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Free Content Perceptions and experiences of tuberculosis among African patients attending a tuberculosis clinic in London

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SETTING: Little is known of the social and cultural issues influencing the uptake of and attitudes to tuberculosis (TB) care by people of African extraction living in the UK.

OBJECTIVE: To describe the perceptions and experiences of African patients with TB in London, focusing on issues relating to diagnosis, treatment adherence and stigma.

DESIGN: Qualitative study using in-depth interviews.

RESULTS: Misinterpretation of early symptoms led to delays in seeking health care. Although half of the respondents reported denial of the diagnosis, they reported good treatment adherence, noting the role of TB specialist nurses in promoting adherence. Respondents felt stigmatised by the diagnosis, although actual experiences of stigma were rare. Experience of TB in a known person mitigated stigma. Human immunodeficiency virus (HIV) disease was perceived to have worsened TB stigma, and most patients offered HIV testing initially declined, fearing stigmatisation and poor illness outcomes if positive.

CONCLUSIONS: Awareness of TB can be improved among migrants at high risk of developing the disease and among health professionals. Counselling around HIV testing for TB patients must take their beliefs into account if a high uptake of testing is to be achieved.
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Keywords: diagnosis; qualitative research; stigma; tuberculosis

Document Type: Regular Paper

Affiliations: 1: London School of Hygiene & Tropical Medicine, London, United Kingdom 2: London School of Hygiene & Tropical Medicine, London, United Kingdom; and Centre for International Health, Hospital Clinic University of Barcelona, Barcelona, Spain 3: North East London TB Network, London, United Kingdom; Homerton University Hospital, London, United Kingdom

Publication date: 2006-09-01

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  • 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.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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