: 1.45–3.42) than those without formal education. Similarly, abattoir workers were about 6.4 times more likely to be knowledgeable (OR: 6.39, 95%CI: 4.31–9.47) and two times more likely to demonstrate good practice (OR: 2.03, 95%CI: 1.40–2.92) than the herdsmen. There were important knowledge gaps with poor practices about zoonotic TB prevention amongst livestock workers in Nigeria. Strong predictors of knowledge and practice were being an abattoir worker and having post-primary education. Well-designed grassroots enlightenment programmes addressing modes of transmission, handling infected cattle and seeking medical check-up are urgently needed among high risk settings considering the recently launched Road Map for Zoonotic Tuberculosis which resonates that every tuberculosis case counts towards 2030 End-TB Strategy.
Tuberculosis (TB) remains a major global health problem [1–2]. It plays a central role in public health and animal health due to its severe disease in humans and significant economic losses to cattle producers related to affected herds and slaughtered cattle [3–6]. It causes ill-health in millions of people each year and in 2015 was one of the top 10 causes of death worldwide, ranking above HIV/AIDS as one of the leading causes of death from an infectious disease . It is caused by Mycobacterium tuberculosis in humans resulting in active TB in approximately 10.4 million people in 2015  and M. bovis in cattle with a broader host range for TB in domestic and wild animals . In addition, M. bovis infects humans, causing zoonotic TB in humans [8–10]. An estimated 147 000 new cases of zoonotic TB were reported in 2015 globally and 12, 500 deaths due to the disease with the highest incidence in Africa . These global estimates are however imprecise due to lack of routine surveillance data from human and animal populations . For instance, earlier local studies have reported higher proportions in humans [9, 12–13].
Adequate knowledge and effective practices of zoonotic TB prevention among the occupationally exposed groups particularly in sub-Saharan African countries where the burden of TB is high is vital to achieve the WHO’s 2030 End TB Strategy which seeks to end the global TB epidemic by 2030. This becomes more important in the wake of the recently launched Road Map for Zoonotic Tuberculosis by WHO/OIE/FAO/IUATLD  and supported by the Stop TB Partnership’s Global Plan to End TB 2016–2020 –The Paradigm Shift, which identifies people at risk of zoonotic TB as a neglected population deserving greater attention .
The livestock workers were knowledgeable about zoonotic TB prevention; however, there were important knowledge gaps in some core areas, including its modes of transmission coupled with their poor levels of preventive practices. Education and types of occupation were significant factors for knowledge and practices about zoonotic tuberculosis prevention amongst the livestock workers. Considering the fact that the greatest burden of zoonotic diseases including tuberculosis lies within poor, marginalised, rural communities that live in close proximity with livestock and lack access to safe food and adequate health care, there is need to step up increased awareness programmes about these diseases amongst such settings. Since most zoonotic diseases often share common risk factors, well-designed education prevention strategies can reduce risks posed by several diseases at once, thereby increasing their overall cost- and resource-effectiveness. Hence, grassroots enlightenment programmes on zoonotic disease preventive measures are urgently needed amongst livestock communities especially in developing countries in line with the goal of the recently launched Road Map for Zoonotic Tuberculosis by WHO/OIE/FAO/IUATLD  towards achieving 2030 End-TB Strategy.