Tuberculosis in rural northwest Ethiopia: community perspective.

A community based cross sectional study was conducted in April 1997 to assess the perspective of the rural community towards Tuberculosis (TB) and TB patients and identify prevailing misconceptions and other problems related with TB in the south Gonder administrative zone of the Amhara region. A total of 1000 heads of household were interviewed and disease information was obtained for 5078 family members. The prevalence of productive cough lasting more than 3 weeks was 4.6% (233/5078) and cervical, axillary or inguinal swelling with or with out a sinus tract that lasted more than 12 months was 1.0% (52/5078). TB treatment defaulters were found in 10% of the rural households. Apparent clinical improvement after the intensive phase was the commonest reason for defaulting (45%) followed by far distance of the health institution (25.3%). Evil spirit and sexual intercourse were incriminated as a cause for TB in 19.9% and 4.7% of respondents respectively. TB was believed as curable disease by 66.7% of the respondents. The rural community exhibited a great deal of ostracism towards TB patients. Majority (76.2%) of the respondents have heard about HIV/AIDS out of whom 19.4% disclosed that there could be an association between HIV/AIDS and TB. It was demonstrated that misconceptions about TB, its treatment, patients and families were prevalent among the communities in South Gonder. Community based awareness creating strategies should be designed and dissemination of TB information and education are strongly recommended.