Knowledge, attitude and practice regarding leprosy and tuberculosis in Bangladesh.

A small survey was carried out in two areas of northern Bangladesh to assess and compare the level of knowledge, attitude and practice towards leprosy and tuberculosis (TB) among two communities that differed widely in the amount of health education received about these diseases. The results indicate that without a health education programme, levels of knowledge about the cause and treatability of the diseases are poor, worse for leprosy than TB, with correspondingly negative attitudes. Only 16% of the respondents in the 'uninformed' area mentioned 'skin patch' in a question about what they knew about leprosy; and only 44% mentioned 'cough' as a symptom of TB. In the area that had received health education, 90% mentioned, respectively, 'skin patch' and 'cough'. Seventy-eight percent of the respondents would not buy goods from a shopkeeper known to have leprosy, 76% if he had TB in the uninformed area; but in the community who had received health education the proportions were reversed, with three-quarters agreeing to purchase from a diseased shopkeeper. The implications of these findings for the DBLM and National Health Education programmes are discussed.

Expenditure and loss of income incurred by tuberculosis patients before reaching effective treatment in Bangladesh.

This small study undertook to assess the economic consequences of developing tuberculosis (TB) among patients presenting to the TB clinic run by the Danish Bangladesh Leprosy Mission in NW Bangladesh. The loss of income resulting from the illness, and the actual expenditure incurred by medicines and doctor's fees before registration for treatment, were estimated and totalled for 21 patients serially registered at the clinic. The results showed a mean financial loss to the patient of US$ 245-an exorbitant sum for a village Bangladeshi. Perhaps economic deprivation suffered by TB patients could be used as a measure of success of the programme.

Tuberculosis control is good for established leprosy programmes.

Tuberculosis (TB) control was introduced into part of the Danish Bangladesh Leprosy Mission's large leprosy control programme in 1994. This was in line with the Government's policy of combining leprosy and TB control. We report our experience with integration. Leprosy case-finding has increased during the period, and staff satisfaction and morale has also risen despite the larger workload. We observed that the field work skills of leprosy workers was brought to bear in a very positive way on TB control. TB patients suffer considerable impoverishment as a result of their illness, paralleling the social dehabilitation often seen in leprosy sufferers. TB control is good for established leprosy programmes.