Alcohol brewing and the African tuberculosis epidemic

Countries in much of Africa are struggling with large tuberculosis (TB) epidemics. Although the treatment programs are being implemented as well as the many constraints allow, more prevention of TB is needed. Based on literature on alcohol and TB, and observations and case studies, we consider one potential area for intervention might be the popular and ubiquitous small bars and beer huts in many towns and cities. In these usually poverty-ridden sites, with their densely packed clientele, large amounts of alcohol are consumed often by those with compromised immune systems who are at risk of acquiring the disease. The alcohol brewers-called Mama Pimas (from kupima, to measure, in Kiswahili) in Kenya-are the subject of this editorial. We look at the risks and potential benefits of reaching these women. Medical anthropologists are needed to help provide better evidence for TB prevention programs.