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Free Content Health-seeking norms for tuberculosis symptoms in southern Angola: implications for behaviour change communications

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SETTING: A passive case-finding strategy as present in the DOTS strategy presupposes a patient's willingness to seek care. This requires awareness of tuberculosis (TB) symptoms and the diagnostic process, and positive attitudes towards access and probability of cure.

OBJECTIVE: To measure parameters of health-seeking intention in Southern Angola and to inform the design of context-specific interventions to improve case detection.

DESIGN: A survey in four communities based on the cough-to-cure pathway represented by five domains with either one or two proxy measures. These were assessed for association with appropriate health-seeking behaviour (visiting a medical institution or service).

RESULTS: In total, 805 individuals were included in the study. Appropriate health-seeking behaviour was positively associated with knowing the disease (OR 3.1, 95%CI 1.4–6.8), knowing key symptoms (OR 1.4, 95%CI 1.0–1.9), perceived curability (OR 1.3, 95%CI 1.0–1.6), and the perception that TB services were free of charge (OR 1.9, 95%CI 1.4–2.7). Respondents who perceived a personal risk for TB were less likely to have an appropriate intended health-seeking behaviour (OR 0.7, 95%CI 0.5–0.9).

CONCLUSION: Knowledge about TB should include key symptoms, perceived curability and information on access to services when designing interventions to improve case detection. The study highlights the importance of advocacy, social mobilisation and communication strategies.

Keywords: ACSM; Angola; KAP survey; health seeking; tuberculosis

Document Type: Regular Paper


Affiliations: 1: Igreja Evangélica Sinodal de Angola, Lubango, Angola 2: KNCV Tuberculosis Foundation, The Hague, The Netherlands 3: União de Igrejas Evangélicas de Angola Serving in Mission, Rio de Huila, Angola 4: KNCV Tuberculosis Foundation, The Hague, The Netherlands; Center for Poverty-related Communicable Diseases, Amsterdam Institute of Global Health and Development, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

Publication date: July 1, 2011

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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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