Knowledge of Causative Agent of Tuberculosis Among Patients

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Knowledge of causative agent of Tuberculosis among TB patients in Jaipur district (Rajasthan).

  • Dr Shobha Tomar, Resident Community, Medicine,NIMS Medical College , Jaipur.
  • Dr Dharmendra Mandarwal, Assistant Professor, Community Medicine,NIMS Medical College , Jaipur
  • Dr Brajesh kumar chahar, Assistant Professor(statistics), Community Medicine,NIMS Medical College , Jaipur
  • Dr. Sumit Ahluwalia, Demonstrator, Community Medicine,NIMS Medical College , Jaipur

ABSTRACT :Background: Tuberculosis is known since ages and its causative agent was discovered eight to nine decades ago and still misconception is present regarding its cause in india. India is facing TB epidemic at present. Objectives: to assess the knowledge of TB patients regarding causative agent of the disease. Results: Total 300 TB patients participated in the study, 75% were male and 25% were female, 60% were married and 25% were unmarried 15% were widow or widower, 77% were hindu and 22% were muslim,49% were literate and 51%were illetrate, 59% patients belonged to social class 4. 56% of patients knew the causative organism, 72% of the female don’t know the causative agent. 71% to 73% literate patients knew about the causative agent. Evil eye(56%), past sins(52%) were main myths as cause of TB. Lower socio economic class had more myths about the causative agent (23% in class 4) (58% in class 5). Conclusion: In poor country like india emphasis must be paid regarding awareness of tuberculosis among poor and low socioeconomic group people and patient.

KEYWORDS : Tuberculosis, knowledge, myth.

Introduction:

Tuberculosis kills more people in economically productive age group greater than any other infectious disease worldwide. Tuberculosis alone kills more people than malaria and AIDS combined. Women death due to maternal mortality lies second to tuberculosis, such is the magnitude of problem worldwide.

Tuberculosis is turning out to be greatest epidemic of this century, so great is the concern about tuberculosis epidemic.

The problem of tuberculosis is acute in developing countries which accounts for three fourth of cases in the world. The impact of tuberculosis is greatest on poor 99.00% of deaths and 95.00% of all cases occurring in developing and poor countries. The majority of people affected by tuberculosis are in economically active age group. Tuberculosis and poverty go hand in hand people who are poor get tuberculosis and people who get tuberculosis becomes poor1.

In developing countries still lot number of tuberculosis patients goes undiagnosed. There has been over all increase in absolute number of tuberculosis cases during last 30 years because of population explosion during this period2.

Tuberculosis is the oldest known disease to mankind and is caused by mycobacterium tuberculosis. The causative organism was discovered long back but myths regarding cause of tuberculosis is still prevalent not only in general population but also among the TB patients.

AIMS AND OBJECTIVES

The present study aims to study knowledge of TB cases regarding causative agent of tuberculosis and myths related to its causation.

MATERIAL AND METHODS

Period of study:

Survey was conducted from 1st January 2013 to 30th Dec, 2013 for a period of 1 year.

Sampling units:

Study was conducted on the tuberculosis patients of the Jaipur treatment unit at DTC and at 20 DOTS enters:

Area of study:

The present study was conducted as District tuberculosis centre and randomly selected DOT centres of Jaipur treatment unit. Patients attending DTC and DOT’s centre to which they belonged to.

Sampling Technique:

During the period of study a total of 173 TB patients were registered for treatment at District TB centre Jaipur of which 167 were included in the study while 6 refused to participate in the study.

Tuberculosis unit – Jaipur at the time of study had 415 DOT’s providers of which 5% i.e. every 20th DOT’s provider was include for study by using systemic random sampling technique i.e. choosing every 20th DOT’s provider from the available list. Thus this figure came to be 20 DOT’s provider out of 415. During the period of study 133 TB patients were taking treatment from these 20 DOTS provider and these 133 patients were taken up for the study. Thus the total sample size came to be 167+133 = 300 (167 form DTC and 133 from DOTs provider).

 

 

Technique used:

The study was conducted by taking interview of TB patients attending DTC and DOT’s centre.

Data were collected in pre designed and pre tested proforma.

All the details of TB patients, which included socio-demographic and clinical profile of the patient such as age, sex, marital status, religion, education, occupation, socio-economic condition etc. Clinical profile consisted of symptoms of tuberculosis, past history, family history, diet, bowel habits BCG vaccination etc. Environmental factors such as type of housing was also taken in account. Revised B G Prasad classification was used to determine the social class of the tuberculosis patient in the present study.

Knowledge of the causative agent of tuberculosis patients regarding their disease and myths regarding causation was studied in pre tested proforma.

 

OBSERVATIONS

Socio-demographic characteristics of TB patients

CHARACTERISTICS

NUMBER(%) n= 300 (100%)

SEX

Male

FEMALE

225(75)

75(25)

AGE (in years)

≤14

15-29

30-39

40-49

50-59

60+

6(2)

110(36.6)

82(27.3)

44(14.6)

38(12.67)

20(6.6)

MARITAL STATUS

Married

Unmarried

Widow/Widower

182(60.66)

74(24.67)

44(14.67)

EDUCATIONAL STATUS

Illiterate

Primary

Secondary

Sr.Secondary

Graduate

146(48.67)

72(24)

52(17.33)

23(7.67)

7(2.33)

OCCUPATION

Agriculture

Labour

Govt

Self-employed

Housewife

Others

34(11.33)

120(40)

8(2.67)

71(23.67)

50(16.67)

17(5.67)

Table shows 75% of TB patients are male and 25% female. Most of the cases are in age group 15-39yr i.e. 63.9%. Married constitutes about 60% of the cases and among illiterate 48.67%. TB is more common among labourers.

 

 

Table: 2

Observation showing cases distribution according to

social class & area of residence

Social Class

Urban

Urban Slum

Rural

Total

No.

%

No

%

No

%

No

%

I

0

0.00

2

1.27

0

0.00

2

0.66

II

1

1.00

21

13.29

4

9.52

26

8.67

III

10

10.00

20

12.66

8

19.05

38

12.67

IV

17

17.00

31

19.62

10

23.81

58

19.33

V

72

72.00

84

53.16

20

47.62

176

58.67

Total

100

100.00

158

100.00

42

100.00

300

100.00

                 

Above table indicates that 258(86%) patients belong to urban and urban slum in this study

Table: 3

Distribution of cases according to the

knowledge of causative organism

Causative

Organism

Male

Female

Total

No.

%

No

%

No

%

Knows

146

64.89

21

28.00

67

55.67

Don’t Know

79

35.11

54

72.00

133

44.33

Total

225

100.00

75

100.00

300

100.00

             

2 = 28.72 df = 1 p<0.001

Table shows that 55.67% had knowledge about causative organism. 64.89% of males and 28.00% of females had knowledge about causative organism.

44.33% cases had no knowledge about causative organism 72.00% female and 35.11% males had no knowledge about causative organism.

The difference was statistically significant.

Table: 4

Correlation between awareness about TB causative organisms

and literacy

Literacy Status

Present

Absent

Total

No.

%

No

%

No

%

Illiterate

83

56.84

63

43.16

146

100.00

Primary

25

34.72

47

65.28

72

100.00

Secondary

31

59.61

21

40.39

52

100.00

Senior Secondary

17

73.91

06

26.09

23

100.00

Graduate

05

71.42

02

28.58

07

100.00

Total

161

53.67

139

46.33

300

100.00

             

2 = 16.41 df = 4 p < 0.001

Observation in this table shows that 73.91% and 71.42% of TB cases with literacy status of sr. secondary and graduate respectively knew about causative agent. 34.72 and 59.61% of cases who were primary and secondary educated knew about causative organism. Knowledge about causative organism among illiterate was found to be 56.84%. The difference was statistically significant.

.

Distribution of TB cases as per literacy status

Table: 5

Observation showing myths among tuberculosis cases

Myth about disease

Present

Absent

Total

No.

%

No

%

No

%

Punishment

from God

140

46.66

160

53.34

300

100.00

Curse

127

42.33

173

57.67

300

100.00

Ghost intrusion

93

31.00

207

69.00

300

100.00

Past sins

156

52.00

144

48.00

300

100.00

Evil eye

170

56.66

130

43.34

300

100.00

             

Table shows that 56.66% of the respondents ststed evil eye, 52.00% of the respondents considered past sins as the cause of tuberculosis. Respondents gave multiple response regarding myths about tuberculosis cause.

Table: 6

Observation showing myth about disease in relation to social class

Myth about disease

Yes

No

Total

No.

%

No

%

No

%

Social Class I

0

0

2

1.5

2

0.67

Social Class II

14

8.38

12

9.02

26

8.67

Social Class III

17

10.18

21

15.79

38

12.67

Social Class IV

39

23.35

19

14.29

58

19.33

Social Class V

97

58.08

79

59.40

176

58.67

Total

161

100.00

139

100.00

300

100.00

             

2 = 7.56 df = 4 p > 0.05

Observation in this table shows that 53.67% cases had myth about disease as the social class rose the percentage of cases with myth declined. It was 8.75% in social class II. While it was 23.35% and 58.08% in social class IV and V.

The difference was statistically non significant.

DISCUSSION

Present study is an attempt to explore various socio-demographic factors and knowledge of TB patients regarding the causative agent of the disease, factors like personal habits were not taken. Study was carried out in 300 patients of tuberculosis attending DTC and DOTS provider.

Age break-up of 300 patients revealed that maximum number of them i.e.36.60% belonged to age-group of 15-29 yrs followed by 27.30%in the age group of 30-39yrs. The observation suggest that about 2/3rd of the patients belonged to active age group for earning and productivity Shrivastav et al (1977)7 and Arya VR (2000)6 also found majority of patients below 40yrs. Mohamed et al (2007)15 in his study found 60.8% of respondents belonged to age group 20-39 years.

75.00% of the patients were male and 25.00%female. Male, female ratio being 3:1. Gopi et al (1978)10 also found prevalence of tuberculosis three times higher in males than in female. Chaterjee et al (2000)5 also found about three quarter of patients being male and one quarter being female. ICMR (1959)3 also found Male- female ratio of tuberculosis patients to be 3:1.

Of the total 300 patients one third i.e. 33.34% were from urban area and more than half (52.60%) were from urban slums. 14.00% of the patients were from rural areas. Chaddha et al (1977)8 and Srivastav et al (1977)7 also found maximum patients belonging to urban slums (47.70% and 44.00% respectively).

77.00% of the patient were Hindus & 22.33% Muslim. Shah M J (1993)9 found tuberculosis to be 70.40% Hindus and 26.00% Muslim Gopi et al (1997)4 and Laring R D (1995)8 found higher number of Muslim patient i.e. 32.80% and 35.60% respectively.

Observation from literacy status of tuberculosis cases indicate that about half 48.60% were illiterate another 24.00% were literate upto primary level. Only 27.33% of patients were literate upto secondary level or above. Chaddha et al (2000)8, Gopi et al (1997)4 and Shah M J (1993)9 also found that maximum numbers of patients to be illiterates (39.00%, 58.60% and 58.30% respectively). Damor D, Singh MP (2012) 16 in their study found that 31.9% of the respondents were illiterate.

Only two third of patients i.e 65.67% knew about the causative organism. No correlation between awareness of causative agent and literacy status was found . In study by Ali et al (2003)13, 78.00 % of patients knew about causative organism while Rajeshwari et al (1995)12 found that 86.00 % of cases were aware about causative organism. Dubey et al (2000)11 noted 95.00% of tuberculosis cases being aware of causative agent. Damor D, Singh MPS (2012) 16 in their study found only 6.9% of the cases knew the cause of disease. Ali Khan Khwaja (2010) 17 in his study found that 39% of the cases knew germ as the cause of disease.

Various myths related to T B prevalent in tuberculosis patients were ; Punishment from God (40.66%) , Curse (42.33%) , Past sins (52.00%) , Evil eye (55.66%) , Ghost

intrusion (31.00%). The myth were prevalent more frequently in lower social class cases then upper class. Javed Ahmed khan (2006) 14 also found that 50% of the respondents had myths regarding the cause of tuberculosis.

Observation on correlation between knowledge of duration of treatment and literacy status reveal a positive correlation i.e higher the literacy higher the knowledge .It was 42.20% in illiterate while it was 85.71% in graduate.

SUMMARY AND CONCLUSION

  • 63.90% ie.2/3 rd of the patients belonged to active age-group i.e. 15-39 yrs. Which is age for earning and productivity.
  • 75.00% of patients were male and 25.00% were female. Male female ratio being 3:1
  • 1/3rd of patients belonged to urban area. More than half (52.60%) from urban slums and 14.00% of rural areas.
  • About 60.00% of patients were married and 40.00% were either unmarried, widow and widower.
  • 77.00% of patients were Hindu, 22.33% were Muslims and rest belong to other religion.
  • Maximum number of patients were laborers (40.00%) followed by self employed (23.67%), 18.67% were housewives.
  • Literacy status of sample was 51.40%
  • 2/3 rd of the patients belonged to nuclear family
  • Majority of the patients ie. 78.00% were from lower socio economic classes.
  • Only 2/3rd of the patients i.e. 65.67% knew about the causative organism and literacy status was found.
  • Myths regarding causation of TB were widely prevalent especially in lower class than upper class which were; punishment from God (40.66%), curse (42.33%), past sins (52.00%), evil eye (55.66%) and ghost intrusion (31.00%) indicating the need of creating awareness in patients in particular and community in general.

BIBLIOGRAPHY

  1. World TB report WHO – 1998
  2. Ian Smith (1999) Stop TB-is DOTS the Answer ? Indian Journal Tuberculosis, April –1999, Vol:46, p 81.
  3. Godhi et. al. (1979). Prevalence of Tuberculosis in a South Indian District Indian Journal of Tuberculosis 1979 p.26, 121.
  4. Chatterjee et. al. (2000). Multicentre study on TB cases. 55th TB & Chest disease conference Kolkata. P100.
  5. Khatri G.R. (1999). RNTCP – Status report on first 1,00,000 patients. NTL Bulletin Vol. 35/ 1-4. 1999. p 18-26.
  6. Khatri G.R. (2000) Forum. Ind. J. Of Tuberculosis. Vol. – 47. p-117.
  7. Chaddha et. al. (2000). Treatment outcome of TB patients placed under DOTS- A cohort study. Ind. J. of TB Vol. – 47 (2000). P-155,158.
  8. Laring R.D. (1995). Prevalence of TB in age group 5-14 yr and 45+ among Tribal community. Calcutta University P-45.
  9. Nagpal D.R. Tuberculosis epidemic in India – editorial. Ind. J. tuberculosis Vol. 46-1999. P-79-80.
  10. Mishra P. (1990). A study of evaluation of NTP in Ahmedabad District. Study report of supervised field training MD PSM Gujarat University.
  11. Pavo Tanni – Medical & Social aspects of chi TB in Finland. Scand J. of Respiratory disease 1970, 73 (supp) P 93-105.
  12. Bansal AK. – Assessment of Tribal and Non Tribal community regarding need for TB education. International Journal of Lund disease (1994) Vol. 3 p 782.
  13. San Sebestian And Bothanley. Tuberculosis preventive therapy; perspective form a multi ethinic community. Respiratory medicine 2000 (94). P 648-653.
  14. Javed Ahmed Khan et al knowledge. Attittude and misconceptions regarding TB in Pakistani patients. Journal of Pakistan Medical Association May 2006,Vol. 2(1).
  15. Mohamed A I et al. Knowledge of TB –A survey among TB Patients in Omdurman Sudan. Sudanese journal of public health January 2007:Vol2(1).
  16. Damor D, Singh DMP. Assessment of knowledge about TB among newly diagnosed patients registered in DTC Bhavnagar ,Gujrat. NJIRM (2012) 3(3):90-94.
  17. Ali Khan Khwaja. Knowledge about TB among patients attending clinic in karanchi(2010) www. /uhms,edu.pk/jlumhc/Vol 04 No.02

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