Knowledge of tuberculosis and self disclosure amongst patients accessing treatment in an urban Local Government Area, Lagos, south west Nigeria

Abstract

Background: Disease-related stigma and knowledge of the disease by individual are believed to be associated with patients' willingness to seek and adhere to treatment. Increased morbidity and mortality of tuberculosis (TB) have been blamed on neglect of the human dimension of TB control. Assessing knowledge, self disclosure status and perceived stigma among TB patients would help to understand TB-related stigma as a social process and a better understanding of patients.

Methods: A descriptive cross sectional study was carried out among newly diagnosed TB patients aged ≥18 years on treatment for at least four weeks. Consecutive enrollment was carried out in all the seven DOTS centers in Ikeja LGA.
Patients were asked questions about TB knowledge, self- disclosure and level of perceived stigma. Knowledge scores were grouped as poor (1-11), fair (12-17) and good (18-22). A total of 309 patients were interviewed between January and September 2012.

Results: Fifty-six percent of the patients were between 21 to 40 years with the male to female ratio of 1:1.13 while 45.3% and 51.5% had secondary school education and were married respectively. Thirty-two percent, 58% and 10% had poor, fair and good knowledge respectively. Majority (86%) of the patients have disclosed their status and treatment to family members with 39% disclosing to friends and associates. Regarding level of perceived stigma, 50% reported that having TB is an embarrassment to the family while 77% and 68% reported that TB patients should not share plates and sleep on the same bed with others respectively. Those with good knowledge and those that have retired from active service were more likely to selfdisclose to family members than others (p<0.05).

Conclusion: Although perceived stigma and poor knowledge of TB was common among patients, most still disclosed status to family members. Health education of new patients on TB should be intensified.