Urban-rural inequities in knowledge, attitudes and practices regarding tuberculosis in two districts of Pakistan's Punjab province

Mushtaq, Muhammad Umair; Shahid, Ubeera; Abdullah, Hussain Muhammad; Saeed, Anum; Omer, Fatima; Shad, Mushtaq Ahmad; Siddiqui, Arif Mahmood; Akram, Javed

doi:10.1186/1475-9276-10-8

Cited by 105 publications

(121 citation statements)

References 33 publications

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“…However, the patients in our study demonstrate a lack of knowledge about TB, once almost one half did not know how the disease was transmitted. Misconceptions about TB transmission have been reported in other studies 33 , and it is related to delays in diagnosis and treatment non-adherence 33,34,35,36 . We could not show an association between patient delay and lack of knowledge about TB, but is important to develop strategies to improve patient education about their illness in the TB services, since it can have implications in treatment adherence.…”

Section: Discussionmentioning

confidence: 90%

Health care seeking behavior and patient delay in tuberculosis diagnosis

2015

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Delays in diagnosis of TB cases are major impeding factors in the control of TB. The objectives of this study were to describe the health care seeking behavior of TB patients, assessing patient delay and the number of health care facilities visited before the start of TB treatment. A cross-sectional study was carried out with adult patients with pulmonary TB presenting to two TB facilities to start treatment. We found a median patient delay of 20 days. The factors associated negatively with patient delay in multivariate analysis were weight loss, and have sought treatment because of the first symptom. We also demonstrated that 44.8% of patients incorrectly reported the mode of transmission of TB. In addition, the local of first attendance was an emergency room of public hospitals in 37.3% of patients. We demonstrated that the median patient delay in TB diagnosis in two TB services in a region with a high prevalence of TB was 20 days, and the protective factors associated with this delay in multivariate analysis were weight loss, and have sought treatment because of the first symptom.

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Section: Discussionmentioning

confidence: 90%

Health care seeking behavior and patient delay in tuberculosis diagnosis

2015

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“…A number of research studies conducted in Pakistan have significantly added value to the knowledge and operational capacity of the programme, including the TB health-seeking behaviour and practices of the general population, and have facilitated the design of effective communication strategies [16][17][18][19][20][21]. The predictors of default and major barriers to treatment adherence were identified as poor patient-provider interaction and patients' lack of knowledge regarding side-effects and stigma [22,23].…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis control in Pakistan: reviewing a decade of success and challenges

Metzger¹,

Baloch²,

Kazi³

et al. 2010

East Mediterr Health J

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Pakistan has shown drastic expansion of tuberculosis (TB) care during the past 10 years, increasing case notifications from 11 050 in 2000 to 248 115 in 2008. Over 1 million TB patients have been cared for since 2000, with a treatment success rate of 91% in 2007. This paper examines the strategic decisions and infrastructure improvements underlying this achievement, such as the implementation of universal DOTS coverage, expansion of the laboratory network, effective drug management systems, improved communication strategies, and inclusion of private practitioners, laboratories and hospitals in the TB control programme through the publicprivate mix strategy. The paper also outlines challenges faced in further expanding TB control within the private sector and parastatal health care institutions; strengthening the laboratory network for diagnosis of drug-resistant TB; and ensuring uninterrupted supply of quality anti-TB drugs, all requiring continued and coordinated technical and donor support.

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“…People with TB may be ostracized; others are fearful of physical contact with persons with TB in Ethiopia 20 and Pakistan. 64 However, family and friends in Malaysia 32 or the United Kingdom believe that TB is socially acceptable and do not feel threatened. 68 Social isolation for patients with TB has been reported in Congo, 5 Ethiopia, 20,24 South Africa, 65,66 Pakistan 35 and Croatia, 57 and among Samoans 71 and African Americans in the United States.…”

Section: Association With Human Immunodeficiency Virus/ Acquired Immumentioning

confidence: 99%

A systematic review of global cultural variations in knowledge, attitudes and health responses to tuberculosis stigma

2014

int j tuberc lung dis

150

144

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S E T T I N G. 1 TB is a widespread global disease that affects family and social relationships and results in adverse health and economic consequences. 2,3 Individuals with TB and their families can experience prejudice and negative attitudes, such as shame, blame and a sense of judgment. [4][5][6][7][8] Enacted TB stigma refers to exclusion, rejection or devaluation by others against patients and their families based on beliefs of social unacceptability or inferiority. 9 Perceived TB stigma refers to patient and family fears of inferiority stemming from the anticipation of an adverse judgment related to a TB diagnosis. 9 TB stigma can be a barrier to early diagnosis and a deterrent to treatment adherence. 10-13 Multicountry studies comparing TB stigma suggest intra-and intercountry differences. 14-16 However, little is known as to how similarities or differences in the knowledge, attitudes and health responses of individuals or communities infl uence TB stigma. To reduce barriers to diagnosis and treatment pathways, TB stigma needs to be understood within the socio-cultural context. This will allow for control efforts to address stigma at the individual, community and system levels.The aim of this review was to describe the infl uence of stigma on knowledge, attitudes and responses to TB and to identify similarities and differences across countries. METHODSFor this review, the PubMed/Medline, Web of Science, Cochrane, PsycINFO and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched in January 2012. Medical subject heading (MeSH) terms included 1) 'tuberculosis' AND 'tuberculosis/psychology' and 2) 'prejudice' OR 'stereotyping' OR 'social perception' OR 'social stigma' OR 'social isolation' OR 'health knowledge, attitudes, practice.' Inclusion criteria were English language, peer-reviewed, original research using qualitative, quantitative or mixed methods, and study S U M M A R YCultural attitudes toward TB 169 fi ndings related to attitudes, beliefs or responses in relation to TB stigma. Exclusion criteria were intervention studies, review articles, dissertations, commentaries, letters and guidelines. The title and abstract were fi rst reviewed by one author, then both authors screened the remaining articles based on the inclusion criteria.The 'signal and noise' technique, a narrative interpretive method of systematic review and a technique that is intuitive and value-based, was used for study appraisal. 17,18 According to Edwards et al., the 'weight of evidence' in a topic area can be judged by assessing the 'signal' from available research publications and tempering the importance attached by the level of 'noise' (the inverse of methodological quality).' 17 The signal and noise evaluation technique is valid and reliable and can be applied to the 'qualitative overview' segment of systematic reviews. 17 As an alternative to evaluating the quality of studies, a signal score is used to assess the relevance of publications. The process does not eliminate research simply b...

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Urban-rural inequities in knowledge, attitudes and practices regarding tuberculosis in two districts of Pakistan's Punjab province

Cited by 105 publications

References 33 publications

Health care seeking behavior and patient delay in tuberculosis diagnosis

Health care seeking behavior and patient delay in tuberculosis diagnosis

Tuberculosis control in Pakistan: reviewing a decade of success and challenges

A systematic review of global cultural variations in knowledge, attitudes and health responses to tuberculosis stigma

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