Tuberculosis knowledge, attitudes and health-seeking behaviour among tuberculosis patients in Nelson Mandela Bay Municipality, sub district C, South Africa
- Authors: Onyango, Peggy
- Date: 2019
- Subjects: Tuberculosis
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/16780 , vital:40773
- Description: The aim of this study was to examine the knowledge and attitude of Tuberculosis (TB) patients regarding TB disease, causes, treatment adherence and health seeking behaviour in Nelson Mandela Bay, sub district C, South Africa. A cross-sectional study was done in three community health centres in Nelson Mandela Bay Municipality sub district C, South Africa. It involved 327 respondents aged eighteen years and above who were on TB treatment for more than one month who were conveniently selected from the three clinics. 54.1% of the patients were males and 45.9% of the patients were females. A structured questionnaire was used to collect data. Frequency counts and percentages were used to analyse the data. Multivariate logistic regression analysis was used to examine the influence of demographic variables on the knowledge, attitude and health seeking behaviour towards TB. None of the demographic variables was statistically significant to determine the TB patients’ knowledge and attitude of TB disease, causes, treatment and adherence. Only housing was statistically significant (p<0.05) as a variable determining the knowledge of TB causes, treatment and adherence. Compared with the reference group (informal housing scheme), the knowledge of TB patients with formal housing scheme were 0.556 (95% CI: 0.316-0.977) higher to determine the correct knowledge. Spearman correlation was used to determine the statistical significance between knowledge-attitude (K-A), Knowledge-Health seeking behaviour (K-HSB) and attitude-health seeking behaviour (A-HSB). There was statistical significance association among the variables. Results show that TB knowledge was generally good amongst the TB clients. However, there was misconception that TB is caused by cold air, dust and that TB disease can change into HIV. More than half of the respondents felt that TB treatment is difficult, takes a long time, unpleasant and interferes with work /marriage. Health seeking behaviour was fair amongst the participants.
- Full Text:
- Date Issued: 2019
- Authors: Onyango, Peggy
- Date: 2019
- Subjects: Tuberculosis
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/16780 , vital:40773
- Description: The aim of this study was to examine the knowledge and attitude of Tuberculosis (TB) patients regarding TB disease, causes, treatment adherence and health seeking behaviour in Nelson Mandela Bay, sub district C, South Africa. A cross-sectional study was done in three community health centres in Nelson Mandela Bay Municipality sub district C, South Africa. It involved 327 respondents aged eighteen years and above who were on TB treatment for more than one month who were conveniently selected from the three clinics. 54.1% of the patients were males and 45.9% of the patients were females. A structured questionnaire was used to collect data. Frequency counts and percentages were used to analyse the data. Multivariate logistic regression analysis was used to examine the influence of demographic variables on the knowledge, attitude and health seeking behaviour towards TB. None of the demographic variables was statistically significant to determine the TB patients’ knowledge and attitude of TB disease, causes, treatment and adherence. Only housing was statistically significant (p<0.05) as a variable determining the knowledge of TB causes, treatment and adherence. Compared with the reference group (informal housing scheme), the knowledge of TB patients with formal housing scheme were 0.556 (95% CI: 0.316-0.977) higher to determine the correct knowledge. Spearman correlation was used to determine the statistical significance between knowledge-attitude (K-A), Knowledge-Health seeking behaviour (K-HSB) and attitude-health seeking behaviour (A-HSB). There was statistical significance association among the variables. Results show that TB knowledge was generally good amongst the TB clients. However, there was misconception that TB is caused by cold air, dust and that TB disease can change into HIV. More than half of the respondents felt that TB treatment is difficult, takes a long time, unpleasant and interferes with work /marriage. Health seeking behaviour was fair amongst the participants.
- Full Text:
- Date Issued: 2019
Investigation of the comparative cost-effectiveness of different strategies for the management of multidrug-resistant tuberculosis
- Authors: Rockcliffe, Nicole
- Date: 2003
- Subjects: Tuberculosis , Multidrug resistance , Tuberculosis -- Treatment
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:3788 , http://hdl.handle.net/10962/d1003266 , Tuberculosis , Multidrug resistance , Tuberculosis -- Treatment
- Description: The tuberculosis epidemic is escalating in South Africa as well as globally. This escalation is exacerbated by the increasing prevalence of multidrug-resistant tuberculosis (MDRTB), which is defined by the World Health Organisation (WHO) as resistance of Mycobacteria to at least isoniazid and rifampicin. Multi-drug resistant tuberculosis is estimated to occur in 1-2% of newly diagnosed tuberculosis (TB) patients and in 4-8% of previously treated patients. MDRTB is both difficult and expensive to treat, costing up to 126 times that of drug-sensitive TB. Resource constrained countries such as South Africa often lack both the money and the infrastructure to treat this disease. The aim of this project was to determine whether the performance of a systematic review with subsequent economic modelling could influence the decision making process for policy makers. Data was gathered and an economic evaluation of MDRTB treatment was performed from the perspective of the South African Department of Health. Three treatment alternatives were identified: a protocol regimen of second line anti-tuberculosis agents, as recommended in the South African guidelines for MDRTB, an appropriate regimen designed for each patient according to the results of culture and drug susceptibility tests, and non-drug management. A decision-analysis model using DATA 3.0 by Treeage® was developed to estimate the costs of each alternative. Outcomes were measured in terms of cost alone as well as the ‘number of cases cured’ and the number of ‘years of life saved’ for patients dying, being cured or failing treatment. Drug, hospital and laboratory costs incurred using each alternative were included in the analysis. A sensitivity analysis was performed on all variables in order to identify threshold values that would change the outcome of the evaluation. Results of the decision analysis indicate that the individualised regimen was both the cheaper and more cost-effective regimen of the two active treatment options, and was estimated to cost R50 661 per case cured and R2 070 per year of life saved. The protocol regimen was estimated to cost R73 609 per case cured and R2 741 per year of life saved. The outcome of the decision analysis was sensitive to changes in some of the variables used to model the disease, particularly the daily cost of drugs, the length of time spent in hospital and the length of treatment received by those patients dying or failing treatment. This modelling exercise highlighted significant deficiencies in the quality of evidence on MDRTB management available to policy makers. Pragmatic choices based on operational and other logistic concerns may need to be reviewed when further information becomes available. A case can be made for the establishment of a national database of costing and efficacy information to guide future policy revisions of the South African MDRTB treatment programme, which is resource intensive and of only moderate efficacy. However, due to the widely disparate range of studies on which this evaluation was based, the outcome of the study may not be credible. In this case, the use of a systematic review with subsequent economic modelling could not validly influence policy-makers to change the decision that they made on the basis of drug availability.
- Full Text:
- Date Issued: 2003
- Authors: Rockcliffe, Nicole
- Date: 2003
- Subjects: Tuberculosis , Multidrug resistance , Tuberculosis -- Treatment
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:3788 , http://hdl.handle.net/10962/d1003266 , Tuberculosis , Multidrug resistance , Tuberculosis -- Treatment
- Description: The tuberculosis epidemic is escalating in South Africa as well as globally. This escalation is exacerbated by the increasing prevalence of multidrug-resistant tuberculosis (MDRTB), which is defined by the World Health Organisation (WHO) as resistance of Mycobacteria to at least isoniazid and rifampicin. Multi-drug resistant tuberculosis is estimated to occur in 1-2% of newly diagnosed tuberculosis (TB) patients and in 4-8% of previously treated patients. MDRTB is both difficult and expensive to treat, costing up to 126 times that of drug-sensitive TB. Resource constrained countries such as South Africa often lack both the money and the infrastructure to treat this disease. The aim of this project was to determine whether the performance of a systematic review with subsequent economic modelling could influence the decision making process for policy makers. Data was gathered and an economic evaluation of MDRTB treatment was performed from the perspective of the South African Department of Health. Three treatment alternatives were identified: a protocol regimen of second line anti-tuberculosis agents, as recommended in the South African guidelines for MDRTB, an appropriate regimen designed for each patient according to the results of culture and drug susceptibility tests, and non-drug management. A decision-analysis model using DATA 3.0 by Treeage® was developed to estimate the costs of each alternative. Outcomes were measured in terms of cost alone as well as the ‘number of cases cured’ and the number of ‘years of life saved’ for patients dying, being cured or failing treatment. Drug, hospital and laboratory costs incurred using each alternative were included in the analysis. A sensitivity analysis was performed on all variables in order to identify threshold values that would change the outcome of the evaluation. Results of the decision analysis indicate that the individualised regimen was both the cheaper and more cost-effective regimen of the two active treatment options, and was estimated to cost R50 661 per case cured and R2 070 per year of life saved. The protocol regimen was estimated to cost R73 609 per case cured and R2 741 per year of life saved. The outcome of the decision analysis was sensitive to changes in some of the variables used to model the disease, particularly the daily cost of drugs, the length of time spent in hospital and the length of treatment received by those patients dying or failing treatment. This modelling exercise highlighted significant deficiencies in the quality of evidence on MDRTB management available to policy makers. Pragmatic choices based on operational and other logistic concerns may need to be reviewed when further information becomes available. A case can be made for the establishment of a national database of costing and efficacy information to guide future policy revisions of the South African MDRTB treatment programme, which is resource intensive and of only moderate efficacy. However, due to the widely disparate range of studies on which this evaluation was based, the outcome of the study may not be credible. In this case, the use of a systematic review with subsequent economic modelling could not validly influence policy-makers to change the decision that they made on the basis of drug availability.
- Full Text:
- Date Issued: 2003
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