Community Involvement in the Prevention of Bovine Tuberculosis among Nomadic Fulani and their Host Communities in Oyo State, Nigeria

Abstract

Globally, Bovine Tuberculosis (BTB) is one of the strains of tuberculosis, which accounts for 1.5 million deaths annually. Nigeria is the fourth most affected country in the world and Oyo State is third in the country. Previous studies have focused largely on the prevalence and control of BTB through the use of drugs and not on how Community Involvement (CI) could help curtail BTB. This study was therefore designed to investigate the effects of BTB awareness, health-seeking behaviours, gatekeeping system and inter-ethnic relationship on community involvement in the prevention of BTB in Oyo State, Nigeria. Social Network Theory and Health Belief Model were adopted as the framework. Exploratory and cross-sectional survey designs were employed. Multistage sampling was adopted. Oyo State was purposively selected, while cluster sampling was used to select six local government areas (LGAs) with nomadic camps. Iseyin, Saki West and Ibarapa East LGAs with high tuberculosis cases and Saki East, Itesiwaju and Ibarapa North LGAs with low cases were purposively selected. Communities with nomadic camps (with at least 100 residents) were purposively selected. Yamane’s (1967) method was used to select 812 respondents comprising Iseyin (183), Itesiwaju (101), Saki West (122), Saki East (193), Ibarapa North (110) and Ibarapa East (103) LGAs. The 171-items questionnaire covered BTB awareness, consumption practices, health-seeking behaviour, gatekeeping, inter-ethnic relationship and CI (decision making, activities and accountability). Twelve in-depth interviews and nine key informant interviews were conducted among community/camp leaders and gatekeepers (community volunteers, and veterinarians) respectively. Quantitative data were analysed using descriptive and inferential (chi-square, binary and multinomial regressions) statistics at p≤0.05, while qualitative data were content analysed. Respondents’ age was 37±22 years and 51.0% were male. About 44.5% had no formal education and 46.3% were Fulani. Fifty percent consumed unpasteurised milk, of which 84.0% were not aware of their tendency to contract BTB from its consumption. In general, the knowledge of respondents about consumption of unpasteurised milk (χ2=8.11), roasted meat (χ2=13.30) and milking cattle (χ2=19.71) was significantly related to the levels of tuberculosis prevalence in the LGAs. Also, there was a significant relationship (χ2=17.02) between perceived threat of contracting BTB and health-seeking behaviour in the LGAs. Ethnic group was significantly related to the adoption of sensitisation (χ2=37.53), avoidance of infected animal products (χ2=8.61) and BTB suspect referral (χ2=9.33) for BTB prevention. In the LGAs with high tuberculosis prevalence, respondents prevented BTB through avoidance of close contact with suspected BTB patients (β=0.55), supports for drug adherence (β=1.51) and mobilisation (β=1.79) of the community members. Also, inter-ethnic relationship (OR=1.51) was not a significant reason for involving in preventive activities geared toward BTB among the Fulani. The respondents were involved in decision-making (2.7%), activities (8.7%) and accountability (0.1%). Gatekeepers explained that their inability to prevent BTB adequately was due to limited manpower, while community leaders were not engaged in the BTB prevention. Communities were less involved in the curtailment of bovine tuberculosis. Thus, sufficient bovine tuberculosis information should be made available to the public to engender high community involvement in the bovine tuberculosis prevention.