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Tuberculosis Treatment Completion for Tribal Patients in Kerala: Needs Constant Push!

Journal of Tuberculosis Research 2019年第4期7卷 185-201页

作者： Jyothilakshmi Chettipparan Rajan Tanu Anand Sharath Burugina Nagaraja Sabu Kochupurackal Ulahannan Karuna Sagili manu muraleedharan sarojini Wayanad Social Service Society Wayanad Kerala India Department of Community Medicine North Delhi Municipal Corporation Medical College Hindu Rao Hospital Delhi India Department of Community Medicine ESIC Medical College and PGIMSR Bengaluru India Institute of Public Health Bengaluru India Department of TB and communicable diseases The Union New Delhi India State TB Demonstration and Training Centre Trivandrum India

Introduction: Tuberculosis (TB) incidence among tribal patients is high owing to their social and geographic vulnerability. Ensuring adherence to TB treatment among them remains a challenging task as it is dependent on socio-cultural and environmental factors. Objective: 1) To know the individuals’ perception of TB disease and anti-TB treatment;2) To explore the personal, social, family and cultural factors influencing on patient’s treatment adherence;3) To identify the challenges faced by health care providers in delivering services to the tribal population. Material and Methods: A descriptive qualitative study conducted among tribal patients (n = 16) and health providers (n = 6) of Manathavady TB unit, Wayanad District of Kerala. The data were collected through in-depth interviews (IDIs), audio-recorded in Malayalam, transcribed verbatim and translated into English. Transcripts were analysed using manual descriptive content analysis. Results: Most of the patients were oriented about the importance of completing TB treatment though lacked awareness about its causation. The supportive attitude of the community further encouraged them to continue TB treatment. However, substance abuse emerged as the biggest challenge to treatment adherence particularly among males. While accessibility to the health system, animal confrontation, and disaster risk emerged as barriers owing to the geographic landscape of the community, health services were found to be acceptable, available and affordable to all the patients. No stigma or discrimination was perceived by the patients at family, community and health system level. However, their beliefs in herbal medicines and conduct of certain rituals delayed them for seeking care. The personal commitment of the health care staff helped the TB patients to adhere better with the treatment thereby yielding best results. Conclusion: The TB treatment adherence among the tribal population was satisfactory due to personal, social and health sys

关键词： Treatment Adherence Kerala Qualitative Operational Research

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