Gender and literacy: factors related to diagnostic delay and unsuccessful treatment of tuberculosis in the mountainous area of Yemen
Abstract:SETTING: People in the mountainous area of Yemen, having maintained their traditional lifestyle, generally believe that uneducated women are unsuccessful in using modern medical care. Whether this belief applies to tuberculosis (TB) diagnosis and treatment has not been researched in Yemen.
OBJECTIVE: To examine how gender and literacy influence TB diagnosis and treatment.
DESIGN: Individual interviews and data collection were conducted for 74 smear-positive pulmonary TB patients visiting the National Tuberculosis Institute in Sana'a from December 2001 to March 2002. The treatment outcome for each patient was checked from September 2002 to March 2003.
RESULTS: Illiterate patients had a longer diagnostic delay than literate patients (P = 0.006, univariate logistic regression analysis). They also maintained their traditional view of illness, not the illness ‘TB’. More females than males completed treatment (P = 0.046, univariate logistic regression analysis). Supervision by male relatives contributed to completion of treatment among female patients.
CONCLUSION: Lack of education does not hinder women from receiving TB diagnosis and treatment. The concept of traditional illness, however, causes a longer diagnostic delay among illiterate patients, and the role of male relatives positively influences treatment outcomes for female patients.
Document Type: Regular Paper
Affiliations: Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
Publication date: 2005-06-01
The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
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