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Original Research

Health-seeking behavior and social stigma for tuberculosis in tuberculosis patients at a tertiary-care center in North West India

Vinod Kumar Jangid, Neeraj Kumar Agrawal, Gulab Singh Yadav, Shubham Pandey, Brij Bihari Mathur.


Background: Tuberculosis is a classical example of a disease with both medical and social dimensions. Nonadherence to treatment often results from inadequate knowledge or understanding of the disease prevention and its treatment and social stigma attached to disease itself.

Objective: To know the health-seeking behavior and social stigma for TB and assess knowledge and awareness about TB prevention and sputum disposal practices among TB patients.

Materials and Methods: A cross-sectional, questionnaire-based, epidemiological study was conducted in 510 TB patients of age group 16–78 years for 9 months in a tertiary-care hospital, Bikaner, Rajasthan.

Result: Of 510 patients, 335 (65.7%) were male subjects aged from 16 to 78 years, 385 (75.4%) were from rural area, 370 (72.5%) were illiterate, 475 (93.1%) belonged to Hindu religion, and 345 (67.6%) had less than Rs. 1,500 per capita income. Majority of patients (84.3%) responded that TB is curable and TB patients can line normal life, but about half of patients ashamed of having TB. About 75.4% patients hide the TB because people will avoid them. About 99% of them told that they will treat their spouse if they develop TB. About 66.6% respondents think that TB can be prevented by proper treatment of the patients. About 28.43% patients do not practice anything for prevention of TB in family. About 50.3% patients used to dispose their sputum in dustbins, but 21.3% do not know about the practice of sputum disposal. Indiscriminate spitting practice was more in female (20%) than male patients (8.3%), more in rural (15.5%) than urban patients (2.4%), and more in illiterate (14.3%) than literate patients (7.1%). Majority of (85.3%) patients sought medical consultation before reporting to our center, and cough was the main symptom for seeking medical consultation (82.3%). Before reporting to our center, more than half of the patients (59.80%) preferred private practitioner for the treatment of their illness. But, majority of them wanted to have further treatment for TB from government health facilities. Illiteracy and rural residence and female sex significantly impacted the knowledge and awareness of TB in negative direction.

Conclusion: Apart from the multidrug therapy, poor knowledge, awareness, and understanding regarding TB prevention and treatment among TB patients is an alarming sign for the nation. There is a strong need to modify or more robust Information Education and Communication activities for the TB patients, especially in rural and illiterate populated areas and remove the social stigma attached to it, which makes the TB patients come forward for seeking their treatment part.

Key words: Tuberculosis, social stigma TB, health-seeking behavior TB, sputum disposal practice TB

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