||San Sebastian M & Bothamley GH
||Tuberculosis preventive therapy: perspective from a
||RESPIRATORY MEDICINE 2000, 94, 648-653
A study was undertaken to explore the knowledge,
attitudes and perception of TB and their influence on the adherence
to preventive therapy for TB. During 1997, 24 subjects were interviewed
by using a semistructured questionnaire which included demographic
details, background information on TB, knowledge and perception
of TB and chemoprophylaxis. The persons were interviewed in the
outpatient clinic in London at the start of the treatment and at
monthly intervals thereafter. They were given INH daily for 6 months.
The data was analysed descriptively and thematically. The outcome
was assessed ? 6 months after the start of preventive treatment.
The sample was representative of age, ethnicity
and previous BCG vaccination status. The study results revealed
that 63% were aware of TB before starting chemoprophylaxis indicating
a medium level of awareness. None mentioned health centre as the
source of information. Knowledge of TB was gained outside the family.
About 63% of them knew about transmission of the disease but few
symptoms of active TB were recognized. Most (92%) were aware that
TB was infectious. The perceived threat from TB was high (71% believed
that TB was potentially fatal), although the estimated risk was
low. Over half of the subjects (66.6%) suggested that TB was preventable.
Knowledge of preventive therapy exceeded the general knowledge of
TB, although the latter was associated with better adherence. Most
denied knowledge of the risk of hepatitis from isoniazid. Defaulters
failed to attend their first appointment, attributed more side effects
to isoniazid and perceived a longer waiting time in clinic. The
rate of non-attendance for appointment at the TB clinic was high.
The study has shown that there is an important
lack of knowledge of the symptoms of TB. A better general knowledge
of TB is more helpful than merely an understanding of the treatment
regimen in promoting adherence. It recommends a single daily tablet,
prior warning of dizziness and an open discussion of the problems
of keeping to treatment for 6 months encouraging adherence to preventive
|KEY WORDS: SOCIO-CULTURAL; SOCIAL AWARENESS; SOCIAL
ATTITUDE; TB PREVENTION THERAPY; UK