title: Socio-cultural and Knowledge-Based Barriers to Tuberculosis Diagnosis for Women in Bhopal, India.
abstract: BACKGROUND
  In India, only one woman is diagnosed with tuberculosis (TB) for every 2.4 men. Previous studies have indicated gender disparities in care-seeking behavior and TB diagnosis; however, little is known about the specific barriers women face.
  
  
  OBJECTIVE
  This study aimed to characterize socio-cultural and knowledge-based barriers that affected TB diagnosis for women in Bhopal, India.
  
  
  METHODS
  In-depth interviews were conducted with 13 affected women and 6 health-care workers. The Bhopal Diagnostic Microscopy Laboratory Register (n = 121) and the Bhopal district report (n = 261) were examined for diagnostic and care-seeking trends.
  
  
  RESULTS
  Women, especially younger women, faced socio-cultural barriers and stigma, causing many to hide their symptoms. Older women had little awareness about TB. Women often sought treatment from private practitioners, resulting in delayed diagnosis.
  
  
  CONCLUSIONS
  Understanding these diagnostic and help-seeking behaviors barriers for women is critical for development of a gender-sensitive TB control program.
authors.affiliation: Department of Biology, University of North Carolina, Chapel Hill, North Carolina, USA; School for International Training, New Delhi, India.
authors.forename: Evonne
authors.initials: E
authors.lastname: McArthur
authors.affiliation: Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
authors.forename: Surya
authors.initials: S
authors.lastname: Bali
authors.affiliation: School for International Training, New Delhi, India.
authors.forename: Azim A
authors.initials: AA
authors.lastname: Khan
keywords: Age; Bhopal; gender; stigma; tuberculosis