Abstract
BackgroundTuberculosis (TB) is a global health concern. Inadequate case finding and case holding has been cited as major barrier to the control of TB. The TB literature is written almost entirely from a biomedical perspective, while recent studies show that it is imperative to understand lay perception to determine why people seek treatment and may stop taking treatment. The Eastern Cape is known as a province with high TB incidence, prevalence and with one of the worst cure rates of South Africa. Its inhabitants can be considered lay experts when it comes to TB. Therefore, we investigated knowledge, perceptions of (access to) TB treatment and adherence to treatment among an Eastern Cape population.MethodsAn area-stratified sampling design was applied. A total of 1020 households were selected randomly in proportion to the total number of households in each neighbourhood.ResultsTB knowledge can be considered fairly good among this community. Respondents' perceptions suggest that stigma may influence TB patients' decision in health seeking behavior and adherence to TB treatment. A full 95% of those interviewed believe people with TB tend to hide their TB status out of fear of what others may say. Regression analyses revealed that in this population young and old, men and women and the lower and higher educated share the same attitudes and perceptions. Our findings are therefore likely to reflect the actual situation of TB patients in this population.ConclusionsThe lay experts' perceptions suggests that stigma appears to effect case holding and case finding. Future interventions should be directed at improving attitudes and perceptions to potentially reduce stigma. This requires a patient-centered approach to empower TB patients and active involvement in the development and implementation of stigma reduction programs.
Highlights
Tuberculosis (TB) is a global health concern
TB is endemic in the Eastern Cape [2,21] and the cure rate of 41% lags far behind the 85% rate recommended by the WHO [4]
Our findings are likely to reflect the actual situation of TB patients in this population
Summary
Tuberculosis (TB) is a global health concern. Inadequate case finding and case holding has been cited as major barrier to the control of TB. The Eastern Cape is known as a province with high TB incidence, prevalence and with one of the worst cure rates of South Africa. Tuberculosis (TB) is a global health concern It is a major cause of illness and death worldwide, especially in lowand middle-income countries where it is fuelled by human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), by population increase where TB is most prevalent and by increased poverty [1]. The estimated incidence of TB in South Africa is 692 per 100,000 people [2], a rate the WHO classifies as a serious epidemic. Even though the DOTS program has been active since 1995, TB remains a major health problem in South Africa and especially in the Eastern Cape [3]. At 41%, The Eastern Cape's cure rate lags even further behind the national average [4]
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