Abstract

BackgroundBangladesh National Tuberculosis (TB) Control Programme adopted a number of strategies to facilitate TB diagnosis and treatment. ‘Advocacy, Communication and Social Mobilization’ (ACSM) was one of the key strategies implemented by BRAC (Bangladesh Rural Advancement Committee, a non-governmental development organization) TB control program. The purpose of this study is to assess the knowledge and attitudes of the key community members (KCMs) participated in ACSM in BRAC TB control areas.MethodsThis study combined quantitative and qualitative methods using a mixed method approach. KCMs in three districts with low TB case detection rates were targeted to assess the ACSM program. The quantitative survey using a multi-stage random-sampling strategy was conducted among 432 participants. The qualitative study included in-depth interviews (IDIs) of a sub sample of 48 respondents. For quantitative analysis, descriptive statistics were reported using frequencies, percentages, and Chi square tests, while thematic analysis was used for qualitative part.ResultsMost (99%) of the participants had heard about TB, and almost all knew that TB is a contagious yet curable disease. More than half (53%) of the KCMs had good knowledge regarding TB, but BRAC workers were found to be more knowledgeable compared to other KCMs. However, considerable knowledge gaps were observed among BRAC community health workers. Qualitative results revealed that the majority of the KCMs were aware about the signs, symptoms and transmission pathways of TB and believed that smoking and addiction were the prime causes of transmission of TB. The knowledge about child TB was poor even among BRAC health workers. Stigma associated with TB was not uncommon. Almost all respondents expressed that young girls diagnosed with TB.ConclusionsThis study finding has revealed varying levels of knowledge and mixed attitudes about TB among the KCMs. It also provides insight on the poor knowledge regarding child TB and indicate that despite the significant success of the TB program stigma is yet prevalent in the community. Future ACSM activities should engage community members against stigma and promote child TB related information for further improvement of BRAC TB Control Programme.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1390-5) contains supplementary material, which is available to authorized users.

Highlights

  • Bangladesh National Tuberculosis (TB) Control Programme adopted a number of strategies to facilitate TB diagnosis and treatment

  • This paper offers insight on the current knowledge regarding TB among the Key Community Member (KCM) who participated in Advocacy Communication and Social mobilization (ACSM) program in three Bangladesh Rural Advancement Committee (BRAC) TB control areas in Bangladesh

  • The findings from the qualitative component revealed that the majority of the KCMs of this study identified a cough for more than three weeks to be the major indicator of TB, which is similar to a study in Pakistan [16]

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Summary

Introduction

Bangladesh National Tuberculosis (TB) Control Programme adopted a number of strategies to facilitate TB diagnosis and treatment. The prevalence is 411/100 000 and the incidence is 225/100 000 population per year [1] To reduce this burden, the National TB Control Programme (NTP) has adopted the Directly Observed Treatment, Short-course (DOTS) strategy, delivered primarily through government-run health facilities [4]. Major obstacles to implementation remain, primarily owing to insufficient infrastructure and a shortage of appropriately trained health personnel [5,6] To address these challenges, the World Health Organization recommends the utilization of an Advocacy, Communication and Social Mobilization (ACSM) framework for national TB Control Programmes. The World Health Organization recommends the utilization of an Advocacy, Communication and Social Mobilization (ACSM) framework for national TB Control Programmes This strategy framework addresses four key challenges: improving case detection and treatment adherence, reducing stigma and discrimination, empowering TB patients, and mobilizing the resources and political commitment required to combat TB [7]

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