Long N H, Johansson E, Diwan V K, Winkvist A
National Institute of Tuberculosis and Respiratory Diseases, Hanoi, Viet Nam.
Soc Sci Med. 1999 Sep;49(6):815-22. doi: 10.1016/s0277-9536(99)00171-9.
After decades in decline, tuberculosis (TB) has been increasing worldwide. In 1993, the World Health Organisation declared TB a global emergency. Passive case-finding is an important part of TB control programmes, and this is strongly affected by people's perceptions and beliefs of TB and society's behaviour towards TB sufferers. The aim of this study was to describe the perceptions and beliefs of Vietnamese people regarding TB and its risk factors with special reference to differences between men and women. Sixteen focus group discussions (FGDs) were organised in four districts representing different regions in Vietnam and consisting of men and women, TB patients and non-TB participants. In general, participants had good knowledge of TB being a dangerous, contagious and infectious disease, caused by germs. However, traditional beliefs in different types of TB still exist, mainly among older people in rural areas, but also resorted to by other people once ill. Four main types of TB were reported: (1) 'Lao truyen' (hereditary TB), handed down from older generations to latter ones through 'family blood', regardless of sexes; (2) 'Lao luc' (physical TB), caused by hard work, more men affected; (3) 'Lao tam' (mental TB), caused by too much worrying-more women affected; and (4) 'Lao phoi' (lung TB), dangerous and caused by TB germs, transmitted through the respiratory system-more men affected. Other general risk factors were also mentioned. Men were perceived to get TB more often than women, as they were more exposed to risk factors during both work and leisure time. These traditional beliefs may contribute to long delays to TB diagnosis and increased social stigma and isolation of TB patients and their families due to erroneous beliefs in transmission routes. Our findings demonstrate areas where TB control programmes may be improved.
在经历了数十年的下降之后，结核病在全球范围内一直在增加。1993年，世界卫生组织宣布结核病为全球紧急情况。被动病例发现是结核病控制项目的重要组成部分，这受到人们对结核病的认知和信念以及社会对结核病患者行为的强烈影响。本研究的目的是描述越南人对结核病及其危险因素的认知和信念，并特别提及男女之间的差异。在越南代表不同地区的四个区组织了16次焦点小组讨论（FGD），参与者包括男性和女性、结核病患者和非结核病参与者。总体而言，参与者对结核病是一种由细菌引起的危险、传染性疾病有很好的了解。然而，不同类型结核病的传统观念仍然存在，主要存在于农村地区的老年人中，但其他人群患病时也会采用。报告了四种主要类型的结核病：（1）“痨传”（遗传性结核病），通过“家族血脉”从老一辈传给后代，不分性别；（2）“痨力”（身体结核病），由劳累引起，男性受影响更多；（3）“痨心”（精神结核病），由过度担忧引起，女性受影响更多；（4）“痨肺”（肺结核），危险且由结核病菌引起，通过呼吸系统传播，男性受影响更多。还提到了其他一般危险因素。人们认为男性比女性更容易患结核病，因为他们在工作和休闲时间都更容易接触到危险因素。这些传统观念可能导致结核病诊断长期延误，并由于对传播途径的错误认识而增加结核病患者及其家庭的社会耻辱感和孤立感。我们的研究结果表明了结核病控制项目可以改进的领域。
