BackgroundMultidrug-resistant tuberculosis (MDR-TB) is resistant to the two main first-line anti-tuberculosis drugs: rifampicin and isoniazid. It is a major threat to public health worldwide. The objective of this study was to assess the potential risk factors for multidrug-resistant tuberculosis among patients undergoing MDR-TB treatment at two community hospitals in Ethiopia.MethodsA case-control study design was conducted from February 1, 2016, to April 29, 2016. TB-positive patients with MDR-TB and non-MDR-TB were considered as cases and controls, respectively. A total of 219 study participants were included in the study. An interviewer-administered structured questionnaire was used to collect primary data from the patients, and a checklist was used to collect data from the clinical records. Bivariate and multivariate logistic regression analyses were used to assess the potential risk factors for the occurrence of MDR-TB.ResultsThe odds of developing MDR-TB were higher in patients previously treated with anti-TB drugs (odds ratio [OR] = 6.1, 95%CI: 2.92–12.62, P < 0.001), those with a history of contact with known TB patients (OR = 2.1, 95%CI: 1.04–4.43, P < 0.001), those living in a rural setting (OR = 5.6, 95%CI: 2.14–14.46, P = 0.001), those with a history of alcohol consumption (OR = 4.3, 95%CI: 2.29–10.49, P < 0.001) and those without a job (OR = 2.4, 95%CI: 1.06–5.42, P = 0.001).ConclusionsThe study revealed that contact with known TB patients, previous TB treatment, residence area, lack of a job, and alcohol consumption were potential risk factors for the occurrence of MDR-TB. Enhancing public health education, intensifying directly observed therapy programmes for all TB patients and designing control strategies are recommended.

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A cross-sectional study was conducted from October, 2009 to March, 2010 to assess the level of contamination of informally marketed milk with Staphylococcus aureus at farms and milk collection centers in Debre-Zeit, Ethiopia. One hundred and seventy raw farm bulk milk samples, 25 mixed bulk milk samples and 20 pasteurized and packaged milk samples were collected from 14 milk collection centers and isolation and identification of S. aureus were carried out following standard method. S. aureus was isolated from 44% of farm bulk milk and 72% of milk collection centers' bulk milk and it was not detected from pasteurized milk samples. Contamination rates of farm bulk milk with S. aureus were significantly different among the collection centers (χ 2 = 31.8, df = 13, p = 0.003). The milk produced and collected in peri-urban areas was significantly more contaminated with S. aureus (64%) than milk produced and collected in urban areas (38%) (χ 2 = 7.18, df = 1, p = 0.007). The frequency of isolation of S. aureus in milk collection centers bulk milk varied between 67 and 100% among collection centers. However, the contamination rates were not significantly different among these collection centers (χ 2 = 1.5, df = 4, p = 0.83). The overall contamination rate at collection centers (72%) was significantly higher than that at the farm level (33%, χ 2 = 10.6, df = 1, p = 0.001). Overall, the study revealed that milk produced and collected in and around Debre-Zeit was found to be contaminated with S. aureus, raising the issue of quality control and improving the safety of milk to safeguard the consumer from associated health problems and enabling the producers to earn much more from milk sale.

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A cross-sectional study was conducted on 858 dairy cows, 1107 slaughter animals and 58 dairy workers in and around Sululta District to investigate the epidemiology and public health importance of bovine tuberculosis (BTB). To that end, comparative intradermal tuberculin test (CIDT), post-mortem examinations, bacteriological analysis, molecular typing and questionnaire survey were employed. The herd and individual animal level prevalence were 11.4% (98/858) and 20% (9/45), respectively. The individual animal prevalence was affected by farming system, herd size, management system, sex, age, breed and body condition (P<0.05). Abattoir survey showed a prevalence of BTB to be 3.5% (39/1107) based on suspicion of tuberculous lesion. Culture positivity in primary culture media was confirmed in 7.7% (3/39) of tissue samples, 11.1% (5/55) of milk samples and 2.5% (1/40) of nasal swab samples. Genus typing of the nine positive isolates indicated that only 11.1% (1/9) one isolate was positive for the genus Mycobacterium. Among the farm attendants, only 6.9% (4/58) of the farm attendants had awareness on the existence of BTB, 10.3% (6/58) had awareness that milk and meat could be a source of BTB and 79.3% (46/58) had habit of raw milk and raw meat consumption. The study reveals the importance of BTB and poor awareness on the existence, source and transmission of the diseases in the study area call for urgent intervention. Conventional preventive measures and large scale collaborative action to design cost effective preventive and control measures at national level is recommended.