b) Socio-Cultural, Socio-Economic & Demographic Aspects
AU : Wiese HJC
TI : Tuberculosis in rural Haiti.
SO : SOC SCI MED 1974, 8, 359-362.
DT : Per
AB :

A study was conducted in southern Haiti, from Sept. 1969 through to March 1971, to determine the socio-cultural factors associated with the utilization of a TB out-patient clinic by the indigenous population. In the entire region of some 2200 miles, there was one western health facility for the treatment of TB. Dossiers of 832 patients, newly diagnosed with pulmonary TB and admitted to treatment between 1967 and 1970, were reviewed to determine their treatment utilization pattern on the recommended 2-year chemotherapy regimen. The data from these records were then anlaysed to investigate possible correlations between rural variables involved in patient utilization of the facility: a) the age distribution of the TB patients, b) the geographic distribution of their residences, c) proximity of these residences to main roads, d) withdrawal from treatment over varying time spans. Preliminary analysis revealed that this clinic was largely ineffective in combating the disease. A vigorous examination of its organization mechanism and patient files revealed that the attrition rate among the TB patients was 75.12 percent within the first 6 months of treatment. An in-depth analysis of the total cultural situation indicated that the clinic`s lack of knowledge about the local culture (the term TB meant symptoms not serious enough to merit a visit to the clinic in the local people's minds, the Haitians' concept that any person able to discharge their normally expected social functions was healthy and the clinic's operating time schedule which did not fit with the local people's way of life and activities) and consequent failure to operate within it was a major source of the problem. Suggested changes include: a) Shifting the clinic schedule to correspond with the daily flow of people in the rural areas, b) undertaking health education measures to teach the early signs of TB, the importance of early detection and the need for prolonged treatment, c) changing the term used in advertising the clinic and, d) using the newer combination drugs to reduce the treatment cost and enable patient to remain on treatment longer.