Rights & Health Alliance for Integrated Development, Islamabad, Pakistan.
Health Services Academy, Islamabad, Pakistan.
Biomed Res Int. 2020 Apr 21;2020:1850541. doi: 10.1155/2020/1850541. eCollection 2020.
Pakistan is a country with one of the highest burden of tuberculosis (TB) in the world, and therefore, it is imperative to revisit the design of behaviour change interventions in the program. This study was designed to understand and assess the knowledge, awareness, perceptions, and health-seeking behaviour of general and specifically TB-affected population and to determine the presence and level of stigma and discrimination toward TB patients.
A mixed-method study was conducted in district Haripur of the Khyber Pakhtunkhwa province, comprising a household survey, whereby 526 individuals were interviewed, and five focus group discussions with various subgroups including TB patients and health workers and authorities. Study sought an ethical approval, and data of all respondents was kept confidential.
Quantitative results show that women were more knowledgeable on symptomatology and spread of TB, and with rising education, awareness on TB improves. The majority of our respondents had the understanding that it is a curable disease, yet some would avoid TB patients. Most of the respondents (both men and women) knew that one must go to a government facility for treatment. Only one-third would speak to doctor first, if they suspect TB-like symptoms. Television was a popular source of information on TB. Qualitative results captured people's perceptions that TB was related with poverty and was still considered a stigma in the community; hence, patients afflicted feared disclosing the disease.
With contextual understanding of communities' knowledge, attitudes, health-seeking behaviour, and care-seeking patterns, it can be concluded that there is a need to increase the awareness about TB symptoms, mode of transmission, prevention, diagnosis and treatment, and destigmatization of the disease through health education.
巴基斯坦是全球结核病(TB)负担最重的国家之一,因此,有必要重新审视该计划中行为改变干预措施的设计。本研究旨在了解和评估普通人群和受结核病影响人群的知识、意识、看法和就医行为,并确定对结核病患者的耻辱感和歧视的存在和程度。
在开伯尔-普赫图赫瓦省哈里普尔县进行了一项混合方法研究,包括一项入户调查,共访谈了 526 人,并进行了五次焦点小组讨论,涉及包括结核病患者和卫生工作者和当局在内的各种亚组。该研究寻求了伦理批准,所有受访者的数据均保密。
定量结果表明,女性对结核病的症状和传播了解更多,随着教育水平的提高,对结核病的认识也有所提高。我们的大多数受访者都知道这是一种可治愈的疾病,但有些人会回避结核病患者。大多数受访者(男性和女性)都知道必须去政府机构接受治疗。如果他们怀疑有类似结核病的症状,只有三分之一的人会先去看医生。电视是了解结核病的热门信息来源。定性结果捕捉到人们的看法,即结核病与贫困有关,在社区中仍然被视为一种耻辱;因此,受感染的患者害怕透露这种疾病。
通过对社区知识、态度、就医行为和寻求护理模式的背景理解,可以得出结论,需要通过健康教育提高对结核病症状、传播方式、预防、诊断和治疗以及消除对该疾病的耻辱感的认识。