Perceptions of community members on tuberculosis and its effect on health-seeking behavior in Nigeria

BackgroundTuberculosis (TB) remains a major health challenge in the sub-Saharan African countries; Nigeria being one of the most affected countries. A number of interventions have been employed to reduce the scourge of the disease; however, the burden of the disease remains of public health dimensions. This study seeks to provide insight into the factors that may be affecting access to TB services by exploring the perception of the TB disease among the general population and how this affects health-seeking behavior. The specific perceptions addressed in this study are the causes of TB and whether there is a cure for TB.MethodsQualitative methodology using in-depth interviews and focus group discussions (FGDs) were employed. This was done as part of a knowledge, attitude and practice survey. The survey was conducted in six States, namely: Akwa Ibom, Ebonyi, Gombe, Katsina, Benue and Ondo States.ResultsCommunity key informants and FGD participants identified financial capability, knowledge about orthodox medicine, fear of stigmatization and the influence of religious leaders as factors that determine the choice of treatment. Across the six States, the general thought is that people first consult the chemist, then traditional healers/faith-based healers before visiting the hospital because it is cheaper.It was found that persons who believe that the disease is caused by germs usually seek health care in the formal health settings, while those who believe that TB is caused by supernatural forces, such as ancestral curses and witchcraft, usually seek help at the herbalists/traditional/unorthodox health settings. Also, people who believe that TB can be cured are more likely to seek medical care.ConclusionSpecific information on TB, such as the fact that TB is curable and caused by a germ, if well disseminated at the population level to the point where the information is understood and accepted to be true, is able to change the health-seeking behavior of the population such that the population seek care for TB at the formal health clinics