The tribal community's perception on tuberculosis: A community based qualitative study in Tamil Nadu, India

Abstract

Background and Objective:Tuberculosis is a highly contagious bacterial infection. It is a major public health issue with India being the highest prevalent country in the world. The nation has a large and heterogeneous tribal population of approximately 104 million people which accounts for 8.6% of the total population. This study focuses on assessing the tuberculosis scenario amongst the tribal population their perceptions on risk factors of TB, general health problems, health seeking behavior, and challenges faced by them.Methods:The study was conducted using in-depth interviews and focus group discussions in the three sampled study districts namely Nilgiris, Namakkal, and Villipuram of Tamil Nadu, India. A thematic analysis was performed to identify the major emerging themes. Following thematic analysis, an interventional strategy for improving the overall knowledge and awareness among the community health education was imparted.Results:The conducted in-depth interviews and focus group discussions identified major themes that emerged from the codes which included stigma and discrimination, association with HIV, detection of symptoms, health seeking behavior, knowledge and awareness of TB, acculturation, treatment adherence and lack of lab facility.Conclusion:This qualitative study has captured the overall perception towards tuberculosis from the tribal community as a whole as well as from the health workers. The tribal community stigmatized and discriminated people suffering from TB which had an impact on the health seeking behavior as well as on the treatment adherence. The primary care providers were aware of the situation of TB in tribes but were poorly equipped. Primary healthcare providers should in fact, have a crucial role in identification of at-risk subjects, for prompt referrals, and delivery of treatment services.

Stigma and discrimination of tuberculosis in India: A systematic review

“…Patients go through the Depression at the base, Quality of life and mental health must be focused highly. The relationship between a doctor and a person (Illiterate) should have the same focus on each other (Joseph et al, 2019) [2] . The gender varies exist in the Community of TB and Stigma, Both the Male and Female worries on their Remoteness by Family-Workers and Neighbours.…”

Tuberculosis epidemic in India – a systematic review

“…11,13,14 Scheduled Tribes represent 8.6% of India's population with having high TB prevalence (703 per 1,00,000) as compared to national TB average cases (256 per 1,00,000). 6,15,16,22,61 Individual patients in tribal areas in India face major challenges due to poor socioeconomic conditions, socio-cultural variables, individual ignorance or discrimination, mental health challenges, limited resources or transportation, gender-specific education, a lack of basic understanding about the disease, and difficulty accessing the healthcare facility. 1,3,22,43,[60][61][62][63] According to studies by Rao et al 29 , Bhat et al 55 , and Thomas et al 16 , PTB exposures were more prevalent among tribal groups, and 2.8 times higher prevalent among males than females.…”

“…22,[33][34][35][36]38 Furthermore, healthcare professionals can contribute to TB treatment failure due to various factors, including inadequate monitoring systems, a lack of courier services, insufficient knowledge and resources, increased workload, and a shortage of diagnostic kits. 3,5,6,64,66,67 Resistance to frequently given anti-tuberculosis medications results in extensively drug-resistant tuberculosis (XDR-TB) and MDR-TB. 7,40,64 Furthermore, XDR-TB, a subtype of MDR-TB, is resistant to isoniazid, rifampicin, and any of three second-line injectable drugs (e.g., levofloxacin, moxifloxacin, and bedaquiline), whereas MDR is only resistant to drugs of the isoniazid and rifampicin types.…”

“…[1][2][3][4] TB is a highly contagious and transmissible disease that spreads naturally from person to person through sneezing or coughing in the vicinity. [5][6][7] The World Health Organization (WHO) estimates that 10.6 million people worldwide will have TB (in 2021), including 6 million men, 3.4 million women, and 1.2 million children. 8 According to the Global Tuberculosis Report (2022) claimed that TB killed 1.6 million people and was difficult to diagnose and treat.…”

Negotiating the Pandemic

“…Traditionally, stigma and so-called "othering" have not been common features among Indian tribal peoples. However, due to the infl uence of urbanization and close contact with other non-tribal peoples, they have by now developed some forms of stigmatization within their own communities, such as around HIV infection and tuberculosis ( Vlassoff et al 2012 ;Joseph et al 2019 ). In contrast, they are often the victims of stigmatization and "otherization" from their non-tribal counterparts ( Kharshiing 2020 ).…”