The authors explored treatment-seeking behavior among people with tuberculosis (TB) in Bali, Indonesia. They conducted in-depth interviews with 5 people who had been diagnosed with TB and 6 people who were suspected of having TB but who had not yet received a diagnosis. Participants reported frequent delays in obtaining a diagnosis of TB and obtaining adequate treatment. The authors describe issues associated with treatment-seeking behavior using the following five main themes: awareness of TB-causes, symptoms, and seriousness; influence of others; treatment quality; treatment barriers and default; and stigma and fear. Their findings reinforce the importance of a comprehensive TB control program that provides quality diagnostic and treatment services, and patient and community education, and enables patient involvement in treatment.
Participants focused on issues closely related to effective and ineffective management of RF/RHD. The lessons learned are indicators for health staff attempting to improve the quality of management that people receive.
To date there has been no satisfactory explanation of the worldwide excess of tuberculosis (TB) notifications among adult males. We investigated the epidemiological basis for sex differences in TB notifications in high-burden countries using available group-level data. Multiple linear regression analysis was used to explore the ecological relationship between smoking and sex differences in TB notifications among high-burden countries. Cigarette consumption was a significant predictor of the sex ratio of TB notifications, and explained 33% of the variance in the sex ratio of TB notifications. Our findings suggest that smoking is an important modifiable factor which has a significant impact on the global epidemiology of TB, and emphasize the importance of tobacco control in countries with a high incidence of TB. This analysis provides support for the interpretation of sex differences in worldwide TB notification rates as indicative of true differences in the epidemiology of TB between males and females.
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