Knowledge, Attitudes and Health-seeking behaviour among Patients with Tuberculosis: A Cross-sectional Study

Abstract

Background: South Africa is hugely overburdened with the cases of Tuberculosis (TB); individual’s lack of knowledge, attitude towards the disease and delays in health-seeking behaviour, are indirectly associated with death. This study assessed the knowledge, attitude and treatment of TB, and further examined the health-seeking behaviour of TB patients. Methods: This cross-sectional study involved 327 conveniently selected participants with TB from three community health centres in Nelson Mandela Bay Health District, Eastern Cape, South Africa. A close-ended questionnaire was used to collect demographic details, knowledge, attitude and health-seeking behaviour variables. Descriptive and multivariate logistic regression analyses were performed. Statistical significance was considered at alpha <0.05 and a confidence interval of 95%. Results: The majority of these TB patients indicated that cold air (76.5%), a dusty environment (85.9%), TB bacteria in the air (88.4%), and smoking (84.7%) had caused the disease. About 87.2% of the respondents indicated that TB treatment duration took six months or longer. Participants thought that follow-up sputum tests are an important part of TB treatment (70.6%); non-adherence to TB treatment might lead to drug-resistant TB or death (80%); TB disease could turn into HIV if not properly treated (77.4%) and that individuals with TB disease have HIV (59.9%). About 56.9% participants felt that TB treatment is difficult, takes a long time, is unpleasant, interferes with work or marriage, and people who drink and smoke are to blame for its spread (60.6%). The majority of the participants (74.0%) disagreed with TB being an African disease and 53.5% did not associate TB with poverty. The majority of the participants (92%) indicated that follow-ups at clinics were avoided because of stigmatisation. In the multivariate logistic regression analysis, the informal housing scheme was a statistically significant (p<0.05) factor determining the correct knowledge of TB (AOR=0.556; 95% CI: 0.316-0.977). There was a statistically significant association among TB knowledge, attitude and health-seeking behaviour. Conclusion: The participants generally had good knowledge about TB; however, there were misconceptions regarding its spread by cold air and dusty environments. The majority of participants did not attend follow-up TB treatment because of fear of stigmatisation. Formal settlements are associated with the correct knowledge of TB. Measures aimed at addressing the misconceptions about TB and its treatment are needed.

Tuberculosis Knowledge and Delayed Health Care Seeking Among New Diagnosed Tuberculosis Patients in Primary Health Facilities in an Urban District, South Africa

“…Delayed health care seeking was not affected by gender, educational status, age, and employment status, except for marital status. 8-10,14,18,31 We further did not find a statistically significant association of overall TB knowledge and delay in seeking treatment since the overall TB knowledge was high. Lack of suspicion of a TB diagnosis which was prevalent in 45.2% of respondents was statistically significant in determining delay in seeking healthcare.…”

“…Patients who reported suspension of TB diagnosis had lower odds of delaying seeking health. Failure to associate symptoms with TB was reported in other studies 31 ; these patients may suspect other common respiratory syndromes that are not considered serious. 8 Thus, some patients self-medicated and treated themselves with over-the-counter complementary and traditional medication.…”

“…Waiting until a cough is severe leads to a delayed diagnosis and treatment commencement. 31 Delay in seeking care for TB diagnosis and treatment means that a considerable proportion of patients continue to transmit the disease to others. 14 Previous research has demonstrated that negative attitudes toward TB are often underscored by the fear of being infected, 23,32 which affects screening and seeking healthcare.…”

“…Thus, health education efforts should address misconceptions about TB and strengthen information to reduce the fear of TB stigma and transmission. 23,31 Adequate knowledge and positive attitudes about TB will contribute to improved health care-seeking practice. 1 One of the limitations of this study is that the results are all based on self-reports by patients and subjected to recall bias.…”

“…Waiting until a cough is severe leads to a delayed diagnosis and treatment commencement. 31 Delay in seeking care for TB diagnosis and treatment means that a considerable proportion of patients continue to transmit the disease to others. 14…”