Attitude and social consequences of tuberculosis in Addis Ababa, Ethiopia

(East African Medical Journal: 2001 78(7): 382-388

ATTITUDE AND SOCIAL CONSEQUENCES OF TUBERCULOSIS IN ADDIS ABABA, ETHIOPIA

Objective: To gain a better understanding of the attitude and social consequences oftuberculosis (TB) in Addis Ababa, Ethiopia.Design: A cross sectional survey using a structured questionnaire and a qualitative studybased on the focus group discussion (FGD) technique.Setting: Eight different kebeles (urban dwellers' associations) or'six woredas (next higheradministrative level to kebele).Subjects and methods: Seven hundred and three participants, corn prising 326 males and 377females were interviewed using the written questionnaire and 116 recent and current TBpatients through focus group discussion. Data were analysed sing SPSStPC statisticalpackage. The proportions were compared using univariate and I~ivariate analyses to showthe frequency distribution and evaluate the relationship among different variables. In FGD,topics relevant to the research questions were identified, sorted and analysed. Conclusionswere then formulated.Main outcome measures: Attitude of participants towards TB 2nd its victims and socialconsequences of being a TB patient.Results: Eighty three per cent of the respondents were aware that r'B is a disease transmittedfrom one person to another and 80.1 % perceived TB as an extren ~ely severe disease. Of thetotal, 81.5% answered that TB is caused by cold, 69.0% feel that TI1 patients are not acceptedin the community and 78.3% fear physical contact with TB patients. Most participants of theFGD sessions agreed that TB is a very dangerous, contagious but curable disease and thecommunity has a generally negative attitude towards them. They also think that TB isassociated with IIIVIAIDS in the society. These attitudes have social :onsequences particularlythe stigmatisation and social isolation uf TB patients. Four hundred and four (57.5%)respondents were found to be in favour of the short course chemoth :rapy against 226 (32.1 %)choosing the longercourse. Clinical improvement and unavailability of some drugs or theircostwere the first and second main reasons indicated, respectively, for c lefaulting by respondents.Conclusion: The perception by most respondents that tuberculosis i i incurable, transmittableand associated with HIVIAIDS, led to the understanding that TB is a very dangerous disease.This, in turn, contributes to social avoidance and the resultant consequences in TB patients.Healtheducationmust bestepped-up within the TBcontrol prograr Ime,and the psychosocialimplications of TB should be given due attention