Skip to main content
Top
Published in: BMC Health Services Research 1/2019

Open Access 01-12-2019 | Tuberculosis | Research article

Health care providers’ knowledge, attitude and perceived stigma regarding tuberculosis in a pastoralist community in Ethiopia: a cross-sectional study

Authors: Bezawit Temesgen Sima, Tefera Belachew, Fekadu Abebe

Published in: BMC Health Services Research | Issue 1/2019

Login to get access

Abstract

Background

Tuberculosis (TB) remains the prime killer disease among infectious diseases. TB control depends on early case detection and treatment in a directly observed treatment short course (DOTS) programme. The success of DOTS depends on the ability of the health care system to identify and properly manage TB cases. The present study aims to assess healthcare provider (HCP) knowledge, attitude and perceived stigma regarding TB and perception about traditional healers.

Methods

A descriptive cross sectional study was conducted among 108 HCPs using a semi-structured, self-administered questionnaire from September 2014 to January 2015. The study district has a high TB burden area with one district hospital, 4 health centres, and 18 health posts. All health facilities and HCPs available during the study period in the district were included in the study. Statistical software for social science (SPSS) version 22 and STATA version 14 were used to enter and analyse data, respectively.

Results

The majority (64%) of the HCPs had poor overall knowledge regarding TB, and 67.6 and 57.6% had poor knowledge regarding TB diagnosis and nature of the disease, respectively. Moreover, most 66.7 and 55.6% of the HCPs had an unfavourable attitude towards TB and TB control systems, respectively. Slightly under half (49.1%) of the HCPs had a favourable attitude towards TB patients, and the majority (88.9%) had low perceived stigma. The majority (87.0%) of the HCPs indicated the importance of community involvement in TB control activity. Moreover, most (60.2%) of the HCPs showed willingness to collaborate with traditional healers (THs) on TB control activity.

Conclusions

Healthcare workers’ knowledge gap and unfavourable attitude towards TB control systems reported in this study may cause poor TB care delivery. HCPs’ perception of the importance of community involvement in TB control and willingness to collaborate with THs on TB management could be an opportunity to strengthen the World Health Organization’s (WHO’s) component of End TB strategy through community engagement. Training and workshops could be used to address the knowledge gap and the unfavourable attitude regarding TB among HCPs.
Appendix
Available only for authorised users
Literature
1.
go back to reference WHO: Global tuberculosis report. World Health Organization: Global tuberculosis report 2017. WHO: Global tuberculosis report. World Health Organization: Global tuberculosis report 2017.
2.
go back to reference WHO. Ethiopia: on the road to ending. Tuberculosis. 2016. WHO. Ethiopia: on the road to ending. Tuberculosis. 2016.
3.
go back to reference Organization WH: WHO:Global tuberculosis report 2016. 2016. Organization WH: WHO:Global tuberculosis report 2016. 2016.
4.
go back to reference Xu L, Gai R, Wang X, Liu Z, Cheng J, Zhou C, Liu J, Zhang H, Li H, Tang W. Socio-economic factors affecting the success of tuberculosis treatment in six counties of Shandong Province China. The International Journal of Tuberculosis and Lung Disease. 2010;14(4):440–6.PubMed Xu L, Gai R, Wang X, Liu Z, Cheng J, Zhou C, Liu J, Zhang H, Li H, Tang W. Socio-economic factors affecting the success of tuberculosis treatment in six counties of Shandong Province China. The International Journal of Tuberculosis and Lung Disease. 2010;14(4):440–6.PubMed
5.
go back to reference WHO: Stop TB partnership. The global plan to stop TB, 2006-2015. In: WHO/HTM/STB/200635. Edn.; 2006. WHO: Stop TB partnership. The global plan to stop TB, 2006-2015. In: WHO/HTM/STB/200635. Edn.; 2006.
6.
go back to reference WHO: World Health Organization;global tuberculosis control. WHO report Geneva 2011. WHO: World Health Organization;global tuberculosis control. WHO report Geneva 2011.
7.
go back to reference Naseer M, Khawaja A, Pethani AS, Aleem S. How well can physicians manage tuberculosis? A public-private sector comparison from Karachi Pakistan. BMC Health Serv Res. 2013;13(1):439.CrossRef Naseer M, Khawaja A, Pethani AS, Aleem S. How well can physicians manage tuberculosis? A public-private sector comparison from Karachi Pakistan. BMC Health Serv Res. 2013;13(1):439.CrossRef
8.
go back to reference Kanjee Z, Catterick K, Moll AP, Amico KR, Friedland GH. Tuberculosis infection control in rural South Africa: survey of knowledge, attitude and practice in hospital staff. J Hosp Infect. 2011;79(4):333–8.CrossRef Kanjee Z, Catterick K, Moll AP, Amico KR, Friedland GH. Tuberculosis infection control in rural South Africa: survey of knowledge, attitude and practice in hospital staff. J Hosp Infect. 2011;79(4):333–8.CrossRef
9.
go back to reference Hashim DS, Al Kubaisy W, Al Dulayme A: Erratum: Knowledge, attitudes and practices survey among health care workers and tuberculosis patients in Iraq (Eastern Mediterranean Health Journal (2003) vol. 9 (4) (718–731)). East Mediterr Health J 2004, 10(4–5):493. Hashim DS, Al Kubaisy W, Al Dulayme A: Erratum: Knowledge, attitudes and practices survey among health care workers and tuberculosis patients in Iraq (Eastern Mediterranean Health Journal (2003) vol. 9 (4) (718–731)). East Mediterr Health J 2004, 10(4–5):493.
10.
go back to reference Sima BT, Belachew T, Abebe F. Knowledge, attitude and perceived stigma towards tuberculosis among pastoralists; do they differ from sedentary communities? A comparative cross-sectional study. PLoS One. 2017;12(7):e0181032.CrossRef Sima BT, Belachew T, Abebe F. Knowledge, attitude and perceived stigma towards tuberculosis among pastoralists; do they differ from sedentary communities? A comparative cross-sectional study. PLoS One. 2017;12(7):e0181032.CrossRef
11.
go back to reference Legesse M, Ameni G, Mamo G, Medhin G, Shawel D, Bjune G, Abebe F. Knowledge and perception of pulmonary tuberculosis in pastoral communities in the middle and lower Awash Valley of Afar region, Ethiopia. BMC Public Health. 2010;10:187.CrossRef Legesse M, Ameni G, Mamo G, Medhin G, Shawel D, Bjune G, Abebe F. Knowledge and perception of pulmonary tuberculosis in pastoral communities in the middle and lower Awash Valley of Afar region, Ethiopia. BMC Public Health. 2010;10:187.CrossRef
12.
go back to reference Tolossa D, Medhin G, Legesse M. Community knowledge, attitude, and practices towards tuberculosis in Shinile town, Somali regional state, eastern Ethiopia: a cross-sectional study. BMC Public Health. 2014;14(1):804.CrossRef Tolossa D, Medhin G, Legesse M. Community knowledge, attitude, and practices towards tuberculosis in Shinile town, Somali regional state, eastern Ethiopia: a cross-sectional study. BMC Public Health. 2014;14(1):804.CrossRef
13.
go back to reference Gele A, Sagbakken M, Abebe F, Bjune A. Barriers to tuberculosis care: a qualitative study among Somali pastoralists in Ethiopia. BMC research notes. 2010;3:86.CrossRef Gele A, Sagbakken M, Abebe F, Bjune A. Barriers to tuberculosis care: a qualitative study among Somali pastoralists in Ethiopia. BMC research notes. 2010;3:86.CrossRef
14.
go back to reference Gele AA, Bjune G, Abebe F. Pastoralism and delay in diagnosis of TB in Ethiopia. BMC Public Health. 2009;9(1):5.CrossRef Gele AA, Bjune G, Abebe F. Pastoralism and delay in diagnosis of TB in Ethiopia. BMC Public Health. 2009;9(1):5.CrossRef
15.
go back to reference Zinsstag J, Ould Taleb M, Craig PS. Editorial: health of nomadic pastoralists: new approaches towards equity effectiveness. Tropical Med Int Health. 2006;11(5):565–8.CrossRef Zinsstag J, Ould Taleb M, Craig PS. Editorial: health of nomadic pastoralists: new approaches towards equity effectiveness. Tropical Med Int Health. 2006;11(5):565–8.CrossRef
16.
go back to reference Belay M, Bjune G, Ameni G, Abebe F. Diagnostic and treatment delay among tuberculosis patients in Afar region, Ethiopia: a cross-sectional study. BMC Public Health. 2012;12:369.CrossRef Belay M, Bjune G, Ameni G, Abebe F. Diagnostic and treatment delay among tuberculosis patients in Afar region, Ethiopia: a cross-sectional study. BMC Public Health. 2012;12:369.CrossRef
17.
go back to reference Gebreegziabher SB, Bjune GA, Yimer SA. Patients' and health system's delays in the diagnosis and treatment of new pulmonary tuberculosis patients in west Gojjam zone, Northwest Ethiopia: a cross-sectional study. BMC Infect Dis. 2016;16(1):673.CrossRef Gebreegziabher SB, Bjune GA, Yimer SA. Patients' and health system's delays in the diagnosis and treatment of new pulmonary tuberculosis patients in west Gojjam zone, Northwest Ethiopia: a cross-sectional study. BMC Infect Dis. 2016;16(1):673.CrossRef
18.
go back to reference Hussen A, Biadgilign S, Tessema F, Mohammed S, Deribe K, Deribew A. Treatment delay among pulmonary tuberculosis patients in pastoralist communities in bale zone Southeast Ethiopia. BMC Research Notes. 2012;5:320.PubMedPubMedCentral Hussen A, Biadgilign S, Tessema F, Mohammed S, Deribe K, Deribew A. Treatment delay among pulmonary tuberculosis patients in pastoralist communities in bale zone Southeast Ethiopia. BMC Research Notes. 2012;5:320.PubMedPubMedCentral
19.
go back to reference Teklehaimanot HD, Teklehaimanot A. Human resource development for a community-based health extension program: a case study from Ethiopia. Hum Resour Health. 2013;11(1):39.CrossRef Teklehaimanot HD, Teklehaimanot A. Human resource development for a community-based health extension program: a case study from Ethiopia. Hum Resour Health. 2013;11(1):39.CrossRef
20.
go back to reference Hashim D, Al Kubaisy W, Al Dulayme A. Knowledge, attitudes and practices survey among health care workers and tuberculosis patients in. Iraq. 2003. Hashim D, Al Kubaisy W, Al Dulayme A. Knowledge, attitudes and practices survey among health care workers and tuberculosis patients in. Iraq. 2003.
21.
go back to reference WHO. Advocacy, communication and social mobilization for TB control: a guide to developing knowledge. In: Attitude and practice surveys; 2008. WHO. Advocacy, communication and social mobilization for TB control: a guide to developing knowledge. In: Attitude and practice surveys; 2008.
22.
go back to reference Liew A. Understanding data, information, knowledge and their inter-relationships. Journal of Knowledge Management Practice. 2007;8(2):1–16. Liew A. Understanding data, information, knowledge and their inter-relationships. Journal of Knowledge Management Practice. 2007;8(2):1–16.
23.
go back to reference Sheik-Mohamed A, Velema JP. Where health care has no access: the nomadic populations of sub-Saharan Africa. Tropical Med Int Health. 1999;4(10):695–707.CrossRef Sheik-Mohamed A, Velema JP. Where health care has no access: the nomadic populations of sub-Saharan Africa. Tropical Med Int Health. 1999;4(10):695–707.CrossRef
24.
go back to reference FMoH: Federal Democratic Republic of Ethiopia, Ministry of Health: health sector development Programme IV 2010/11–2014/15. 2010. FMoH: Federal Democratic Republic of Ethiopia, Ministry of Health: health sector development Programme IV 2010/11–2014/15. 2010.
25.
go back to reference Banerjee A, Sharma B, Ray A, Kannuri N, Venkateswarlu T. Acceptability of traditional healers as directly observed treatment providers in tuberculosis control in a tribal area of Andhra Pradesh India. Int J Tuberc Lung Dis. 2004;8(10):1260–5.PubMed Banerjee A, Sharma B, Ray A, Kannuri N, Venkateswarlu T. Acceptability of traditional healers as directly observed treatment providers in tuberculosis control in a tribal area of Andhra Pradesh India. Int J Tuberc Lung Dis. 2004;8(10):1260–5.PubMed
26.
go back to reference Van Brakel WH. Measuring health-related stigma—a literature review. Psychology, Health and Medicine. 2006;11(3):307–34.CrossRef Van Brakel WH. Measuring health-related stigma—a literature review. Psychology, Health and Medicine. 2006;11(3):307–34.CrossRef
27.
go back to reference Efron R. What is perception? In: Proceedings of the Boston colloquium for the philosophy of science 1966/1968: 1969: Springer; 1969. p. 137–73. Efron R. What is perception? In: Proceedings of the Boston colloquium for the philosophy of science 1966/1968: 1969: Springer; 1969. p. 137–73.
28.
go back to reference Noé A, Ribeiro RM, Anselmo R, Maixenchs M, Sitole L, Munguambe K, Blanco S, le Souef P, García-Basteiro AL. Knowledge, attitudes and practices regarding tuberculosis care among health workers in southern Mozambique. BMC Pulmonary Medicine. 2017;17:2.CrossRef Noé A, Ribeiro RM, Anselmo R, Maixenchs M, Sitole L, Munguambe K, Blanco S, le Souef P, García-Basteiro AL. Knowledge, attitudes and practices regarding tuberculosis care among health workers in southern Mozambique. BMC Pulmonary Medicine. 2017;17:2.CrossRef
29.
go back to reference Buregyeya E, Kulane A, Colebunders R, Wajja A, Kiguli J, Mayanja H, Musoke P, Pariyo G, Mitchell E. Tuberculosis knowledge, attitudes and health-seeking behaviour in rural Uganda. Int J Tuberc Lung Dis. 2011;15. Buregyeya E, Kulane A, Colebunders R, Wajja A, Kiguli J, Mayanja H, Musoke P, Pariyo G, Mitchell E. Tuberculosis knowledge, attitudes and health-seeking behaviour in rural Uganda. Int J Tuberc Lung Dis. 2011;15.
30.
go back to reference Lertkanokkun S, Okanurak K, Kaewkungwal J, Meksawasdichai N. Healthcare providers’ knowledge, attitudes & practices regarding tuberculosis care. JItMM2012 PrOcEEDInGs. 2013;2:1–10. Lertkanokkun S, Okanurak K, Kaewkungwal J, Meksawasdichai N. Healthcare providers’ knowledge, attitudes & practices regarding tuberculosis care. JItMM2012 PrOcEEDInGs. 2013;2:1–10.
31.
go back to reference Dodor E. Health professionals expose TB patients to stigmatization in society: insights from communities in an urban district in Ghana. Ghana Medical Journal. 2008;42(4):144.PubMedPubMedCentral Dodor E. Health professionals expose TB patients to stigmatization in society: insights from communities in an urban district in Ghana. Ghana Medical Journal. 2008;42(4):144.PubMedPubMedCentral
32.
go back to reference Wu P-S, Chou P, Chang N-T, Sun W-J, Kuo H-S. Assessment of changes in knowledge and stigmatization following tuberculosis training workshops in Taiwan. J Formos Med Assoc. 2009;108(5):377–85.CrossRef Wu P-S, Chou P, Chang N-T, Sun W-J, Kuo H-S. Assessment of changes in knowledge and stigmatization following tuberculosis training workshops in Taiwan. J Formos Med Assoc. 2009;108(5):377–85.CrossRef
33.
go back to reference Viney K, Johnson P, Tagaro M, Fanai S, Linh N, Kelly P, Harley D, Sleigh A. Traditional healers and the potential for collaboration with the national tuberculosis programme in Vanuatu: results from a mixed methods study. BMC Public Health. 2014;14(1):393.CrossRef Viney K, Johnson P, Tagaro M, Fanai S, Linh N, Kelly P, Harley D, Sleigh A. Traditional healers and the potential for collaboration with the national tuberculosis programme in Vanuatu: results from a mixed methods study. BMC Public Health. 2014;14(1):393.CrossRef
Metadata
Title
Health care providers’ knowledge, attitude and perceived stigma regarding tuberculosis in a pastoralist community in Ethiopia: a cross-sectional study
Authors
Bezawit Temesgen Sima
Tefera Belachew
Fekadu Abebe
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-3815-1

Other articles of this Issue 1/2019

BMC Health Services Research 1/2019 Go to the issue