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The impact of pastoralist mobility on tuberculosis control in Ethiopia : a systematic review and meta-synthesis

Nooh, Faisal and Crump, Lisa and Hashi, Abdiwahab and Tschopp, Rea and Schelling, Esther and Reither, Klaus and Hattendorf, Jan and Ali, Seid M. and Obrist, Brigit and Utzinger, Jürg and Zinsstag, Jakob. (2019) The impact of pastoralist mobility on tuberculosis control in Ethiopia : a systematic review and meta-synthesis. Infectious Diseases of Poverty, 8. p. 73.

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Abstract

Directly observed treatment, short-course (DOTS) is the current mainstay to control tuberculosis (TB) worldwide. Context-specific adaptations of DOTS have impending implications in the fight against TB. In Ethiopia, there is a national TB control programme with the goal to eliminate TB, but uneven distribution across lifestyle gradients remains a challenge. Notably, the mobile pastoralist communities in the country are disproportionately left uncovered. The aim of this study was to summarize the evidence base from published literature to guide TB control strategy for mobile pastoralist communities in Ethiopia.; We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and systematically reviewed articles in seven electronic databases: Excerptra Medical Database, African Journal Online, PubMed, Google Scholar, Centre for Agriculture and Bioscience International Direct, Cochrane Library and Web of Science. The databases were searched from inception to December 31, 2018, with no language restriction. We screened 692 items of which 19 met our inclusion criteria. Using a meta-ethnographic method, we identified six themes: (i) pastoralism in Ethiopia; (ii) pastoralists' livelihood profile; (iii) pastoralists' service utilisation; (iv) pastoralists' knowledge and awareness on TB control services; (v) challenges of TB control in pastoral settings; and (vi) equity disparities affecting pastoralists. Our interpretation triangulates the results across all included studies and shows that TB control activities observed in pastoralist regions of Ethiopia are far fewer than elsewhere in the country.; This systematic review and meta-synthesis shows that TB control in Ethiopia does not align well with the pastoralist lifestyle. Inaccessibility and lack of acceptability of TB care are the key bottlenecks to pastoralist TB service provision. Targeting these two parameters holds promise to enhance effectiveness of an intervention.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Former Units within Swiss TPH > Health Impact Assessment (Utzinger)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Human and Animal Health > One Health (Zinsstag)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Society, Gender and Health > Medical Anthropology (Obrist)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medicine (MED) > Clinical Research (Reither)
UniBasel Contributors:Crump, Lisa and Tschopp, Rea and Schelling, Esther and Reither, Klaus and Hattendorf, Jan and Ali, Seid Mohammed and Obrist van Eeuwijk, Brigit and Utzinger, Jürg and Zinsstag, Jakob Z
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Biomed Central
e-ISSN:2049-9957
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:18 Sep 2019 07:31
Deposited On:18 Sep 2019 07:31

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