Lay attitudes and misconceptions and their implications for the control of brucellosis in an agro-pastoral community in Kilombero district, Tanzania

Abstract

Brucellosis is a priority zoonotic disease in Tanzania that causes ill-health in people and affects livestock productivity. Inadequate awareness and behavior risking transmission can impede control efforts. We conducted a cross-sectional survey of 333 livestock owners in three villages in the Kilombero district, Tanzania, to understand their awareness, knowledge and behavior associated with brucellosis. Six Focus Group Discussions (FGDs), two in each village, were conducted, as well as an additional FGD with male herders from one of the villages. Factors associated with knowledge on brucellosis, food consumption and animal husbandry behavior risking transmission of this disease, were identified using generalized linear models. Predictors for knowledge of brucellosis were being male and having a higher educational level, while age was positively associated with a higher level of knowledge. Faith and ethnicity were associated with the performance of practices risking transmission. Following traditional religion and belonging to the Wamaasai ethnicity significantly increased the odds of carrying out these practices. Qualitative analysis gave insight into risk practices and reasoning. Of the 333 respondents, 29% reported that they had experienced abortions in their herds, 14% witnessed retained placentas, and 8% had seen still-births in their cattle within the previous year. However, survey results also showed that only 7.2% of participants had heard about brucellosis as a disease in livestock. Of those who had heard about brucellosis in livestock, 91% associated abortions with it and 71% knew that humans can get infected through raw milk consumption. People overwhelmingly attributed symptoms and transmission of brucellosis in livestock to infection with trypanosomiasis and to supernatural reasons instead. In the community, consumption of raw milk was valued and handling of aborted material was not considered a risk for infection. This agro-pastoralist community holds on to long-held beliefs and practices and lacks understanding of the biomedical concept of brucellosis. Transmission routes and symptoms of brucellosis in humans and livestock are completely unknown. The disparity between risk perception and actual transmission risk related to animal handling and consumption of animal products presents a challenge for disease awareness communication. This study recommends focused community engagement and sensitization to address the limited awareness and misconceptions among agro-pastoralists.

Using Intersectionality to Identify Gendered Barriers to Health-Seeking for Febrile Illness in Agro-Pastoralist Settings in Tanzania

“…As such, being male and young (aged 40 years or less) was negatively associated with promptly seeking treatment for fever. These findings are consistent with what Mbruru et al (56) found in a study of lay attitudes of animal to human infections, and how etiologies of febrile illness potentially caused by animalhuman interaction influence men and women's treatmentseeking behavior. In our study, and as we describe in detail later, power relations at community and household level shape access to medical resources, including medical fees, money for buying OTC medication, interpretation of illness symptoms or time allocation for gathering herbal treatment from the forest.…”

Knowledge, attitudes, and practices of Crimean Congo hemorrhagic fever among livestock value chain actors in Kagadi district, Uganda

“…Such behaviors are practiced regardless of the knowledge of spread of zoonotic pathogens. This is supported by the study conducted in an agropastoral community where agro-pastoralists engaged in risky behaviors, although they knew the existence of a zoonotic disease [ 18 ]. They attributed the risky behaviors to culture, social norms, and the belief that the risk is low since they have been practicing those behaviors for generations without any health implication.…”

Seroprevalence and related risk factors of Brucella spp. in livestock and humans in Garbatula subcounty, Isiolo county, Kenya

“…Nonetheless, this finding emphasizes the well-known association between spontaneous abortion in animals and brucellosis infection [ 48 , 49 ]. Despite the established link between brucellosis and spontaneous abortion in livestock, pastoralists may not always associate spontaneous abortions in their animals with brucellosis [ 50 ]. As a result, they may continuously expose themselves to the disease while handling infected abortion materials.…”