Staff and patient attitudes to tuberculosis and compliance with treatment: an exploratory study in a district in Vietnam.

SETTING

The study, a collaboration between the National Tuberculosis Institute, Hanoi, Vietnam and the Karolinska Institutet, Stockholm, Sweden, was carried out in a district of Quang Ninh Province in North Vietnam.

OBJECTIVES

To describe tuberculosis (TB) services, attitudes of staff, and attitudes of patients considered as defaulters to TB treatment.

DESIGN

Two focus group discussions were carried out with staff at the district hospital. Ten defaulter patients were interviewed in their homes.

RESULTS AND CONCLUSIONS

This exploratory study has revealed some important aspects of staff and patients' attitudes to TB and its treatment. Tuberculosis is considered a 'dirty' disease, which mainly affects poor people. There is a tendency to avoid telling others about it. Obvious symptoms are explained as 'being overworked'. A patient with TB feels 'less respected' by others. The social stigmatization leads to delays in seeking medical care, often only after self-medication: anti-tuberculosis drugs can be bought without prescription in various pharmacies. The patient's economic situation is also an important determinant of compliance and non-compliance. These factors need to be taken into consideration in TB control in Vietnam.