Attitude and social consequences of tuberculosis in Addis Ababa, Ethiopia

Abstract

Objective: To gain a better understanding of the attitude and social consequences of tuberculosis (TB) in Addis Ababa, Ethiopia. Design: A cross sectional survey using a structured questionnaire and a qualitative study based on the focus group discussion (FGD) technique. Setting: Eight different kebeles (urban dwellers' associations) of six woredas (next higher administrative level to kebele). Subjects and methods: Seven hundred and three participants, comprising 326 males and 377 females were interviewed using the written questionnaire and 36 recent and current TB patients through focus group discussion. Data were analysed using SPSSRC statistical package. The proportions were compared using univariate and bivariate analyses to show the frequency distribution and evaluate the relationship among different variables. In FGD, topics relevant to the research questions were identified, sorted and analysed. Conclusions were then formulated. Main outcome measures: Attitude of participants towards TB and its victims and social consequences of being a TB patient. Results: Eighty three per cent of the respondents were aware that TB is a disease transmitted from one person to another and 80.1 % perceived TB as an extremely severe disease. Of the total, 81.5% answered that TB is caused by cold, 69.0% feel that TB patients are not accepted in the community and 78.3% fear physical contact with TB patients. Most participants of the FGD sessions agreed that TB is a very dangerous, contagious but curable disease and the community has a generally negative attitude towards them. They also think that TB is associated with EIIVIAIDS in thesociety. These attitudes have social consequences particularly the stigmatisation and social isolation of TB patients. Four hundred and four (57.5%) respondents were found to be in favour of the short course chemotherapy against 226 (32.1 %) choosing the longer course. Clinical improvement and unavailability of some drugs o r their cost were the first and second main reasons indicated, respectively, for defaulting by respondents. Conclusion: The perception by most respondents that tuberculosis is incurable, transmittable and associated with HIVIAIDS, led to the understanding that TB is a very dangerous disease. This, in turn, contributes to social avoidance and the resultant consequences in TB patients. Health education must bestepped-up within the TB control programme,and the psychosocial implications of TB should be given due attention.

Is There a Need to Mitigate the Social and Financial Consequences of Tuberculosis at the Individual and Household Level?

“…Gelaw et al [12] find that stigmatisation and social exclusion of TB patients are fuelled by the failure of the Male patients often worried about economic problems, while female patients worried about social consequences of the disease. Both in the family and the community, isolation could be subtle, but it could also be obvious and had a tendency to continue much longer than medically justified Rajeswari et al [16] India Focus group discussions and interviews (n = 304 patients, n = 17 focus groups) 34 % of patients reported that due to loss of income they could not afford to buy adequate food or clothing or books for their children.…”

Factors associated with knowledge about tuberculosis and attitudes of relatives of patients with the disease in Ribeirão Preto, São Paulo, Brazil

“…Nevertheless, the study did not find any discriminatory attitude from families toward the patients, showing much support and continuity of care. A remark that must be registered, however, which has already been documented in another study about attitudes, is that the answers provided by the participants may be those socially acceptable and do not reflect accurately their points of view 35 . Such bias is difficult to control in studies using the object.…”

Factors affecting psychosocial adjustments to illness of active tuberculosis patients

“…Although there were some studies which identified the social effects of tuberculosis, we couldn't found any study to determine the psychosocial adjustment to illness of active tuberculosis patients in the literature [4,5,[11][12][13][14]. Negative behaviours as stigmatization, isolation, etc.…”