Gender difference in treatment seeking behaviors of tuberculosis cases in rural communities of Bangladesh.
This descriptive cross-sectional study was conducted to investigate gender differences in the epidemiological factors associated with the treatment seeking behaviors of TB cases in the rural communities of Bangladesh. The study reveals that there is significant gender difference in treatment seeking behaviors of rural TB cases and the majority of them (52%) have taken prior treatment from various traditional healers, 70% of them are females who attended health centers (UZHCs) as the other choice (adjusted OR: 4.2, 95% CI: 2.0-8.4). It was found that the mean patient delay was 63 days (range 14-210 days) where half of the females delayed more than 60 days while they were spreading their disease. The study findings reveal gender differences in treatment seeking behaviors associated with socio-cultural barriers, particularly among females in their access to TB care. Fifty-five percent of cases wanted the diagnosis of TB remain confidential to avoid being labeled as TB patients, where 82.7% were female, 85.6% of female TB patients had problems in their relationships with their spouse (61%) and family members (58%) after being diagnosed with TB. The results of the TB service factors found that 39% of females were not satisfied with their provider's behaviors, which was significantly associated with treatment seeking behavior (adjusted OR: 2.6, 95% CI: 1.0-6.6). The study findings strongly suggest that there was a significant gender difference in treatment seeking behavior in rural Bangladesh. Based on the study findings, we recommend developing an appropriate gender strategy for developing a TB control program, comprised of operational, socio-cultural and community awareness interventions aimed at treating undiscovered reservoirs of female TB cases in rural Bangladesh.
Ahsan
Giasuddin
G
DGHS, Ministry of Health and FW, Dhaka, Bangladesh. guahsan@yahoo.com
Ahmed
Jalaluddin
J
Singhasivanon
Pratap
P
Kaewkungwal
Jaranit
J
Okanurak
Kamolnetr
K
Suwannapong
Nawarat
N
Akarasewi
Pasakorn
P
Majid
Mohammad A
MA
Begum
Vikarunessa
V
Belayetali
Kazi
K
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000995:Antitubercular Agents / Q000008:administration & dosage*; D001294:Attitude to Health; D001459:Bangladesh / Q000453:epidemiology; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011336:Probability; D018570:Risk Assessment; D012424:Rural Population; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology
D000995:Antitubercular Agents