Leprosy and tuberculosis in the Blue Nile Valley of Western Ethiopia

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Abstract
Data are presented on the prevalence of leprosy and tuberculosis among different ethnic groups living under different environmental conditions in the Mendi district of the Blue Nile Valley, Western Ethiopia. The data are based on a clinical survey of 1323 persons (main study), representing Highland and Midland Oromos as well as Midland and Lowland Nilotics and on records from the local leprosy and tuberculosis programmes (additional study). It is concluded that cases of leprosy are rarely found in the highlands, whereas prevalences of 53/1000 and 92/1000, respectively, were found in two of the Lowland Nilotic villages. On the other hand, tuberculosis is 2-4 times more frequent among the Highland and Midland Oromo population (10-18/1000) than among the Midland and Lowland Nilotics (3-7/1000). In addition to the genetic difference between the Oromo and Nilotic populations, the higher temperatures, lower humidity and black soil observed at the lower altitudes might be of importance for the prevalence of mycobacterial disease. There is some evidence of an ongoing leprosy epidemic among the previously isolated Lowland Nilotics, and indications of a tuberculosis epidemic starting after their increased contact with the tuberculosis-infested Highland Oromos. This paper is the first in a series that reports on the prevalence of several public health problems in this area, the Blue Nile Public Health Survey (BNPHS). Hence, some general information is provided on the concerned population, the geography and the organization of the public health services in the Mendi district.

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