Smear positive pulmonary tuberculosis and associated risk factors among tuberculosis suspects attending spiritual holy water sites in Northwest Ethiopia

Abstract

BackgroundTuberculosis (TB) remains one of the world’s deadliest communicable diseases. In Ethiopia, tuberculosis patients have different pattern of health care seeking behavior. They usually adopt other approaches like traditional healers and spiritual holy water sites before consulting public health facilities. This study was aimed to assess the prevalence of smear positive pulmonary tuberculosis and associated risk factors among tuberculosis suspects attending spiritual holy water sites.MethodsA cross-sectional study was conducted from February 01, 2015 to March 30, 2015 in seven selected holy water sites in Northwest Ethiopia. During the study period, a total of 1384 adult holy water users were screened for PTB symptoms. A total of 382 pulmonary tuberculosis suspects participated in the study. Socio-demographic data were collected using a semi-structured questionnaire. Spot-morning-spot sputum specimens were collected and examined for acid fast bacilli using Auramine O fluorescence staining technique. Smear positive sputum samples were tested by GeneXpert MTB/RIF assay for rifampicin resistance. Descriptive statistics, binary and multivariate logistic regression analysis were employed using SPSS-16 software.ResultsThe prevalence of smear positive pulmonary tuberculosis was 2.9% with point prevalence of 795/100, 000 holy water users. History of contact with tuberculosis patient (AOR = 9.174, 95% C.I = 2.195–38.34) and the number of family members > 5 per household (AOR = 9.258, 95% C.I = 1.14–74.97) were significantly associated with smear positive pulmonary tuberculosis. Rifampicin resistance was not detected from all smear positives by GeneXpert MTB/RIF assay.ConclusionsThe prevalence of smear positive pulmonary tuberculosis in spiritual holy water sites was 7.4 fold higher than the general population. History of contact with active tuberculosis patients and increased family size were significantly associated with smear positive pulmonary TB. The national tuberculosis program should consider spiritual holy water sites as potential foci for TB transmission and plan regular survey and health education in holy water sites for effective TB prevention and control in the country.

Patient Health Seeking and Diagnostic Delay in Extrapulmonary Tuberculosis: A Hospital Based Study from Central India

“…The levels of awareness of patients regarding tuberculosis in general and pulmonary tuberculosis were similar to those reported in other studies [20, 21]. Majority of the patients first either practiced self-medication or visited traditional healers; these findings were consistent with those of other studies from rural areas [22, 23]. Such health care-seeking behavior of patients causes complications [10, 20]; this finding emphasizes the need for improved public awareness about EPTB [3, 24].…”

Health-seeking pathway and factors leading to delays in tuberculosis diagnosis in West Pokot County, Kenya: A grounded theory study

“…The study also revealed that TB patients delayed seeking health care from the health facilities while receiving care from the informal health care providers. Similar findings were documented in Ethiopia [38], Malawi [39], Tanzania [40], Nepal [41] and Ghana [42]. These providers are crucial in the referral system necessary for timely TB diagnosis and should be educated on the importance of referring patients with a prolonged cough for a TB test even as they continue offering their therapy.…”

Are Shopkeepers Suffering from Pulmonary Tuberculosis in Bahir Dar City, Northwest Ethiopia: A Cross-Sectional Survey

“…Due to the absence of published evidences on TB prevalence among shopkeepers, the author tried to discuss present prevalence with studies at the community, facility, and prison levels in Ethiopia; since they have some similarities, they are relatively higher, risky/congregated settings/to acquire TB infection [ 13 ]. The current prevalence was found to be higher compared to study findings from Dessie and Debre-Birhan (among homeless participants) [ 5 ], people attending spiritual holy water services as the alternative medication to their illnesses [ 10 ], and North Gondar [ 12 , 14 ] where TB prevalence was 2.6%, 2.9%, 5.3%, and 4.9%, respectively. The possible explanation for this variation could be differences in area coverage, comorbidity prevalence, information access, contact status with TB patients, and overcrowdedness.…”

“…In addition, education level (illiteracy), working inside the nonventilated rooms, low awareness of TB transmission, and comorbidity with other chronic diseases such as HIV/AIDS and DM were statistically significant factors to acquire TB infection among shopkeepers ( Table 2 ). All these were reported challenges to the END TB program in 2015 by the WHO [ 2 ] and other studies [ 5 – 10 ].…”