Causes of stigma and discrimination associated with tuberculosis in Nepal: a qualitative study
Causes of stigma and discrimination associated with tuberculosis in Nepal: a qualitative study
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DOI：
10.1186/1471-2458-7-211
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发表时间：
2007-08-16
影响因子：
4.5
通讯作者：
Newell, James N.
中科院分区：
文献类型：
--
作者：
Baral, Sushil C.;Karki, Deepak K.;Newell, James N.
背景：结核病（TB）是主要死亡原因。这种情况是高度污名化的，对患者有相当大的歧视。虽然有几项研究评估了这种歧视的程度，但很少有公开发表的研究明确调查与结核病相关的耻辱和歧视的原因。因此，我们的研究的目标是采取第一步确定与TB.Methods相关的歧视的原因：数据收集在加德满都，尼泊尔进行。对34名结核病患者、患者家属和社区成员进行了深入访谈。结果：自我歧视的原因包括害怕传播结核病、避免流言蜚语和潜在的歧视。一般公众歧视的原因包括：害怕被认为有感染的危险;认为结核病与其他歧视原因，特别是贫穷和低种姓之间有联系;认为结核病与不名誉的行为之间有联系;以及认为结核病是神的惩罚。此外，一些病人认为他们受到卫生工作者的歧视。结论：需要根据当地情况制定一套全面的干预措施，以解决已查明的歧视的多种原因：基本的全民健康教育不太可能有效。
Background: Tuberculosis ( TB) is a major cause of death. The condition is highly stigmatised, with considerable discrimination towards sufferers. Although there have been several studies assessing the extent of such discrimination, there is little published research explicitly investigating the causes of the stigma and discrimination associated with TB. The objectives of our research were therefore to take the first steps towards determining the causes of discrimination associated with TB.Methods: Data collection was performed in Kathmandu, Nepal. Thirty four in- depth interviews were performed with TB patients, family members of patients, and members of the community.Results: Causes of self- discrimination identified included fear of transmitting TB, and avoiding gossip and potential discrimination. Causes of discrimination by members of the general public included: fear of a perceived risk of infection; perceived links between TB and other causes of discrimination, particularly poverty and low caste; perceived links between TB and disreputable behaviour; and perceptions that TB was a divine punishment. Furthermore, some patients felt they were discriminated against by health workersConclusion: A comprehensive package of interventions, tailored to the local context, will be needed to address the multiple causes of discrimination identified: basic population- wide health education is unlikely to be effective.