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Life with Pulmonary Tuberculosis
The "career" of TB patients in the Free State, South Africa
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This book has two main aims. Firstly, it aims to profile the career' of tuberculosis patients by focusing on the socio-economic and socio-cultural variables impinging on the health-seeking behavior and adherence to treatment of pulmonary TB patients. Secondly, it strives to propose criteria for innovative behavioural prevention strategies and health-seeking behaviour for TB patients. The study was conducted at nine primary health care clinics in three geographic areas or health districts in the Free State province (South Africa). The majority of patients were new patients. Using Suchman's illness stages, the study reveals that the patients not only had to cope with physical disabilities and the side effects of treatment, but also with the fear of recurrence of TB and social stigma. In respect of determinants of treatment adherence, the data shows that stigma, the socio-economic circumstances of the patient, and migrancy play an important role in explaining non-adherence. Based on this evidence, recommendations are made regarding a number of provider-, patient- and community-centred interventions that can improve adherence.
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