DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20160315

Cultural disgrace among tuberculosis patients in Sagar district of Madhya Pardesh in India

Talha Saad, Abhay Shashin Tirkey, Wahid Khan

Abstract


Background: The overall objective of the research study was to gather new empirical evidence and develop further theoretical understanding of the mechanisms of stigma associated with TB and delay in seeking its treatment.

Methods: This prospective study was carried out in the outpatient of Pulmonary Medicine at Bundelkhand Government Medical College, Sagar. The sample consisted of 300 tuberculosis patients. Between patients who consider TB a stigmatizing disease and patients who did not consider TB a stigmatizing disease distribution of patient delay was compared.

Results: Of the total of 300 patients 79 (26.3%) considered TB a socially stigmatizing disease. Among them 43 (54.4%) were females and 36 (45.6%) males. Among patients in the age group 18-24 years, nine (50%) considered TB a socially stigmatizing disease compared to seven (12.3%) among patients in the age group 65-75 years. The average time interval from the appearance of first symptoms of tuberculosis until the first visit to a health care facility for those who consider TB a stigmatizing disease was 6.41 weeks and for those who did not consider it a stigmatizing disease the average time interval was 4.99 weeks.

Conclusions: Most TB patients failed to recognize their symptoms as due to TB, because of the stigma attached to the disease in society. The way people treat those with TB, especially close contacts is also a source of worry to the patients. This may lead to delay in reporting to the hospital and consequently increase mortality from the disease. It may also make it difficult for the patients to comply with the long duration of TB treatment. Study results revealed high stigma-generating attitudes towards tuberculosis.

 


Keywords


Community norms, Tuberculosis, Health-seeking behaviour, Tuberculosis stigma

Full Text:

PDF

References


RNTCP status report. Central TB Division, Director General of Health Services, Ministry of Health & Famil Welfare, New Delhi. 2001.

Jaggarrajamma K, Ramchandran R, Charles N, Chandrasekaran V, Muniuandi M, Ganapathy S. Psycho- social dysfunction: Perceived and enacted stigma among tuberculosis patients registered under RNTCP. Indian J Tuberc. 2008;55:179-87.

Macq J, Solis A, Martinez G, Martiny P, Dujardin B. An exploration of the social stigma of tuberculosis in five “municipios” of Nicaragua to reflect on local interventions. Health Policy. 2005;74:205-17.

Joseph HA, Waldman K, Rawls C, Wilce M, Shrestha- Kuwahara R. TB perspectives among a sample of Mexicans in the United States: results from an ethnographic study. J Immigr Minor Health 2008;10:177-85.

Jaramillo E. Tuberculosis and stigma: predictors against people with tuberculosis. Health Psychology. 1999;4:71-9.

Dodor EA, Neal K, Kelly S. An exploration of the causes of tuberculosis stigma in an urban district in Ghana. Int J Tuberc Lung Dis. 2008;12:1048-54.

Gelaw M, Genebo T, Dejene A, Lemma E, Eyo G. Attitude and social consequences of tuberculosis in Addis Ababa, Ethiopia. East Afr Med J. 2001;78:382-8.

Baral SC, Karki DK, Newell JN. Causes of stigma and discrimination associated with tuberculosis in Nepal: a qualitative study. BMC Public Health. 2007;7:211.

Sharma N, Malhotra R, Taneja DK, Saha R, Ingle GK. Awareness and perception about tuberculosis in the general population of Delhi. Asia Pac J Public Health. 2007;19:10-5.

De-Graft Aikins, A. Reframing applied disease stigma research: a multilevel analysis of diabetes stigma in Ghana", Journal of Community & Applied Social Psychology. 2006;16,(6):426-41.

Khan M, Walley J, Witter S, Shah S, Javeed S. Tuberculosis patient adherence to direct observation: results of a social study in Pakistan. Health Policy and Planning. 2005.

Liefooghe R, Michiels N, Habib S, Moran MB, De Muynck A. Perception and social consequences of tuberculosis: a focus group study of tuberculosis patients in Sialkot. 1995.

Weiss MG, Auer C, Somma DB, Abouihia A. Pakistan. Social Science & Medicine. Gender and tuberculosis: cross-site analysis and implications of a multi-country study in Bangladesh, India, Malawi and Colombia, WHO, 3. 2006;41,(12):1685-92.

Jurcev-Savicević A. Attitudes towards tuberculosis and sources of tuberculosis-related information: study on patients in outpatient settings in Split, Croatia. Acts Clin Croat. 2011;50:37-43.

Christodoulou M. The stigma of tuberculosis. Lancet Infect Dis. 2011;11:663-4.

Joseph HA, Waldman K, Rawls C, Wilce M, Shrestha- Kuwahara R. TB perspectives among a sample of Mexicans in the United States: results from an ethnographic study. J Immigr Minor Health. 2008;10:177-85.

Qureshi SA, Morkve O, Mustafa T. Patient and health system delays: health-care seeking behaviour among pulmonary tuberculosis patients in Pakistan. J Pak Med Assoc. 2008;58:318-21.

Mushtaq MU, Shahid U, Abdullah HM, Saeed A, Omer F, Shad MA, et al. Urban-rural inequities in knowledge, attitudes and practices regarding tuberculosis in two districts of Pakistan’s Penjab province. Int J Equity Health. 2011;10:8

Sabawoon W, Sato H, Kobavashi Y. Delay in treatment of pulmonary tuberculosis: a report from Afghanistan. Envirom Health Prev Med. 2012;17:53-61.

Ali SS, Rabbani F, Siddiqui UN, Zaidi AH, Sophie A, Virani SJ, et al. Tuberculosis: do we know enough? A study of patients and their families in an out-patient hospital setting in Karachi, Pakistan. Int J Tuberc Lung Dis. 2003;7:1052-8.

Karim F, Johansson E, Diwan VK, Kulane A. Community perceptions of tuberculosis. A qualitative exploration from a gender perspective. Public Health. 2011;125:84-9.

Long NH, Johansson E, Diwan VK, Winkvist A. Fear and social isolation as consequences of tuberculosis in Vietnam: a gender analysis. Health Policy. 2001;58:69-81.

Ottmani S, Obermeyer Z, Bencheikh N, Mahjour J. Knowledge, attitudes and beliefs about tuberculosis in urban Morocco. East Mediterr Health J. 2008;14:298-304.

World Health Organisation. Global tuberculosis report. Geneva: World Health Organisation. 2012.

Kipp AM, Pungrassami P, Nilmanat K, Sengupta S, Strauss RP, Chongsuvivatwong V, et al. Sociodemographic and AIDS related factors associated with tuberculosis stigma in southern Thailand: a quantitative, cross-sectional study of stigma among patients with TB and healthy community members. BMC Public Health. 2011;11:675.

Eastwood SV, Hill PC. A gender-focused qualitative study of barriers to accessing tuberculosis treatment in The Gambia, West Africa. Int J Tuberc Lung Dis. 2004;8:70-5.

Pungrassami P, Kipp AM, Stewart PW, Chongsuvivatwong V, Strauss RP, Van Rie A. Tuberculosis and AIDS stigma among patients who delay seeking care for TB symptoms. Int J Tuberc Dis. 2010;14:181-7.

Somma D, Thomas BE, Karim F, Kemp J, Arias N, Auer C, et al. Gender and socio-cultural determinants of TB-related stigma in Bangladesh, India, Malawi and Colombia. Int J Tuberc Lung Dis. 2008;12:856-66.

Cambanis A, Ramsay A, Yassin MA, Cuevas Duration and associated factors of patient delay during tuberculosis screening in rural Cameroon. Trop Med Int Health. 2007;12:1309-14.

Noyes J, Popay J. Directly observed therapy and tuberculosis: how can a systematic review of qualitative research contribute to improving services? A qualitative meta-synthesis. J Adv Nurs. 2007;57:227-43.