Abstract
Background: Multidrug resistant tuberculosis is a significant public health problem with serious repercussions. Since Tuberculosis is a social problem, an attempt was made to explore the issue in Kashmir region.
Methods: A total of 33 “on treatment” Multi drug resistant tuberculosis cases were interviewed using semi-structured questionnaire.
Results: More than 2/3rd of cases interviewed were females, belonging to reproductive age group. None of them was HIV positive, however 27% had other comorbidities. Around 60% cases perceived Tuberculosis as stigma. Important to note was that 65% cases were happy with the behaviour of Health care worker (HCW) towards them.
Conclusion: The perception of tuberculosis as a stigma or curse is still prevalent in our setting. Much needs to be done to dispel the stigma associated with Tuberculosis as the fear of being ostracized forces persons with TB to hide their disease status. It was concluded that there is a need of strengthening the ways of tackling tuberculosis as a Clinico-social entity as such.
Key Words: Multi drug resistant tuberculosis; profile; Kashmir; Stigma; resistance; Health care workers.
References
- World Health Organization, Multi drug resistant tuberculosis, 2015 update.[cited 2016 November 2] Available fromhttp://www.who.int/tb/challenges/mdr/mdr_tb_factsheet.pdf.
- Annual report 2013-14. [cited 2016 November 20].Available fromhttp://mohfw.nic.in/WriteReadData/l892s/Chapter615.pdf..
- Annual rep 2012-2013. [cited 2016 November 20].Available fromhttp://mohfw.nic.in/WriteReadData/l892s/CHAPTER%206.pdf.
- Results-Framework Document (RFD) for Department of Health and Family Welfare (2013-14) Section 1: DEPARTMENT'S VISION, MISSION, OBJECTIVES AND FUNCTIONS. [cited 2016 November 25]. Available from http://mohfw.nic.in/WriteReadData/l892s/7896537896321456325.pdf.
- Drug-resistant tuberculosis now at record levels.News release. 18 March 2010 | Geneva | Washington DC. [cited 2016 November 11] Available fromhttp://www.who.int/mediacentre/news/releases/2010/drug_resistant_tb_20100318/en/.
- Status of Literacy. [cited 2016 November 20]. Available fromhttp://censusindia.gov.in/2011-prov-results/data_files/mp/07Literacy.pdf.
- Mitnick, C; Bayona, J; Palacios, E; Shin, S; Furin, J; Alcantara, F et al (2003). Community-based therapy for multidrug-resistant tuberculosis in Lima, Peru. The New England journal of medicine, 348 (2). pp. 119-28.
- Aleyamma Thomas, Rajeswari Ramachandran, Fathima Rehaman, K. Jaggarajamma, T. Santha , N. Selvakumar et al. Management of Multi Drug Resistance Tuberculosis In The Field: Tuberculosis Research Centre Experience. Indian J Tuberc 2007: 54: 117-124
- Bhatt G,Vyas S, Trivedil K. An epidemiological study of multi drug resistant tuberculosis cases registered under Revised National Tuberculosis Control Programme of Ahmedabad City. Indian J Tuberc. 2012 Jan;59(1):18-27.
- Gupta S, Bandyopadhyay D, Gupta S, Sadhukhan S, Banerjees S.A sociodemographic study of multidrug resistant tuberculosis cases from DOTS clinics of Kolkata. J Indian Med Assoc. 2012 Oct;110(10):723-5.
- Yatin N. Dholakiaand Divya P. Shah.Clinical profile and treatment outcomes of drug-resistant tuberculosis before directly observed treatment strategy plus: Lessons for the program .Lung India. 2013 Oct-Dec; 30(4): 316–320.
- Udwadia ZF, Moharil G.Multidrug-resistant-tuberculosis treatment in the Indian private sector: Results from a tertiary referral private hospital in Mumbai. Lung India. 2014 Oct; 31(4):336-41.
- Poulomi Mukherjee, Prasanta Ray Karmakar, RivuBasu, Saibendu Kumar Lahiri. Sociodemographic and clinical profile of multi drug resistant tuberculosis patients: a study at drug resistant tuberculosis centers of Kolkata.Journal of Dental and Medical Sciences (IOSR-JDMS) (Aug. 2015); 14(8): 52-58.
- Mohammad A. Tag El Din, Ashraf A. El Maraghy, Abdel Hay R. Abdel Hay. Adverse reactions among patients being treated for multi-drug resistant tuberculosis at Abbassia Chest Hospital. Egyptian Journal of Chest Diseases and Tuberculosis; (4/2015) ; 68.
- Bikram Singh Datta, Ghulam Hassan, Syed Manzoor Kadri, Waseem Qureshi, Mustadiq Ahmad Kamili, Hardeep Singh et al. Multidrug-Resistant and extensively drug resistant tuberculosis in Kashmir, India. J Infect Dev Ctries 2010; 4(1):019-023.
- Tupasi TE,Gupta R, Quelapio MI, Orillaza RB, Mira NR, Mangubat NV et al. Feasibility and cost-effectiveness of treating multidrug-resistant tuberculosis: a cohort study in the Philippines.PLoS Med. 2006 Sep; 3(9):e352.
- Marie Flament-Saillour,Jerome Robert, Vincent Jarlier, andJacques Grosset. Outcome of Multi-drug-resistant Tuberculosis in France. American Journal of Respiratory and Critical Care Medicine(1999);160(2): 587-593.
- Faustini A,Hall AJ, Perucci CA. Risk factors for multidrug resistant tuberculosis in Europe: a systematic review. 2006 Feb; 61(2):158-63.
- Fleming MF,Krupitsky E, Tsoy M, Zvartau E, Brazhenko N, Jakubowiak W et al. Alcohol and drug use disorders, HIV status and drug resistance in a sample of Russian TB patients. Int J Tuberc Lung Dis. 2006 May; 10(5):565-70.
- Manoharam, K.R. John, A.Joseph and K.S. Jacob (2001). Psychiatric Morbidity, Patients Perspectives of Illness and Factors Associated With Poor Medication Compliance among the Tuberculous In Vellore, South India. Ind. J. Tub.;48:77.
- Andrea Gobetti Vieira Coelho,Liliana Aparecida Zamarioli, Maria Alice Telles, Lucilaine Ferrazoli, and Eliseu Alves Waldman. A study of multidrug-resistant tuberculosis in risk groups in the city of Santos, Sao Paulo, Brazil. Mem Inst Oswaldo Cruz. 2012 Sep; 107(6): 760–766.
- Surajit Lahiri,Abhijit Mukherjee, Supabitra Hazra, Pulak Jana, Sandip Roy, and Brojo Kishore Saha. First-line anti-tubercular drug resistance of mycobacterial strains from re-treatment cases that were smear-positive at 4th month onwards under the Revised National Tuberculosis Control Program. Lung India. 2015; 32(2): 127–131.
- Vega, P., Sweetland, A., Acha, J.,Castillo, H., Guerra, D., Fawzi, Shin, S. Psychiatric issues in the management of patients with multidrug-resistant tuberculosis (Review). International Journal of Tuberculosis and Lung Disease (June 2004); 8(6):749-759.
- Baral ,SC, Karki ,DK, Newell ,JN (2007). Causes of stigma and discrimination associated with tuberculosis in Nepal: a qualitative study (Nepal). BMC public health 2007, Aug; 16(7): 211.
- Fazlul Karim, A. M. R. Chowdhury, Akramul Islam and Mitchell G. Weiss (2007). Stigma, Gender, and their Impact on Patients with Tuberculosis in Rural Bangladesh. Anthropology & Medicine;14(2):139–151.
- Anita S. Mathew and Amol M. Takalkar (2007). ‗‘Living with Tuberculosis: The Myths and the Stigma from the Indian Perspective. Clin Infect Dis. Nov; 45(9):1247.
- Rameshchandra M Thakker, Gunjan P Upadhyay(2014) .Psychosocial reaction of diagnosing tuberculosis – An experience of tertiary care center of rural Gujarat. International Journal of Medical Science and Public Health; 3(12).
- Anne Lia Cremers,Myrthe Manon de Laat, Nathan Kapata, Rene Gerrets,Kerstin Klipstein-Grobusch, andMartin Peter Grobusch. Assessing the Consequences of Stigma for Tuberculosis Patients in Urban Zambia.PLoS One. 2015; 10(3): e0119861.
- Chang SH,Cataldo JK . A systematic review of global cultural variations in knowledge, attitudes and health responses to tuberculosis stigma. Int J Tuberc Lung Dis. 2014 Feb; 18(2):168-73, i-iv.
Corresponding Author
Taha Ayub