Community and individual factors influencing the health seeking behavior of tuberculosis defaulters, Sudan

ABSTRACT

This study was carried out in Sudan, in three areas; Abu Anga Hospital, which represented urban areas, Al Gadarif State, stood for rural areas and Mayo Farm represented displaced population, in the period from June-December 2002. The objective is to determine the health seeking behavior of tuberculosis defaulters, and to assess patients' knowledge about tuberculosis, treatment, and mode of spread. Prospective cohort study of 409 new tuberculosis cases, visiting the outpatient chest clinics in the general health services in the three selected areas during March to May 2001, patients were followed up after their registration for six months. Out of the 409 tuberculosis patients included in the study, 107 [26.2%] were defaulters; 36 [33.6%] from Abu Anja hospital, 33 [30.8%] from Al Gedarif State and 38 [35.5%] from Mayo Farm clinic. The majority of defaulters were males [64.5%] compared to 35.5% females. Analysis of results reflected that 64% of defaulters compared to 60% of non-defaulters thought that TB is not infectious. Others had misconception about adverse reactions duration of treatment and other wrong information regarding the management of tuberculosis, which was 31.8% among defaulters to compare to 21.3% among non defaulters. Defaulters came to consultation in severe conditions, and usually did not inform their families about their illness. They tended to seek health care with more period of delay compared to non-defaulters. The main cause of delay in seeking the treatment and defaulting was financial problems, this insists on the role of the ministry of finance to alleviate poverty. The knowledge of both defaulters and non-defaulters about the disease was not sufficient, strengthening of health education activities by the National Tuberculosis program is essential