Kasozi William, Zawedde-Muyanja Stella, Musaazi Joseph, Etwom Alfred, Lemukol James, Sagaki Patrick, Tino Salome, Achar Cerino, Nabukenya-Mudiope Mary G, Stavia Turyahabwe, Murungi Miriam, Rutta Edmund, Nsubuga Tadeo, Picho Brenda
USAID Program for Accelerated Control of TB in Karamoja Region (PACT- Karamoja), Moroto City, Uganda.
Infectious Diseases Institute (IDI)-College of Health Sciences, Makerere University, Kampala City, Uganda.
BMC Health Serv Res. 2024 Dec 23;24(1):1639. doi: 10.1186/s12913-024-12136-z.
The Karamoja subregion is a high TB burden pastoralist community that previously had limited access to public health services. We explored the community's perceptions towards TB to better understand how healthcare services should be structured to meet the needs of the persons with TB and their households.
From September to October 2022, we conducted 12 focus group discussions (FGDs) and interviewed 95 persons (48 community members and 47 health workers). Research assistants trained in qualitative interviewing carried out the FGDs using an FGD guide that was developed iteratively following collection of quantitative data and initial interviews. We transcribed and analyzed data inductively and presented emerging themes about knowledge on, attitudes towards and practices associated with TB in the region.
Participants were aware that TB was a significant public health problem and accurately described the signs and symptoms of TB. However, knowledge on TB transmission was inaccurate. Respondents thought that in addition to being airborne, TB was a contagious disease transmitted through direct contact or sharing of utensils. This affected attitudes towards patients with TB, contributing to stigmatization and isolation of persons diagnosed with TB in several homesteads. Community members preferred to go to public health facilities for TB diagnosis except where these health facilities were too far in which case they resorted to alternative care providers e.g., traditional healers or private health providers. Community members were aware of and had experienced the benefits of TB preventive therapy.
Knowledge about TB transmission is suboptimal and leads to stigmatization and isolation of infected individuals. Addressing this gap would contribute to reducing stigma and enhance care practices for patients diagnosed with TB. Development and distribution of communication messages with accurate information about TB transmission should be a priority. These messages should also include a strong component on the benefits of TB preventive therapy.
卡拉莫贾次区域是结核病负担较重的游牧社区，此前获得公共卫生服务的机会有限。我们探讨了该社区对结核病的看法，以更好地了解应如何构建医疗服务，以满足结核病患者及其家庭的需求。
2022年9月至10月，我们进行了12次焦点小组讨论，并采访了95人（48名社区成员和47名卫生工作者）。接受过定性访谈培训的研究助理使用在收集定量数据和进行初步访谈后反复制定的焦点小组讨论指南开展了焦点小组讨论。我们对数据进行了归纳转录和分析，并呈现了该地区关于结核病的知识、态度和相关实践的新出现主题。
参与者意识到结核病是一个重大的公共卫生问题，并准确描述了结核病的体征和症状。然而，关于结核病传播的知识并不准确。受访者认为，结核病除了通过空气传播外，还是一种通过直接接触或共用器具传播的传染病。这影响了对结核病患者的态度，导致一些家园中被诊断患有结核病的人受到污名化和孤立。社区成员更愿意前往公共卫生机构进行结核病诊断，除非这些卫生机构距离太远，在这种情况下他们会求助于替代护理提供者，如传统治疗师或私人医疗提供者。社区成员了解并体验过结核病预防性治疗的益处。
关于结核病传播的知识欠佳，导致受感染个体受到污名化和孤立。解决这一差距将有助于减少污名化，并加强对被诊断患有结核病患者的护理实践。应优先制定和传播关于结核病传播的准确信息的宣传信息。这些信息还应大力强调结核病预防性治疗的益处。
