Review on Bovine Tuberculosis and Drivers for Initiating Its Control in Ethiopia

Bovine tuberculosis (bTB) is a zoonotic bacterial infection caused by Mycobacterium bovis. This paper reviews the status and drivers for controlling bovine tuberculosis (bTB) in Ethiopia. Bovine tuberculosis, caused by Mycobacterium bovis, is a zoonotic bacterial disease that is endemic and widespread in Ethiopia. The most common route of transmission between cattle is inhalation whereas from animals to humans is through the consumption of raw animal products especially milk. Close contact between humans and animals is another significant risk factor for the spread of zoonotic TB. Bovine TB poses a serious threat to animal production; particularly affecting exotic breeds kept under intensive or semi-intensive production systems, and has considerable public health implications. In humans, zoonotic TB often presents as extra-pulmonary TB, making it clinically and radiologically indistinguishable from TB caused by M. tuberculosis. Misdiagnosis and delayed treatment initiation are common challenges. Moreover, M. bovis is naturally resistant to pyrazinamide, complicating treatment outcomes when healthcare providers initiate therapy without drug susceptibility testing. The challenges in combating zoonotic TB in developing countries include the involvement of multiple hosts, lack of early diagnostic tools, and socio-cultural barriers. While treatment in animals is generally not recommended, vaccination is practiced in human medicine but is not widely used as a preventive measure in animals. In industrialized countries, M. bovis has been significantly reduced through measures such as strict test-and-slaughter policies, meat inspection, milk pasteurization, and financial compensation for farmers. Globally, the End TB Strategy aims to end the TB epidemic by reducing TB deaths by 95% and new cases by 90% between 2015 and 2035 while eliminating catastrophic economic burdens on affected families. However, Ethiopia lacks a national bTB control program. Given the severe impact of M. bovis on both animal and human health, implementing sustainable bTB control and prevention measures in Ethiopia is essential to reduce the disease's burden on both populations.