Perceptions of Tuberculosis Among Individuals Born in a High-Endemic Setting, Now Living in a Low-Endemic Setting
Of all individuals diagnosed with tuberculosis (TB) in Sweden 2015 were 90% born in other countries. Early diagnosis and treatment is essential to avoid TB transmission. Lack of knowledge about TB and anticipated negative social consequences have proved to be significant contributing factors to delay in seeking health care. This study aimed to understand the perception of TB among people originating from a high-endemic region, currently living in a low-endemic region. A qualitative study design, with male and female participants from a high-endemic region divided into focus groups. A semi-structured interview guide was used to elicit their perceptions of TB. A qualitative content analysis was performed on the recorded material from the interviews. The informants noted that their attitude towards individuals with TB had changed, previously they had felt prejudiced towards them whereas now they felt supportive. It seems possible to diminish TB stigma by ensuring suitable health care is available in combination with correct information about transmission, infectiousness and treatment.
KeywordsDiscrimination Immigrant health Qualitative methodology Stigma Tuberculosis
This work was financially supported by the FoU unit in Östersund and Jämtlands Cancer och Omvårdnadsfond. The authors would like to acknowledge the assistance with interpretation provided by Mr Omar Mohammad Mohamoud and Mrs Muuna Hamse. We also wish to acknowledge the guidance we received from Professor Lars-Olof Larsson and Mr Lars Söderström.
Compliance with Ethical Standards
Ethical clearance for this study was obtained from the Regional Ethics Review Board in Umeå under reference number DNR 2016/398-31 on 15 November 2016.
- 1.WHO. WHO Global TB report 2016. Geneva: WHO; 2016.Google Scholar
- 2.Socialstyrelsen. http://infektion.net/wp-content/uploads/2017/05/turbekulos_vagledning-for-sjukhuspersonal_2009-9-19_2-1.pdf. Accessed 28 Aug 2018.
- 5.Golub JE, Bur S, Cronin WA, Gange S, Baruch N, Comstock GW, et al. Delayed tuberculosis diagnosis and tuberculosis transmission. Int J Tuberc Lung Dis. 2000;10:24–30.Google Scholar
- 6.Folkhälsomyndigheten. Tuberkulos Årsrapport 2017 n.d. https://www.folkhalsomyndigheten.se/folkhalsorapportering-statistik/statistikdatabaser-och-visualisering/sjukdomsstatistik/tuberkulos/. Accessed 28 August 2018.
- 9.Goffman E. Stigma: notes on the management of spoiled identity. New Jersey: Prentice-Hall; 1963.Google Scholar
- 11.Folkhälsomyndigheten. Tuberkulos under 2015 n.d. https://www.folkhalsomyndigheten.se/folkhalsorapportering-statistik/statistikdatabaser-och-visualisering/sjukdomsstatistik/tuberkulos/?t=com&p=18610. Accessed 10 May 2017.
- 15.Fatiregun AA, Ejeckam CC. Determinants of patient delay in seeking treatment among pulmonary tuberculosis cases in a government specialist hospital in Ibadan, Nigeria. Tanzan J Health Res 2010;12. https://doi.org/10.4314/thrb.v12i2.56398.
- 17.Citrin D. Somali tuberculosis cultural profile n.d. https://ethnomed.org/clinical/tuberculosis/somali-tb-cultural-profile. Accessed 16 March 2017.
- 18.Nkulu FKK, Hurtig A, Ahlm C, Krantz I. Screening migrants for tuberculosis—a missed opportunity for improving knowledge and attitudes in high-risk groups: a cross-sectional study of Swedish-language students in Umeå, Sweden. BMC Public Health 2010:1–12. https://doi.org/10.1186/1471-2458-10-349.
- 20.Polit DF, Beck CT. Studyguide for essentials of nursing research. 9th ed. Australia: Lippincott Williams and Jenkins; 2012.Google Scholar
- 21.Patton MQ. Qualitative research and evaluation methods. 3rd ed. Thousand Oaks: Sage; 2002.Google Scholar
- 23.Svensson P-G, Starrin B. Kvalitativa studier i teori och praktik. 1st ed. Lund: Studentlitteratur AB; 1996.Google Scholar
- 24.Cremers AL, Gerrets R, Kapata N, Kabika A, Birnie E, Klipstein-Grobusch K, et al. Tuberculosis patients’ pre-hospital delay and non-compliance with a longstanding DOT programme: a mixed methods study in urban Zambia. BMC Public Health. 2016;16:1130. https://doi.org/10.1186/s12889-016-3771-9.CrossRefPubMedPubMedCentralGoogle Scholar
- 25.Mandell GL, Bennett JE, Dolin R. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. 7th ed. Philadelphia: Churchill Livingstone; 2009.Google Scholar
- 32.Sagili KD, Satyanarayana S, Chadha SS. Is knowledge regarding tuberculosis associated with stigmatising and discriminating attitudes of general population towards tuberculosis patients? Findings from a community based survey in 30 districts of India. PLoS ONE. 2016. https://doi.org/10.1371/journal.pone.0147274.CrossRefPubMedPubMedCentralGoogle Scholar