JTR  Vol.1 No.3 , December 2013
Factors affecting TB case detection and treatment in the Sissala East District, Ghana
Abstract: Background: Tuberculosis remains a major heal- th problem affecting about a third of the world population despite a number of preventive and control measures taken in the past few decades. Eighty-five percent of all tuberculosis cases are concentrated in Asia and Africa due to lack of education and health care infrastructure. Objective: To determine factors affecting low tuberculosis case detection in the Sissala East district in the Upper West Region of Ghana. Methods: This was a descriptive study where semi-structured questionnaire was administered to 61 respondents; six focus group discussions and 20 in-depth interviews were conducted to generate both qualitative and quantitative data for analysis. Results: Tuberculosis, known locally as Kesibine was identified as a major problem in the district. The two most frequently reported TB related dis-tresses were coughing (96.7%) and chest pains (95.0%). However, these distresses were reported more after probing for them. The most frequently spontaneously reported distress was reduced income (60.7%) for patients. The most prominent cause reported was sexual pollution (72.2%). Suspected tuberculosis patients are stigmatized and are denied sex by their partners as shown in the following narrative; I will not eat or have sex with her or eat any leftover from her plate (male local healer, In-depth interview). Case detection and treatment is hampered by lack of communication between sub-district facilities and the district hospital to aid laboratory diagnosis. Conclusion: There is therefore the need for vigorous health education to inform the people about the biomedical causes of TB and the availability of appropriate treatment for the disease at health facilities. However, the education should not aim at changing the “wrong beliefs” but focus on making people aware of the biomedical causes and see TB as treatable infection, which could be controlled.
Cite this paper: Ahorlu, C. and Bonsu, F. (2013) Factors affecting TB case detection and treatment in the Sissala East District, Ghana. Journal of Tuberculosis Research, 1, 29-36. doi: 10.4236/jtr.2013.13006.

[1]   World Health Organization (2011) ChouWHO report. Global TB control. WHO/ HTM/TB/2011.16. WHO, Geneva, Switzerland.

[2]   Hargreaves, J.R., Boccia, D., Evans, C.A., Adato, M., Petticrew, M. and Porter, D.H. (2010) The social determinants of Tuberculosis: From evidence to action. American Journal of Public Health, 101, 654-662.

[3]   World Health Organization (2010) WHO report 2010. Global TB control. WHO/HTM/TB/2010.7. WHO, Geneva.

[4]   Balasubramanian, V.N., Oommen, K. and Samuel, R. (2000) Dot or not? Direct observation of anti tuberculosis treatment and patient outcomes, Kerala State, India. The International Journal of Tuberculosis and Lung Disease, 4, 409-413.

[5]   Gilani, S.I. and Khurram, M. (2012) Perception of tuberculosis in Pakistan: Findings of a nationwide survey. Japan Pharmaceutical Manufacturers Association, 62, 116-120.

[6]   Lawn, S.D. and Achempong, J.V.V. (1999) Pulmonary tuberculosis in adults: Factors associated with mortality at a Ghanaian teaching hospital. West African Journal of Medicine, 18, 270-274.

[7]   (2006) Technical policy and guidelines for TB/HIV collaboration in Ghana. Ghana Health Service, Accra.

[8]   Dodor, E.A. and Afenyadu, G.Y. (2005) Factors associated with tuberculosis treatment default and completion at the Effia-Nkwanta Regional Hospital in Ghana. Transactions of the Royal Society of Tropical Medicine and Hygiene, 99, 827-832.

[9]   Lawn, S.D. (2000) Tuberculosis in Ghana: Social stigma and compliance with treatment. International Journal of Tuberculosis and Lung Disease, 4, 1190-1191.

[10]   Dodor, E.A. (2008) Health professionals expose TB patients to stigmatization in society: Insights from communities in an urban District in Ghana. Ghana Medical Journal, 42, 144-148.

[11]   Doror, E.A., Kelly, S. and Neal, K. (2009) Health professionals as stigmatizers of tuberculosis: Insights from community members and patients with TB in an urban district in Ghana. Psychology, Health & Medicine, 14, 301-310.

[12]   Data, K., Bhatnagar, T. and Murhekar, M. (2010) Private practitioners’ knowledge, attitude and practices about TB, Hooghly district, India. Indian Journal of Tuberculosis, 57, 199-206.

[13]   Goffman, E. (1963) Stigma: Notes on the management of spoiled identity. Prentice Hall, Englewood Cliffs.

[14]   Weiss, M.G., Ramakrishna, J. and Somma, D. (2006) Health-related stigma: Rethinking concepts and interventions. Psychology, Health & Medicine, 11, 277-287.

[15]   Lawn, S.D., Afful, B. and Acheampong, J.W. (1998) Pulmonary tuberculosis: Diagnostic delay in Ghanaian adults. International Journal of Tuberculosis and Lung Disease, 2, 635-640.

[16]   Hancock, C. and Oulton, J.A. (2003) Nurses: Fighting AIDS stigma, caring for all. International Council of Nurses, Geneva.

[17]   Liefooghe, R., Michiels, N., Habib, S., Moran, M.B. and De Muynck, A. (1995) Perception and social consequences of tuberculosis: A focus group study of tuberculosis patients in Sialkot, Pakistan. Social Science & Medicine, 41, 1685-1692.

[18]   Macq, J., Solis, A., Martinez, G., Martinez, P. and Dujardin, B. (2005) An exploration of the social stigma of tuberculosis in five “municipios” of Nicaragua to reflect on local interventions. Health Policy, 74, 205-217.

[19]   Volinn, I.J. (1983) Health Professionals as stigmatizers and destigmatizers of diseases: Alcoholism and leprosy as examples. Social Science & Medicine, 17, 385-393.

[20]   Rafferty, J. (2005) Curing the stigma of leprosy. Leprosy Review, 76, 119-126.

[21]   Yeboah-Manu, D., Asante-Poku, A., Ampah, K.A., Kpeli, G., Danso, E., et al. (2012) Drug susceptibility pattern of mycobacterium tuberculosis isolates from Ghana; correlation with clinical response. Mycobacterial Disease, 2, 107.

[22]   Weiss, M.G. (2001) Cultural epidemiology: An introduction and overview. Anthropology & Medicine, 8, 5-29.

[23]   (2012) Population and Housing census. Summary of final results. Ghana Statistical Service, Accra.