Perceptions of Tuberculosis: Attributions of Cause, Suggested Means of Risk Reduction, and Preferred Treatment in the Limpopo Province, South Africa
Promtussananon, Supa, Peltzer, Karl, Journal of Health Population and Nutrition
Despite the availability of effective treatment regimens, exceptionally high rates of tuberculosis persist in South Africa. A better understanding of public perceptions of tuberculosis is important for the improvement of the existing tuberculosis-control programmes. This study was aimed at investigating public perceptions about causes, suggested means of risk reduction, and preferred treatment of tuberculosis. The cross-sectional study included a sample of 80 community members from four different age groups chosen by quota sampling in a semi-urban community. Results indicated that 13.75% of the community members reported biomedical causes of tuberculosis, 35% suggested biomedical methods as a means for risk reduction, and 91.25% preferred medical treatment. Significant gender but not age difference was found. Women reported more often than men a biomedical cause of tuberculosis. A number of misconceptions about the cause and risk reduction of tuberculosis were also mentioned. The results suggest that people in a semi-urban area of the Limpopo province have limited knowledge and understanding of tuberculosis. It is suggested that healthcare workers provide services for increasing basic knowledge about causes and risk reduction of tuberculosis of the population in every age group.
Key words: Tuberculosis; Perceptions; Risk factors; Cross-sectional studies; South Africa
South Africa is burdened by one of the worst tuberculosis epidemics in the world, with disease rates more than double those observed in other developing countries and up to 60 times higher than those currently observed in the USA or Western Europe. The Medical Research Council (MRC) estimated that the country had about 180,507 cases (55% reported) in 1997, or 419 per 100,000 of the total population. Of these, 32.8% (73,679 cases) were probably infected with HIV (1). The tuberculosis problem in South Africa is largely a result of historical neglect and poor management systems, compounded by the legacy of fragmented health services. Prior to the introduction of the Tuberculosis Register in 1995, cure rates were unknown, and consequently control efforts could not challenge the poor performance. The implication of this failure is evident from the fact that, in 1997, a cure rate of only 54% could be recorded, with the consequence of continued high rates of transmission in the country (1). Data on self-reported tuberculosis among men and women related more frequently to older people (e.g. age less than 35 years was 1.5% and age more than 35 was 4.6%) and people living in non-urban areas (e.g. men: urban 2.6%, nonurban 3.3%, women: urban 1.6%, non-urban 2.6%) (2).
The Department of Health in November 1996 declared tuberculosis a top health priority, and National Health Minister Zuma committed her Department to implementing a new control programme based on the directlyobserved therapy (DOT) strategy of the World Health Organization that includes: (a) Government commitment to a national tuberculosis programme as a specific health-system activity, integrated into comprehensive primary care, and supported technically at a national level; (b) Standardized, directly observed, short-course treatment, prioritizing sputum smear-positive patients; (c) Case detection by means of a patient-friendly and clinically-efficient service based primarily on smear microscopy (passive case-finding); (d) An ensured supply of essential anti-tuberculosis drugs; and (e) Effective monitoring (3).
The pace and extent of implementation of the programme is, however, slow in most provinces. Since 1996, a system of case registration based on strict criteria for case definition was implemented in South Africa. These registrations, based on standardized criteria, are now beginning to present a clearer picture of disease rates in the country than what was available before (4). Some progress has been made in DOTS population coverage …
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Publication information: Article title: Perceptions of Tuberculosis: Attributions of Cause, Suggested Means of Risk Reduction, and Preferred Treatment in the Limpopo Province, South Africa. Contributors: Promtussananon, Supa - Author, Peltzer, Karl - Author. Journal title: Journal of Health Population and Nutrition. Volume: 23. Issue: 1 Publication date: March 2005. Page number: 74+. © 2009 International Centre for Diarrhoeal Disease Research Bangladesh. Provided by ProQuest LLC. All Rights Reserved.
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