Community awareness and response to pulmonary tuberculosis in urban Lusaka, Zambia
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Tuberculosis is a growing public health problem in sub-Saharan Africa, and indeed in Zambia. The high prevalence of TB since the mid 1980s, has been associated with HIV. This study sought to determine the level of awareness of the community on TB and its response to the disease. A descriptive cross-sectional study was done on a sample of 400 respondents. Two hundred were patients while the other two hundred were carers of TB patients. Selection of the subjects was done in two stages. First, a simple random selection of four 1st referral health centres random out a total of eight was done, using the lottery method. The subjects were then recruited from the selected four health centres. All patients and carers of TB patients aged fifteen years and above, coming to the TB corner during the time of the study (January to March 2000) were recruited. A structured questionnaire with both open-ended and closed-ended questions was used for data collection. Data was analyzed using Epi - info software, version 6.3. The study revealed that inadequate knowledge of TB exists in the community. Ten percent of the patients were not content with the care they got from the people they were living with. Among those who work, 24 percent said they found their employers to be unsupportive.The striking finding was the use of alternative treatment (60%) other than the prescribed drugs for TB. Half of these used self-administered herbs while the other half used herbs prescribed by a traditional healer. Education seemed to play a significant role on the level of knowledge on TB in both patients and carers (P-value - 0.000097. 0.0004). Other factors such as residential address also seemed to have an influence on level of knowledge (P-values - patients 0.38, carers 0.001), which was the same case for religion and level of knowledge (P-value - patients 0.8, carers 0.027). Such high levels of inadequate knowledge of TB as illustrated in the study are alarming, in this day and age. It is also worrying to note that some patients are not getting the necessary support while on treatment. Support from the people closely interacting with patients is of utmost importance. It is necessary to create a conducive environment for patients to live in, so that they can be able to successfully complete the lengthy treatment for TB. It is therefore recommended that health education programmes are enhanced to cater for the whole community, not only patients, in order to improve the existing levels of knowledge. A strong government commitment and an ensured constant supply of drugs is necessary in order to hinder patients from seeking cheaper alternative methods of treatment.