ObjectiveTo determine and describe clinical symptoms, demographic characteristics and environmental exposures as determinants of pulmonary mycobacterial diseases among patients examined for tuberculosis in agropastoral communities in Northern Tanzania.MethodsThis was a cross sectional study. Sputum samples were collected from patients attending three hospitals in Tanzania, and were investigated for pulmonary tuberculosis by microscopy between November 2010 and June 2012. The patients were interviewed about background information, and potential exposure to mycobacteria.ResultsWe examined 1,711 presumptive tuberculosis cases where 936 (54.2%) were males and 775 (45.3%) females. Of all the study participants, 277 (16%) were found to have sputum samples positive for mycobacteria; 228 (13%) were smear positive, 123 (7%) were culture positive and 74 (4%) were positive by both smear microscopy and culture. Of the 123 mycobacterial culture positive, 15 (12.2%) had non-tuberculous mycobacteria. Males were more likely than females to be positive for mycobacteria. Factors associated with mycobacterial disease were loss of appetite, age groups below 41 years, and being a male. Among HIV negative patients, loss of appetite, age below 20 years and being a male were associated with being mycobacterial positive. Among HIV positive patients, males and those patients with a persistently coughing family member were more likely to harbor mycobacteria.ConclusionThe findings in this study show that both M. tuberculosis and non-tuberculous mycobacterial strains were prevalent in the study community. Some risk factors were identified. Although the reported predictors may improve screening for mycobacterial diseases, their use requires some precaution.

ObjectiveThe current study was conducted to assess experienced risk factors and perceptions of mycobacterial diseases in communities in northern Tanzania.MethodsWe conducted a cross-sectional study in Arusha and Manyara regions in Northern Tanzania. We enrolled tuberculosis (TB) patients attending Mount Meru Hospital, Enduleni Hospital and Haydom Lutheran Hospitals in Arusha municipality, Ngorongoro and Mbulu districts, respectively. Patient addresses were recorded during their first visit to the hospitals. Patients with confirmed diagnosis of TB by sputum smear microscopy and/or culture at central laboratory were followed up and interviewed using pre-tested questionnaires, and selected relatives and neighbors were also interviewed. The study was conducted between June 2011 and May 2013.ResultsThe study involved 164 respondents: 41(25%) were TB patients, 68(41.5%) were their relatives and 55(33.5%) their neighbors. Sixty four (39%) knew a risk factor for mycobacterial disease. Overall, 64(39%) perceived to be at risk of mycobacterial diseases. Exposure to potential risks of mycobacterial diseases were: keeping livestock, not boiling drinking water, large family, smoking and sharing dwelling with TB patients. Rural dwellers were more often livestock keepers (p<0.01), more often shared dwelling with livestock (p<0.01) than urban dwellers. More primary school leavers reported sharing dwelling with TB patients than participants with secondary and higher education (p = 0.01).ConclusionLivestock keeping, sharing dwelling with livestock, sharing household with a TB patient were perceived risk factors for mycobacterial diseases and the participants were exposed to some of these risk factors. Improving knowledge about the risk factors may protect them from these serious diseases.

Like in the rest of the world, the vision for the future of agriculture in the developing world is highly contested. At the centre of this oft-polarized debate, a growing constituency of advocates suggests a large-scale shift to agroecology as the key to transforming Africa's agriculture. Yet, this rhetoric is not only quixotic in its vision for an African agricultural revolution but also profoundly dissociated from the realities of African agriculture. If the aim is to revolutionize African agriculture, rigid philosophical fixations on an idealized farming system are not the answer. For resource-poor farmers looking to lift themselves out of poverty in Africa and the rest of the developing world, such a narrative will only protract the status quo. Most crucially, it represents a pathway that stands to drive them deeper into poverty. Agricultural transformation in the developing world requires a pragmatic outlook, one that leverages the best of agroecology and modern agricultural solutions for smallholder farmers.

Aim: To determine knowledge and perceptions about tuberculosis in agropastoral communities in Northern Tanzania. Study Design: This was a cross sectional study on habits and attitudes to tuberculosis. Methods: The study was conducted between June 2011 and May 2012.We enrolled tuberculosis patients registered at Mount Meru Hospital in Arusha municipal, Enduleni Hospital in Ngorongoro district, and Haydom Lutheran Hospital in Mbulu district. In addition we selected for comparison some of their household relatives and individuals from the neighborhood. Data was collected using a structured questionnaire. Knowledge about tuberculosis was assessed by questions concerning causes, symptoms, modes of transmission and prevention and treatment. Key variables for Kilale et al.; BJMMR, 10(3): 1-9, 2015; Article no.BJMMR.18973 2 assessment of perception on tuberculosis included: individuals considered most at risk, and misconceptions. Results: We recruited 164 respondents of whom 25% were confirmed tuberculosis patients, 41.5% relatives of the patients and 33.5% neighbors. Females constituted 48.8% of all respondents. Of all the participants, only two of the neighbors had never heard about tuberculosis in their life time. Even though 99% had heard about tuberculosis, specific knowledge on causes, prevention and treatment was poor. A total of 67.7% thought that transmission of tuberculosis occurs during sexual intercourse. Respondents thought that risk from tuberculosis was higher among adults (68.9%), alcohol users (39.6%), smoking (26.8%), consumption of raw animal products (6.1%) and childhood (23.2%). Conclusion: Our study shows that study participants had heard about tuberculosis but specific knowledge was low. Misconceptions surrounding causes, transmission, prevention and treatment of the disease were common. Selection of appropriate channels for public health education and awareness programmes targeting knowledge about prevention and control of tuberculosis in agropastoral communities may improve this situation. Original Research Article