The Impact of Tuberculosis (Tb) On Farmer, S Productivity, Income and Food Security, With Special Refrence To Gash Delta, Kassala State Sudan

Abstract

This study was conducted at the Gash delta in Kassala state which located in the eastern north of the Sudan, between latitude 10, 28o-16, 26o north and longitude 35, 56o-36, 25o east. Within the area the Gash delta agricultural scheme is located which represents one of the main agricultural schemes in the country. It was selected based on the fact that agriculture in this area plays an important role in the economical and social development of the region and it satisfied the local demand of food as well as the demand in other regions in the country. TB prevalence rate is high in this area. (The rate of TB infection increased up to 4% i.e. 4000 persons out of 100,000 persons), that obstruct the overall economic activities of this area. The study is designed to evaluate the impact of TB on farmer's productivity, income and food security in the Gash delta. It depends mainly on primary and secondary data, the primary data was collected by questionnaire through direct interview of the respondents in the Gash delta agricultural scheme for season 2005-2006. The sample covers 100 farmers of TB morbidity and debility cases selected randomly from the farmers in the area, who cultivated their land in that season, using the registration list in Aroma, Kassala and Wager hospitals after diagnosis of the disease, another 100 healthy farmers were selected using the same method of sample selection. (The total sample size was 200 farmers). Secondary data was collected from different sources including, Ministry of Agriculture, Ministry of Health, National TB programme (NTP), Gash delta agricultural scheme, Kassala, Aroma, Wager hospitals, v institute of endemic diseases (University of Khartoum), WHO, different net web sites and others official reports related to the field of the study. To test the hypothesis of the study, different statistical procedure were used, including frequencies and chi-square test to identify the significant differences between the two farmer samples (healthy and infected) in terms of the selected variables of the conceptual model. Correlation analysis was also conducted for the selected variables of the conceptualized model as well as multiple regression analysis for generation of the path coefficients for a revised causal model of farmer's productivity, income and food security. The principal results of this study are summarized in the following points: • There is a significant difference between the infected and healthy farmers with respect to socioeconomic characteristics and agronomic factors. • The causal model for the farmer's productivity, income and food security, reflect that: The main factors affecting farmer's productivity were, the number of working daily hours, family size and harvesting time. The main factor affecting farmer's annual income is the farmer's productivity. The main factor affecting food security is farmer's productivity. Based on the finding, the study concluded that, Tuberculosis has a negative impact on farmer's productivity, income and food security in the Gash delta due to: vi 1-TB affects all age groups but its greatest impact is on the economically productive age group. 2-TB negatively impacting farmer's educational level. 3-TB is the cause of the worse farmer's nutritional and health status and vise versa. 4-TB delay both sowing date and harvesting time of the crop. 5-TB decreases number of daily working hours by 7.53 hours/day (73%). 6-TB weakened farmer's ability to work, that result in the farmer loose a number of agricultural seasons without cultivating his land. 7-TB decreases area under cultivation by 2.96 feddan (51.4%). 8-TB decreases crop market price by .61 (1000SD) (12.3%). 9- TB increases annual expenditure by 28.58(1000SD) (15.13%). Finally, a set of recommendations were generated which aimed to reduce TB infection and disease in the Gash delta: 1- Periodic test and prevention of the disease. 2- Isolation of the patient farmers with active disease, before starting effective anti-tuberculosis therapy, so as to break the chain of transmission of the disease among the farmers. 3-Adequate TB control and management program is needed and integration into primary health care. 4- There is a need of health education to teach the farmers about TB disease and how to avoid its infection. 5- Nutritional programmes, to teach the Hadandwa women about the importance of the varieties of food and their processing, specially milk pasteralization. 6- Re-habitation of health units in the deferent areas of the Gash delta and provide them with the required health services so as the infected farmers need not to travel outside the area. vii 7-Aroma hospital should have to coordinate with the Gash delta agricultural scheme to play an effective role in reaching and looking after the patient farmers. 8- The Gash delta agricultural scheme management should have to seek a way for supporting the patient farmer's income. 9- Good ventilation of houses and avoid overcrowding as much as possible. 10-TB control programme in Kassala state should have nutrition- based intervention for the infected farmers. 11-11-The state government should have to compensate the infected farmers for the lost seasons. 12- Incorporate the international NGOs. 13-To make more studied on this subject by the researchers in the future.