Tuberculosis knowledge, attitudes and health-seeking behaviour in rural Uganda
SETTING: Iganga/Mayuge Demographic Surveillance Site, Uganda.
DESIGN: Between June and July 2008, 18 focus group discussions and 12 key informant interviews were conducted, including parents of infants and adolescents and key informant interviews with community leaders, traditional healers and patients with TB.
RESULTS: People viewed TB as contagious, but not necessarily an airborne pathogen. Popular TB aetiologies included sharing utensils, heavy labour, smoking, bewitchment and hereditary transmission. TB patients were perceived to seek care late or to avoid care. Combining care from traditional healers and the biomedical system was common. Poverty, drug stock-outs, fear of human immunodeficiency virus (HIV) testing and length of TB treatment negatively affect health-seeking behaviour. Stigma and avoidance of persons with TB often reflects an assumption of HIV co-infection.
CONCLUSION: The community's concerns about pill burden, quality of care, financial barriers, TB aetiology, stigma and preference for pluralistic care need to be addressed to improve early detection. Health education messages should emphasise the curability of TB, the feasibility of treatment and the engagement of traditional healers as partners in identifying cases and facilitating adherence to treatment.
Keywords: Uganda; health-seeking behaviour; qualitative; stigma; tuberculosis
Document Type: Regular Paper
Affiliations: 1: Makerere University School of Public Health, Kampala, Uganda; Institute of Tropical Medicine, Antwerp, Belgium 2: International Health, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden 3: Institute of Tropical Medicine, Antwerp, Belgium; and University of Antwerp, Antwerp, Belgium 4: Makerere University School of Medicine, Kampala, Uganda 5: Makerere University School of Public Health, Kampala, Uganda 6: KNCV Tuberculosis Foundation, The Hague, The Netherlands
Publication date: 01 July 2011
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