|PREVALENCE OF CHEST SYMPTOMS AND ACTION TAKEN BY
SYMPTOMATICS IN A RURAL COMMUNITY
|Radha Narayan, Susy Thomas, S Pramila Kumari, S Prabhakar,
AN Ramaprakash, T Suresh & N Srikantaramu: Indian J TB 1976,
A study was conducted in 55 randomly selected villages
of Nelamangala taluk, Bangalore district in 1975 (1) to estimate
the prevalence of symptoms in the general population during the
two months prior to the epidemiological survey, (2) to study the
nature of action taken by these symptomatics and, (3) to find out
through sputum examination as to how many of them suffer from pulmonary
tuberculosis. The entire population was interviewed and sputum was
collected from those aged five years and above having symptoms continuously
for seven days and more. A coverage of 98.8% was obtained. Symptomatics
among the directly interviewed were almost double (32.3%) of those
who had to be interviewed by proxy (16.8%). Proportion of symptomatics
were higher in the age groups twenty years and above. 24.8% were
symptomatic during the reference period of two months and 16.7%
had symptoms on the day of interview. ll.1% were found to have chest
symptoms. The prevalence rate of tuberculosis was found to be 21
per 1000, (for males 28 and females 14). Cough was the most prevalent
and the symptom of longest duration.
The findings suggest that symptoms questioning
should focus more on cough and its combination with other symptoms.
Symptoms questioning as a tool to detect cases has less potential
than X-ray, but data reveal that leading questions can elicit more
information on symptoms and action taking. The manner of action
taking was the same for chest symptoms as for other symptoms and
the proportion taking action is also the same for males and females.
Government health facilities are found to be the most important
source of relief, indigenous medicine having some importance marked
second and the private practitioners ranking only third.
|KEY WORDS: SYMPTOMS, ACTION TAKING, RURAL POPULATION.
|INTERVIEW AS A TOOL FOR SYMPTOM SCREENING IN PULMONARY
|Radha Narayan, Susy Thomas, S Prabhakar & N Srikantaramu:
Indian J Soc Work 1978, 38, 367-74.
Persons suffering from pulmonary tuberculosis generally
experience symptoms such as cough, chest pain, fever and haemoptysis.
It is possible to identify the symptomatics by interviewing them
during community health surveys. The symptom survey was carried
out in 62 villages and 4 town blocks of Tumkur district in Karnataka
as a sequel to an epidemiological survey undertaken to estimate
the prevalence of tuberculosis. The data was collected through structured
schedule. The interviewers were given the identification details
of individuals having X-ray shadows suggestive of tuberculosis and
an equal number of matched controls within 4 weeks of the survey.
A total of 1752 persons were taken into the study of whom 875 had
x ray shadows and 877 were normals. Of the total persons under study
89.7% were satisfactorily interviewed. It was observed that 42.6%
of the total symptomatics gave history of one symptom at the
first general question, 13% responded having symptoms after
being asked specific questions. In conclusion a 42.6% affirmative
response to the initial question of 'How is your health' is noteworthy
that an investigator is acceptable health agency as the interviewee
is willing to confide in him regarding his health problems. Additional
number of persons responded to direct specific questions.
It must be pointed out that interview is a generic
term applied to a tool that may be used for obtaining information
through verbal communication. As a tool in surveys for screening
for tuberculosis it is amenable to divese techniques and has great
potentialities of being applied to different situations and various
categories of respondents. Hence, it is necessary to identify the
nature of data to be obtained and to decide on the technique that
would be most suitable. Proper training, skill and supervision of
the interviewer can obviate any possible bias and subjectivity that
could vitiate an interview. As compared to many of the tools of
social science research, the interview is simple, easy and amenable
to being used in live situations. It is also of prime importance
among populations for whom vocalisation is the most important medium
of communication. Hence, in a community survey for the estimation
of the prevalence of chest symptomatics the interview can be
a valuable tool. It also shows that the interview is adequate
as a tool of community survey in tuberculosis.
|KEY WORDS: SYMPTOMS, SCREENING TOOLS, INTERVIEW,
CONTROL PROGRAMME, RURAL POPULATION.
|A SOCIOLOGICAL STUDY OF AWARENESS OF SYMPTOMS AND
ACTION TAKING OF PERSONS WITH PULMONARY TUBERCULOSIS (A RESURVEY)
|Radha Narayan, S Prabhakar, Susy Thomas, S Pramila
Kumari, T Suresh & N Srikantaramu: Indian J TB 1979, 26, 136-46.
A study on awareness of symptoms of pulmonary tuberculosis
and action taking was repeated in the 62 villages and 4 town blocks
of Tumkur district of Karnataka after an interval of 12 years. In
the earlier study, 2106 persons formed the study population. In
the present study, 1752 were intaken to obtain a comparison of these
1752 intaken persons who were eligible for interview, 875 were X-ray
positive and 877 X-ray normal (matched control).
The study showed that 95% of patients having radiologically
active tuberculosis by both X-ray readers, 70% by one reader, 49.5%
inactive by both readers, were aware of symptoms. According to the
bacteriological status 79.5% had symptoms among those who were sputum
positive by both microscopy and culture, 62.2% among those positive
by culture alone and 73.7% among patients sputum positive by any
method. Regarding action taking it was observed that 49.5% of the
bacteriologically positive patients took some action compared by
70% of those found to have radiologically active disease by both
X-ray readers. Thus action taking was higher among the latter category
in both the studies. It may be due to the fact that extent of lesions
are less advanced among those bacteriologically positive than among
those who were in radiologically positive stage.
The findings of the study are similar to the earlier
awareness study carried out in 1963 in the same area (Tumkur). This
also indicates that in spite of having advantage of DTP for a decade
actual and total benefits have not reached the people.
|KEY WORDS: SOCIAL AWARENESS, ACTION TAKING,
SYMPTOMS, RURAL POPULATION, URBAN POPULATION, INTERVIEW, CONTROL PROGRAMME.
|SIGNIFICANCE OF SOME SOCIAL FACTORS IN THE TREATMENT
BEHAVIOUR OF TUBERCULOSIS PATIENTS
|Radha Narayan & N Srikantaramu: NTI Newsletter
1987, 23, 76-90.
This study based on an individualistic model examines
the significance of factors such as symptom awareness, knowledge
about the disease, recall of clinic instructions, economic problems
and social interaction in the treatment regularity of patients with
pulmonary tuberculosis through a multi dimensional comparison
of regular patients, irregular patients and their households.
There was no difference in the symptom awareness of the two groups
of patients. Thus frequency of medical visits is to adopt the sick
role than of stress. In NTP patients are denied the sick role has
rest and special diet the vital elements
of traditional treatment are not recommended as part of treatment.
Yet, three of the four cardinal symptoms of pulmonary tuberculosis,
cough fever and haemoptysis being of a nature observable by
others, have been observed by the households to the extent similar
to patients awareness. Most of the patients who take treatment from
non- paying centres such as the LWTDTC live in overcrowded areas
where there is generally a high degree of neighbourhood interaction
not only social but in sharing common utilities such as courtyard,
water tap, bath room, toilet etc. It is therefore not surprising
that nearly half of the patients and households said that the neighbours
knew about the patient's illness.
Seeking multiple sources of treatment is a common
behaviour pattern of patients. Yet, it is disconcerting to find
that tuberculosis patients who can ill afford to pay and who need
to be under treatment for a long period should 'shop around' for
treatment. It is the irregular patients who have sought treatment
at other agencies more often. The study shows that patients
showing regular drug collection have had help from household members
in collecting the drugs. They have also had help from household
members in remembering to consume the drugs. More of the households
of the regulars mentioned LWTDTC as the place of treatment while
in the in case of the households of the irregulars mentioned several
places of treatment.
No significant differences were seen between the
regular and irregular patients in their social interactions within
the households or in the behaviour of households towards the patients.
To the household, economic difficulties were the most important,
perhaps for the reason that the patients were men in the working
age group. Though economic difficulties were important to patients
also the predominant aspect was pain and discomfort the physical
dimensions of suffering. A treatment agency that can pay adequate
attention to the relief of physical suffering and non- relapse of
symptoms can perhaps help to improve treatment regularity of tuberculosis
|KEY WORDS: PATIENT BEHAVIOUR, SOCIAL FACTORS,
SYMPTOMS, HOUSEHOLD, COMPLIANCE.