Browsing by Author "Nilsen, R."
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Item Mycobacterial adenitis: role of mycobacterium bovis, non-tuberculous mycobacteria, hiv infection, and risk factors in arusha, Tanzania(East African Medical Journal, 2004-04) Mfinanga, S .G .M.; Morkve, O.; Kazwala, R. R.; Cleaveland, S.; Sharp, M. J.; Kunda, J.; Nilsen, R.Objective: To assess risk factors and mycobacterial agents in mycobacterial adenitis. Design: Cross sectional involving comparison analysis of high-risk groups. Setting: Seven hospitals in rural and semi-rural districts of Arusha. Subjects: The study comprised of 457 patients of clinically diagnosed mycobacterial adenitis. Interventions: Biopsy materials were cultured and identification of mycobacterial isolates, and HIV infection testing were performed using standard methods. A questionnaire was used to establish information for assessing risk factors. Main outcome measures: Proportions of mycobacterial isolates, risk factors and odds ratios. Results: Of the 457 specimens, 65(14.2%) were culture positive. Isolates identified were M. bovis, 7(10.8%) M. tuberculosis, 27(41.5%) and non-tuberculous mycobacteria 31(47.7%). HIV infection and ingestion of raw milk were linked with increased risk of M. bovis infection by OR of 13.6 (95% CI, 1.7 - 109.9) and 15.28 (3.26 - 71.7), respectively. On multivariate analysis, an OR of 16.2 (1.3 - 201.3) for having M. bovis adenitis was linked to HIV infection, raw milk and houses with poor ventilation. An OR of 5.2 (1.2 - 20.6) for non-tuberculous mycobacterial adenitis was linked to history of TB in the family, HIV infection, raw milk, raw animal products and poor knowledge on transmission of tuberculosis. Conclusions: M. bovis caused one out of ten cases of culture positive mycobacterial adenitis. Non-tuberculous mycobacteria were more common than M. tuberculosis (50% and 40% of the cases, respectively). HIV infection and raw animal products are among the risk factors identified for M. bovis and non-tuberculous mycobacterial adenitis.Item The role of livestock keeping in tuberculosis trends in Arusha, Tanzania(The International Journal of Tuberculosis and Lung Disease, 2003-01-15) Mfinanga, S. G.; Mørkve, O.; Kazwala, R. R.; Cleaveland, S.; Sharp, J. M.; Shirima, G.; Nilsen, R.OBJECTIVE: To assess risk factors that might influence TB control in the general population and in livestockkeepers. METHODS: Of 242 villages in four districts, 27 were selected randomly. In each village, a general and a livestock- keeping group were selected at random. The households were home-visited and 426 family members were interviewed. RESULTS: On average, three-quarters of households practised at least one risk activity for transmission of zoonotic tuberculosis, and respondents had poor knowledge about tuberculosis. In the livestock-keeping group, the risks of having a tuberculosis patient in the family were determined by poor ventilation (OR 2.6, 95%CI 1.1–6.5), confining livestock indoors with people (OR 2.3, 95%CI 1.1–5.0) and multiple determinants including poor ventilation (OR 13.5, 95%CI 2.5–71.7). Risk activities and the risks of having a tuberculosis patient in a family were significantly higher in the livestock-keeping group. CONCLUSIONS: The respondents had limited knowledge about tuberculosis, and the households had practices that posed potential risks for both human and bovine tuberculosis infection. Poor ventilation and confining livestock indoors were associated with tuberculosis spread in the households. These risks were observed more in the livestock-keeping group than in the general population group.Item Tribal differences in perception of tuberculosis: A possible role in tuberculosis control in Arusha, Tanzania(International Journal of Tuberculosis and Lung Disease., 2003) Mfinanga, S. G.; Mørkve, O.; Kazwala, R. R.; Cleaveland, S.; Sharp, J. M.; Shirima, G.; Nilsen, R.SETTING: Arusha, Tanzania. OBJECTIVE: To determine tribal differences in knowledge and practices that might influence tuberculosis control. METHOD: Twenty-seven villages were selected randomly out of 242 villages in four districts. In each village, a general and a livestock keeping group were selected at random. The households were home-visited and 426 family members were interviewed. RESULTS: On average, 40% of respondents practiced habits that might expose them to both bovine and human tuberculosis. The Barabaig tribe had a significantly higher number of respondents (50%, X2(2) = 5.1, P = 0.024) who did not boil milk. Eating uncooked meat or meat products was practised by 17.9% of all respondents. The habit was practised more by Iraqw (21.1%, X2(2) = 6.9, P = 0.008) and Barabaig (31.6%, X2(2) = 5.6, P = 0.016) than other tribes. About 75% of the respondents had a poor knowledge of tuberculosis. CONCLUSION: All tribes had habits and beliefs that might expose them to both bovine and human tuberculosis. The Iraqw and Barabaig tribes practised such habits more than other tribes. Knowledge of tuberculosis was limited in all tribes.