ABSTRACT
OBJECTIVE: To evaluate the prevalence of tuberculosis (TB) stigma and to determine the relation between socio-demographic characteristics and TB stigma among TB cases and their controls in Gezira State, Sudan. METHODS: A case-control study design was used. New smear-positive TB patients registered in Gezira State in 2010 (n = 425) and controls who attended the same health facility for other reasons (n < 850) formed the study population. Stigma was measured using a standard modified World Health Organization TB KAP (knowledge, attitudes, practice) instrument. RESULTS: TB stigma did not differ between TB cases and controls; mild stigma was found in both groups. The higher degree of stigma among both groups was significantly associated with higher age, lower level of education, residence in rural areas, unemployment and poor TB awareness, while sex had no association with the degree of stigma in either group. CONCLUSION: Although TB stigma among the Gezira population was found to be mild, it can affect treatment adherence. Empowering both TB patients and communities by increasing their knowledge through proper education programmes could effectively contribute to the effort of controlling TB in the state.
Subject(s)
Patient Acceptance of Health Care/psychology , Prejudice , Public Opinion , Stereotyping , Tuberculosis, Pulmonary/psychology , Adult , Age Factors , Case-Control Studies , Chi-Square Distribution , Cost of Illness , Female , Humans , Logistic Models , Male , Middle Aged , Multivariate Analysis , Prevalence , Risk Factors , Sex Factors , Socioeconomic Factors , Sudan/epidemiology , Surveys and Questionnaires , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/epidemiologyABSTRACT
BACKGROUND: Tuberculosis (TB) is among the top ten causes of global mortality. Sudan is among the countries with high TB prevalence; with an estimated incidence of 90/100,000 smear-positive cases. In 1993, the Khartoum State tuberculosis control programme was established. Since its establishment, however, the programme has never been adequately assessed. AIM: To evaluate and describe the tuberculosis control programme in Khartoum State, Sudan in 2006; to find out if the programme achieved its global targeted goals; and to identify the challenges and needs for performing a good standard tuberculosis control programme. METHODS: A descriptive cross-sectional and retrospective study design was used. The study population was tuberculosis control departments at the levels of the state (n = 1), localities (n = 7), health areas (n = 19) and health facilities (n = 42). Records review and group interviews were used to collect the required data. RESULTS: The study found that the TB control programme in Khartoum State achieved a 77.2% case detection rate of the smear-postive cases, and 73.5% treatment success rate, and a case fatality rate of 2.2%, treatment failure rate of 2.2%, and default rate of 14.1%. There was no system to detect the prevalence of MDR-TB (multi-drug resistant TB) or HIV (human immunodeficiency virus) among the TB cases. The programme was not well implemented at locality or health area levels. Conversely, drugs and laboratory supply systems were functioning well. CONCLUSIONS: The tuberculosis control programme in Khartoum State is centralized, not updated, and does not achieve the targeted goals.
