Community understanding of tuberculosis (TB) treatment-seeking behaviour and adherence to therapy: A case study of Kiogoro division, Kisii Central District, Kenya.

Abstract

Tuberculosis (TB), one of the leading opportunistic infections in the face of HIV/AIDS is becoming a major problem. The Sub-Saharan Africa region is most affected due to high AIDS cases, which has facilitated the rising cases of TB. Literature on health¬seeking behaviour and compliance to therapy indicates that people perceive this disease variously. They have their own views and beliefs about the causes, symptoms, mode of transmission and therapy choices, which probably affect their treatment-seeking behaviour. Therefore, the study sought to unveil these beliefs and perceptions. The main objective of the study was to explore people's perceptions on TB and how these perceptions affect their treatment-seeking behaviour and adherence to therapy. Specifically the study sought to explore people's perception about the causes and symptoms ofTB, examine factors that influence therapy choices and those that influence TB treatment compliance. A sample of 100 households was randomly selected from ten sub-locations in Kiogoro division. A standardized questionnaire was administered to household heads to gather quantitative data. Also focus group discussions, interview with key informants and case histories were used to collect qualitative data to enrich that collected through the survey. Because of the nature of data collected both qualitative and quantitative methods were employed in the data analysis. The findings indicate that the majority of people (over 70%) are aware of the causes and symptoms of TB. However, some misinterpret the disease hence delayed action and wrong therapy choices. Besides the misinterpretation of the disease, other factors such as: distance, perceived effectiveness of a given therapy, cost and HIV / AIDS were found to have an effect on treatment-seeking behaviour of people. On compliance to therapy, the study r.eveals that-patients do abuse drugs and get re¬'infected. Some factors that lead to this behaviour include: long TB regimens, transportation cost, lack of knowledge about the risks associated with non-compliance to therapy, alcoholism, medicine sharing and stigma.

The study recommends that lay people should be educated on the causes of TB, its symptoms and how it is transmitted because even though the findings indicate that the majority are knowledgeable about TB, some hold misconceptions, which need to be corrected for an effective fight against TB. This should be done through public media, public seminars and schools/churches- the study found that public media, schools/churches playa major role in information dissemination. There should also be active case detection to ensure that treatment starts early. Finally, the government and other concerned bodies should make health facilities more accessible.