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Open Access Research article

Health-seeking behaviour of human brucellosis cases in rural Tanzania

John Kunda12*, Julie Fitzpatrick3, Rudovic Kazwala4, Nigel P French5, Gabriel Shirima7, Alastair MacMillan6, Dominic Kambarage4, Mark Bronsvoort2 and Sarah Cleaveland2

Author Affiliations

1 National Institute for Medical Research, Muhimbili Centre, Tanzania

2 Centre for Tropical Veterinary Medicine, University of Edinburgh, Easter Bush, EH25 9RG, UK

3 Moredun Research Institute, Pentlands Science Park, Midlothian, Edinburgh, EH26 0PZ, UK

4 Sokoine University of Agriculture, Morogoro, Tanzania

5 Institute of Veterinary, Animal and Biomedical Sciences, Massey University, New Zealand

6 Veterinary Research Directorate, DEFRA, Cromwell House, London, SW1P 3JH, UK

7 Animal Disease Research Institute, Dar es Salaam, Tanzania

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BMC Public Health 2007, 7:315  doi:10.1186/1471-2458-7-315

Published: 3 November 2007

Abstract

Background

Brucellosis is known to cause debilitating conditions if not promptly treated. In some rural areas of Tanzania however, practitioners give evidence of seeing brucellosis cases with symptoms of long duration. The purpose of this study was to establish health-seeking behaviour of human brucellosis cases in rural Tanzania and explore the most feasible ways to improve it.

Methods

This was designed as a longitudinal study. Socio-demographic, clinical and laboratory data were collected from patients who reported to selected hospitals in rural northern Tanzania between June 2002 and April 2003. All patients with conditions suspicious of brucellosis on the basis of preliminary clinical examination and history were enrolled into the study as brucellosis suspects. Blood samples were taken and tested for brucellosis using the Rose-Bengal Plate Test (RBPT) and other agglutination tests available at the health facilities and the competitive ELISA (c-ELISA) test at the Veterinary Laboratory Agencies (VLA) in the UK. All suspects who tested positive with the c-ELISA test were regarded as brucellosis cases. A follow-up of 49 cases was made to collect data on health-seeking behaviour of human brucellosis cases.

Results

The majority of cases 87.7% gave a history of going to hospital as the first point of care, 10.2% purchased drugs from a nearby drug shop before going to hospital and 2% went to a local traditional healer first. Brucellosis cases delayed going to hospital with a median delay time of 90 days, and with 20% of the cases presenting to hospitals more than a year after the onset of symptoms. Distance to the hospital, keeping animals and knowledge of brucellosis were significantly associated with patient delay to present to hospital.

Conclusion

More efforts need to be put on improving the accessibility of health facilities to the rural poor people who succumb to most of the diseases including zoonoses. Health education on brucellosis in Tanzania should also stress the importance of early presentation to hospitals for prompt treatment.