Bovine tb ethiopia ejhd special 2008

142 Ethiop.J.Health Dev.
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association of BTB with particular geographical areas. Detailed information is missing and a lot of areas especially the
pastoral lowland areas are not covered. The situation of BTB on a nationwide level is largely unknown.
Existing Ethiopian publications show similarities with other African countries: in cattle, the individual prevalence of
BTB has been shown to be low whereas herd prevalence is high. BTB is more often found in intensive dairy farming
in urban and peri-urban setting (association of BTB with particular farming practice). There is an association with
wildlife at the interfaces.
One major issue seems to be the laboratory isolation of M. bovis in humans, which is consistent with the problem
encountered in other African countries. Only in Tanzania and Uganda (and Ethiopia) so far, has M. bovis been
successfully isolated from humans. Considering the prevalence described in cattle and the existence of risk factors of
disease transmission to humans, the prevalence in humans should be expected much higher. The question arises
whether there is a problem of detection in the laboratories.
Cost effective control of BTB in the context of developing countries
Collection of detailed epidemiological data on BTB in Ethiopia is a prerequisite before starting any large scale control
program. In developed countries, BTB has been eradicated by means of costly test and slaughter programs. This
approach is unthinkable in developing countries, who should opt for different, country adapted control strategies. An
option would be to integrate BTB control with the control of other zoonotic diseases in order to cut costs.
From an animal health perspective, it is most probably not cost effective to launch a control/eradication program at this
stage (e.g. cattle vaccination, test and slaughter, farmer compensation). However, measures can be readily taken from a
human health perspective in the absence of data on animal BTB: pasteurization of milk, strengthening of meat
inspection, public health education and strengthening awareness about the transmission of BTB (handling of animals,
consumption of raw animal products), BCG vaccination of people.
Building capacity
A huge capacity building is needed in Ethiopia (technology, human resources, education etc.). There is not enough
research done on BTB and baseline information and knowledge on BTB are lacking (national prevalence, impact on
productivity, geographical areas affected etc.).
The country lacks institutional capacity (research facilities), diagnostic capacity, surveillance capacity, and networking
in the advocacy. Abattoir surveys and meat inspection should be strengthened. A priority is the education of
communities, training of professionals and increase extension services. Existing national structures should be used
and linkage between institutions dealing with BTB promoted. Also the animal service should become a single entity
and not split under many divisions, which make it difficult to solve a problem.
Conclusions & recommendations
Bovine TB is prevalent and is probably one of the major zoonotic diseases in Ethiopia, however the magnitude of its
impact is largely unknown. Further studies on a national level should be carried out to investigate geographical areas
affected, especially in pastoral areas, field prevalence and economical impact of the disease. Baseline epidemiological
information is needed for assessing the most cost effective intervention for Ethiopia. Education, and working capacity
has to be strengthened and existing national structures should be used. Tackling a disease like BTB affecting both
livestock and humans requires joint activities between the Ministry of Health and Ministry of Agriculture. Only then
can a control strategy be developed.
If Ethiopia wants to take part in the international market, it has to make use of its own resources, its man power and
great numbers of cattle herds. The husbandry system has to be assessed from a sustainability perspective (ecological
sustainability) as well as from an economic perspective (economical profitability). The value and importance of
indigenous breeds (part of the Ethiopian heritage) has also to be taken into consideration when compared with
imported exotic breeds to increase productivity.
Human TB caused by M. tuberculosis is declared as emergency by WHO, unlike TB caused by M. bovis. If more
information is gathered for BTB and its zoonotic implication proved by hard field data then there would be a
possibility to approach the Global Fund for BTB funding.
Ethiop.J.Health Dev 2008;22(Special Issue).