Factors Contributing To Low Tuberculosis Case Detection Rate In Ejisu-Juaben District

ABSTRACT Tuberculosis (TB) remains a disease of serious public health consequence in Ejisu-Juaben District. TB case detection has remained low in the district, despite the implementation of the National Tuberculosis Programme (NTP) services through the primary health care infrastructure since 1994. This study therefore sets out to find the factors leading to low TB case detection rate in Ejisu-Juaben district. The specific objectives were; 1. To identify community related factors contributing to low TB case detection rate. 2. To identify service related factors contributing to low TB case detection rate. 3. To make recommendations for improving TB case detection in Ejisu-Juaben district. The study was a cross- sectional descriptive study conducted in July 2003. Quantitative information was obtained through a review of medical records, questionnaire administration to 38 TB patients and 28 prescribers from government, mission, and private institutions in the district. Qualitative data were obtained through in depth interviews with four health managers and two unorthodox practitioners. Data were also obtained from seven focus group discussions (FGDs) conducted in three communities. Participants for FGDs included opinion leaders, TB patients, VHC members, and middleaged women. - Caregivers. Out of 38 respondents, (94.7%) agreed TB was a disease. Most of the TB patients 92.1 % and majority of participants in FGDs know that the main symptom of TB was persistent cough. Majority of respondents (52.4%) and most participants from the FGDS do not seek medical care from orthodox practitioners. Many factors, including the strong stigma associated with the disease, make many sufferers seek medical care from unorthodox sources such as such as chemical sellers, quack doctors, traditional and faith healers and private medical practitioners. Despite this state of affairs, there is lack of collaboration among government institutions, private institutions, mission institutions, and unorthodox health providers. xAnother important finding is that many community members were not aware that treatment of TB was free. Practices of health prescribers leave much to be desired. Out of 282 cards reviewed with respiratory tract infection, 216 (76.6%) could not be analyzed because of lack of adequate information due to poor history taking practices. From the study, factors found to be associated with low TB case detection in the district include, practices of health seeking behaviour of the people, lack of collaboration among government institutions, private institutions, mission institutions, traditional healers and community members. In order to increase case detection in the district, the problems in these important areas need to be addressed by all key stakeholders.