https://doi.org/10.4081/monaldi.2024.3154

Knowledge, attitude and perceived barriers related to directly observed treatment, short-course among patients and caregivers attending tuberculosis clinics: a cross-sectional survey

Early Access
Submitted: July 27, 2024
Accepted: August 30, 2024
Published: October 2, 2024
Attitude, DOTS, knowledge, perceived barriers, tuberculosis
Abstract Views: 455
PDF_EARLY VIEW: 153
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Rakhi Gaur
https://orcid.org/0000-0003-0835-4383
College of Nursing, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
Suresh Kumar Sharma
College of Nursing, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Suman Kumar
https://orcid.org/0009-0005-6331-9494
Department of Microbiology, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
Shiv Kumar Mudgal
https://orcid.org/0000-0002-8062-0589
College of Nursing, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
Vipin Patidar
patidar_vipin@yahoo.in
https://orcid.org/0000-0003-4595-9859
College of Nursing, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
Ayesha Juhi
Department of Physiology, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.

Tuberculosis (TB) is a major worldwide health problem, particularly in India, where it accounts for a quarter of infections. Adherence to the directly observed treatment, short-course (DOTS), which is necessary for TB treatment, is difficult in resource-limited circumstances. This study addressed the knowledge, attitude, and perceived barriers related to TB and DOTS adherence among patients and caregivers. A cross-sectional survey was undertaken at the selected TB clinics between November 2023 and March 2024. Purposive sample yielded 180 patients and 217 caregivers. Data were obtained using validated, self-structured questionnaires that assessed knowledge, attitude, and perceived barriers to TB and DOTS adherence. Statistical analysis was carried out with IBM SPSS version 23.0. The study found that caregivers had considerably greater TB knowledge than patients (p<0.05). Many patients misunderstood the cause of TB (50.6%) and embraced various misconceptions about the disease, such as TB spreading by shaking hands or sharing food, swimming in a holy river to cure diseases, and TB being the result of sin or karmic retribution. Distance to treatment facilities (95.6%), the necessity to take time off from work (91.7%), and social stigma (65.0%) were identified as the top three barriers to DOTS adherence. The study highlighted considerable gaps in knowledge, distant healthcare facilities, busy work schedules, and social stigma as barriers to TB treatment adherence in Deoghar, Jharkhand. Addressing these challenges via focused education and support activities is essential for enhancing DOTS adherence and TB treatment outcomes.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Bloom BR, Atun R, Cohen T, et al. Tuberculosis. In: Holmes KK, Bertozzi S, Bloom BR, et al., eds. Major Infectious Diseases. 3rd ed. Washington (DC): The International Bank for Reconstruction and Development/The World Bank; 2017.
WHO. Tuberculosis. 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/tuberculosis. Accessed on: 7/07/2024.
Central Tuberculosis Division, Government of India. Leading the way- India TB report 2023. Available from: https://tbcindia.mohfw.gov.in/wp-content/uploads/2023/06/5646719104TB_AR_2023_04-04-2023_LRP_final.pdf. Accessed on: 7/07/2024.
Zimmer AJ, Heitkamp P, Malar J, et al. Facility-based directly observed therapy (DOT) for tuberculosis during COVID-19: a community perspective. J Clin Tuberc Other Mycobact Dis 2021;24:100248. DOI: https://doi.org/10.1016/j.jctube.2021.100248
Out AA. Is the directly observed therapy short course (DOTS) an effective strategy for tuberculosis control in a developing country? Asian Pac J Trop Dis 2013;3:227-31. DOI: https://doi.org/10.1016/S2222-1808(13)60045-6
Taati SI, Kalemeera F, Kibuule D. Quality of DOTS adherence counselling among hospitalized tuberculosis patients. J Tuberc Res 2019;7:77-94. DOI: https://doi.org/10.4236/jtr.2019.72008
Xi Y, Zhang W, Qiao RJ, Tang J. Risk factors for multidrug-resistant tuberculosis: a worldwide systematic review and meta-analysis. PLoS One 2022;17:e0270003. DOI: https://doi.org/10.1371/journal.pone.0270003
Kvarnström K, Westerholm A, Airaksinen M, Liira H. Factors contributing to medication adherence in patients with a chronic condition: a scoping review of qualitative research. Pharmaceutics 2021;13:1100. DOI: https://doi.org/10.3390/pharmaceutics13071100
Aljofan M, Oshibayeva A, Moldaliyev I, et al. The rate of medication nonadherence and influencing factors: a systematic review. Electron J Gen Med 2023;20:em471. DOI: https://doi.org/10.29333/ejgm/12946
Singh KM, Singh R, Meena M, et al. Rural poverty in Jharkhand: an empirical exploration of socio-economic determinants using high frequency panel data. Available from: https://ssrn.com/abstract=2330844.
Bäckdahl T, Sharma M. Knowledge and transmission risk awareness of tuberculosis among the pilgrims attending a religious mass gathering in India: a cross-sectional study. BMC Public Health 2021;21:2141. DOI: https://doi.org/10.1186/s12889-021-12192-8
National Health Mission. Action oriented monitoring report deoghar district jharkhand Available from: https://nhm.gov.in/images/pdf/nrhm-in-state/state-wise-information/jharkhand/district-tour-report/deoghar_report.pdf. Accessed on: 7/07/2024.
Zeladita-Huaman J, Yuen CM, Zegarra-Chapoñan R, et al. Caregivers' knowledge and perceptions are associated with children's TB preventive treatment completion. Public Health Action 2021;11:85-90. DOI: https://doi.org/10.5588/pha.21.0009
Jani Y, Bhambhani G, Thakor N. Knowledge and awareness of tuberculosis in caregivers of paediatric tuberculosis patients of north Gujarat region, India: a cross sectional study. Int J Res Med Sci 2017;3:3572-5. DOI: https://doi.org/10.18203/2320-6012.ijrms20151401
Rai A, Srivastava S, Singh SA, Srivastava A. study of awareness of caregivers about tuberculosis treatment and its compliance. J Cardiovasc Dis Res 2023;14:3432-42.
Sharma SK, Jelly P, Bhadoria AS, et al. Awareness and perception regarding tuberculosis among patients and their relatives attending a tertiary care hospital in Uttarakhand: a hospital-based exploratory survey. J Family Med Prim Care 2020;9:1555-61. DOI: https://doi.org/10.4103/jfmpc.jfmpc_932_19
Matakanye H, Tshitangano TG, Mabunda JT, Maluleke TX. Knowledge, beliefs, and perceptions of TB and its treatment amongst TB patients in the Limpopo Province, South Africa. Int J Environ Res Public Health 2021;18:10404. DOI: https://doi.org/10.3390/ijerph181910404
Almalki ME, Almuqati FS, Alasmari R, et al. A cross-sectional study of tuberculosis knowledge, attitude, and practice among the general population in the western region of Saudi Arabia. Cureus 2022;14:e29987. DOI: https://doi.org/10.7759/cureus.29987
Onyango PA, Ter Goon D, Rala NM. Knowledge, attitudes and health-seeking behaviour among patients with tuberculosis: a cross-sectional study. Open Public Health J 2020;13:739-47. DOI: https://doi.org/10.2174/1874944502013010739
Courtwright A, Turner AN. Tuberculosis and stigmatization: pathways and interventions. Public Health Rep 2010;125 Suppl 4:34-42. DOI: https://doi.org/10.1177/00333549101250S407
Dodor EA. The feelings and experiences of patients with tuberculosis in the Sekondi-Takoradi Metropolitan district: implications for TB control efforts. Ghana Med J 2012;46:211-8.
Viney KA, Johnson P, Tagaro M, et al. Tuberculosis patients' knowledge and beliefs about tuberculosis: a mixed methods study from the Pacific Island nation of Vanuatu. BMC Public Health 2014;14:467. DOI: https://doi.org/10.1186/1471-2458-14-467

Ethics Approval

The Institute Ethics Committee approved the study (AIIMS- DEO/RC-IEC-Full committee/2023-Jan/61).

How to Cite

Gaur, Rakhi, Suresh Kumar Sharma, Suman Kumar, Shiv Kumar Mudgal, Vipin Patidar, and Ayesha Juhi. 2024. “Knowledge, Attitude and Perceived Barriers Related to Directly Observed Treatment, Short-Course Among Patients and Caregivers Attending Tuberculosis Clinics: A Cross-Sectional Survey”. Monaldi Archives for Chest Disease, October. https://doi.org/10.4081/monaldi.2024.3154.
Copyright (c) 2024 The Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.