Chronic cough and its association with TB-HIV co-infection: factors affecting help-seeking behaviour in Harare, Zimbabwe
If you would like to obtain a copy of this Research Output, please contact Hanlie Baudin at firstname.lastname@example.org.
Objective: To qualitatively investigate reasons why individuals who reported chronic cough of 2 weeks or more in a cross-sectional prevalence survey had not accessed community-based outreach or other diagnostic services.
Methods: This study was nested into a cluster randomised trial comparing two methods of providing community-level diagnosis for tuberculosis (TB). Twenty individuals (12 males) with previously unreported chronic cough, because of undiagnosed pulmonary TB in five cases, were interviewed. An additional 20 individuals who had attended clinical services participated in two focus group discussions. Data were coded and analysed using grounded theory principles.
Results: Participants described cough, and specifically their own symptoms, as having many possible causes other than TB. People avoided care-seeking for cough to avoid a possible diagnosis of 'TB2' (HIV-related TB). Waiting in the hope of spontaneous resolution was common. Delaying treatment-seeking was also a strategy for deferring costs. Another common theme was negative perceptions of health facilities, as places where people anticipated discourteous treatment and being put at risk of contracting
TB and HIV. Expectations that they should be in control of their own health further contributed to delayed health-seeking in men.
Conclusions: Some individuals remain reluctant to be investigated for chronic cough even when provided with community-level services, with fear of the connotations of being diagnosed with TB and an aversion to contact with health providers among the dominant themes. In men, deferred acceptance that a chronic cough should be investigated may be related to concepts of masculinity, especially when symptoms are mild.
Related Research Outputs:
- Impact of HIV/AIDS on SADC countries: recommendations to funders
- Southern Africa: a review of the region
- The development, implementation and evaluation of interventions for the care of orphans and vulnerable children in Botswana, South Africa and Zimbabwe: A literature review of evidence-based interventions for home-based child-centred development
- An audit of HIV/AIDS policies in Botswana, Lesotho, Mozambique, South Africa, Swaziland and Zimbabwe
- HIV/AIDS, tuberculosis and parasites
- HIV/AIDS/STI/TB knowledge, beliefs and practices of traditional healers in KwaZulu-Natal, South Africa
- A controlled study of an HIV/AIDS/STI/TB intervention with traditional healers in KwaZulu-Natal, South Africa
- HIV/AIDS/STI/TB knowledge, attitudes and practices among lay health workers and nurses in KwaZulu-Natal, South Africa
- The use of implementation research networks on orphans and vulnerable children to encourage research-driven policies: the case of Botswana, South Africa and Zimbabwe
- Declines in HIV prevalence can be associated with changing sexual behaviour in Uganda, urban Kenya, Zimbabwe, and urban Haiti
- Macroeconomic impact of HIV and AIDS on the Zimbabwean economy: a human capital approach
- Bayesian approach in estimating risk determinants of infectious diseases
- TB and HIV/AIDS epidemics in South Africa: an overview
- Situational analysis of orphaned and vulnerable children in eight Zimbabwean districts
- Rifampin pharmacokinetics in children, with and without human immunodefiency virus infection, hospitalized for the management of severe forms of tuberculosis
- HIV/AIDS and sexuality: concerns of youths in rural Zimbabwe
- Pyridoxal-5-phosphate plasma concentrations in children receiving tuberculosis chemotherapy including isoniazid
- Community-based intervention to increase HIV testing and case detection in people aged 16-32 years in Tanzania, Zimbabwe, and Thailand (NIMH Project Accept, HPTN 043): a randomised study
- NSP research agenda
- Factors associated with tuberculosis reinfection and treatment failure in Taung sub-district, South Africa