Illness perception of tuberculosis (TB) and health seeking practice among urban slum residents of Bangladesh: a qualitative study

Springer Science and Business Media LLC - Tập 7 - Trang 1-6 - 2014
Kiran Bam1, Lokesh Prasad Bhatt1, Rajshree Thapa2, Hussein Karimjee Dossajee, Mirak Raj Angdembe1
1James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
2Institute of Medicine, Maharajgunj Medical Campus, Tribhuvan University, Kathmandu, Nepal

Tóm tắt

Combating tuberculosis (TB) in urban slums is more complex than in rural areas due to reasons such as over-crowding, unhygienic living conditions and poverty. This study aimed to assess illness perception of TB and identify barriers and facilitators for health seeking practice among the residents of Badda slum, Dhaka, Bangladesh. The Badda slum was purposively selected. Convenience sampling was carried out to select participants aged 18 years and above. Twenty two in-depth interviews, two key informants’ interviews and participatory rapid appraisal (PRA) were conducted. Data were analyzed manually by using defined a priori codes and color coding of the quotes in data matrix table. TB was commonly recognized as Jokkha (pulmonary TB), Sas rog (disease associated to breathing) followed by TB. More females than males had knowledge about TB related illness. Very few perceived of being at risk of TB despite the high risk behavior and environment. Prime barriers for health seeking practice of TB were cost along with other barriers like prevailing stigma on TB, lack of information on service sites and unavailability of accompanying person. Training and orientation to community organizations and people, awareness on TB and free treatment through advertisements/media, community level diagnostic and home based care were identified as the facilitators for the health seeking practice of TB. Perceptions of TB and knowledge associated with the disease shape the health seeking practice, therefore promotion of media awareness campaign, targeting the people of urban slums for reducing misconceptions and promotion of home based service is needed to encourage health seeking practice in the future.

Tài liệu tham khảo

World Health Organization [WHO]: Tuberculosis in the South-East Asia Region The Regional Report. 2012, Geneva, Retrieved on 5th March 2013 from http://www.searo.who.int/entity/tb/documents/sea_tb_338/en/index.html WHO: The Global Plan to Stop TB 2011-2015: Transforming the Fight Towards Elimination of Tuberculosis. 2010, Geneva, Retrieved on 5th March 2013 from http://www.stoptb.org/assets/documents/global/plan/TB_GlobalPlanToStopTB2011-2015.pdf World Bank: Dhaka: Improving Living Conditions for the Urban Poor. World Bank Report No. 35824-BD. 2007, Washington, DC: Sustainable Development Unit, South Asia Region, World Bank, 146-Retrieved on 5th March 2013 from http://siteresources.worldbank.org/BANGLADESHEXTN/Resources/295759-1182963268987/dhakaurbanreport.pdf Bangladesh Bureau of Statistics: Population and Housing Census 2011. 2011, Dhaka, Bangladesh, Retrieved on 5th March 2013 from http://www.bbs.gov.bd/WebTestApplication/userfiles/Image/BBS/PHC2011Preliminary%20Result.pdf Rashid SF: Strategies to reduce exclusion among populations living in urban slum settlements in Bangladesh. Journal of health, population, and nutrition. 2009, 27 (4): 574-Retrieved on 6th March 2013 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2928105/ Harvard Business Publishing: Tuberculosis in Dhaka: BRAC’s Urban TB Program. GHD-011. 2011, Dhaka, Bangladesh, Retrieved on 5th March 2013 from http://cb.hbsp.harvard.edu/cb/product/GHD011-PDF-ENG Karim F, Johansson E, Diwan VK, Kulane A: Community perceptions of tuberculosis: a qualitative exploration from a gender perspective. Public health. 2011, 125 (2): 84-89. 10.1016/j.puhe.2010.10.005. Retrieved on 5th March 2013 from http://www.sciencedirect.com/science/article/pii/S0033350610003288 Somma D, Thomas BE, Karim F, Kemp J, Arias N, Auer C, Gosoniu GD, Abouihia A, Weiss MG: Gender and socio-cultural determinants of TB-related stigma in Bangladesh, India, Malawi and Colombia. Int J Tuberc Lung Dis. 2008, 12 (7): 856-866. Waisbord S: Behavioral Barriers in Tuberculosis Control: A Literature Review 2007. 2011, Retrieved on 20th Feb 2013 from http://pdf.usaid.gov/pdf_docs/Pnadf406.pdf Weiss MG, Somma D, Karim F, Abouihia A, Auer C, Kemp J, Jawahar MS: Cultural epidemiology of TB with reference to gender in Bangladesh, India and Malawi. Int J Tuberc Lung Dis. 2008, 12 (7): 837-847. Bhaskar R: A Realist Theory of Science, Leeds. Leeds Books (second edition, 1979). 1975, Brighton: Harvester Curry LA, Nembhard IM, Bradley EH: Qualitative and mixed methods provide unique contributions to outcomes research. Circulation. 2009, 119 (10): 1442-1452. 10.1161/CIRCULATIONAHA.107.742775. Retrieved on 5th March 2013 from http://circ.ahajournals.org/content/119/10/1442.short Solomon J: Living with x: A Body Mapping Journey in the Time of HIV and AIDS—A Facilitator’s Guide. Psychosocial Well-being Series: Regional Psychosocial Support Initiative (REPSSI). Edited by: Jonathan M. 2007, Retrieved on 6th March 2013 from http://www.comminit.com/global/content/living-x-body-mapping-journey-time-hiv-and-aids-facilitator's-guide Pope C, Ziebland S, Mays N: Qualitative research in health care: analyzing qualitative data. British Medical Journal. 2000, 320: 114-116. 10.1136/bmj.320.7227.114. Retrieved on 6th March 2013 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117368/ Wang J, Fei Y, Shen H, Xu B: Gender difference in knowledge of tuberculosis and associated health-care seeking behaviors: a cross-sectional study in a rural area of China. BMC Public Health. 2008, 8: 354-10.1186/1471-2458-8-354. Retrieved on 6th March 2013 from http://www.biomedcentral.com/1471-2458/8/354 Long NH, Johansson E, Diwan VK, Winkvist A: Different tuberculosis in men and women: beliefs from focus groups in Vietnam. Social Science & Medicine. 2006, 49 (6): 815-822. Retrieved on 6th March 2013 from http://ideas.repec.org/a/eee/socmed/v49y1999i6p815-822.html Zhang T, Liu X, Bromley H, Tang S: Perceptions of tuberculosis and health seeking behaviour in rural Inner Mongolia, China. Health Policy. 2007, 81 (2): 155-165. Retrieved on 7th March 2013 from http://www.healthpolicyjrnl.com/article/S0168-8510%2805%2900302-7/abstract Auer C, Sarol J, Tanner M, Weiss M: Health seeking and perceived causes of tuberculosis among patients in Manila, Philippines. Tropical medicine & international health. 2000, 5 (9): 648-656. 10.1046/j.1365-3156.2000.00615.x. Retrieved on 4th March 2013 from http://onlinelibrary.wiley.com/doi/10.1046/j.1365-3156.2000.00615.x/full Xu B, Fochsen G, Xiu Y, Thorson A, Kemp JR, Jiang QW: Perceptions and experiences of health care seeking and access to TB care—a qualitative study in rural Jiangsu province, China. Health Policy. 2004, 69 (2): 139-149. 10.1016/j.healthpol.2003.11.006. Retrieved on 7th March 2013 from http://www.sciencedirect.com/science/article/pii/S0168851004000776 Demissie M, Getahun H, Lindtjørn B: Community tuberculosis care through “TB clubs” in rural North Ethiopia. Social science & medicine. 2003, 56 (10): 2009-2018. 10.1016/S0277-9536(02)00182-X. Retrieved on 5th March 2013 http://www.sciencedirect.com/science/article/pii/S027795360200182X Dhingra VK, Khan S: A sociological study on stigma among TB patients in Delhi. Indian J Tuberc. 2010, 57: 12-18. Retrieved on 6th March 2013 from http://www.ncbi.nlm.nih.gov/pubmed/20420039 World Health Organization: Diagnostic and treatment delay in tuberculosis. [WHO EMRO report. 2006, Retrieved on 6th March 2013 from: http://applications.emro.who.int/dsaf/dsa710.pdf, ]. Malhotra R, Taneja O, Dhingra V, Rajpal S, Mehra M: Awareness regarding tuberculosis in a rural population of Delhi. Indian Journal of Community Medicine. 2002, 27 (2): 62-Retrieved on 5th March 2013 from: http://www.ijcm.org.in/article.asp?issn=0970-0218;year=2002;volume=27;issue=2;spage=62;epage=62;aulast=Malhotra;type=0asnim