Factors Associated with identification and referral practices of presumptive tuberculosis patients to formal health services by traditional medicine practitioners A case study from resource constrained setting in sumbawanga district, western Tanzania.
- Mwanza, Tanzania | Catholic University of Health and Allied Sciences [CUHAS-Bugando] | 2023.
- Pages xii-92 Includes References
Abstract:
Background: In tuberculosis (TB) control program community partnership involving Traditional Medicine Practitioners (TMPs) have been promoted to enhance TB detection. However, limited research has explored the factors hindering TMPs’ participation in identifying and referring presumptive tuberculosis patients, particularly in resource-constrained rural areas of Tanzania.
Objective: This study aimed to identify the factors associated with TMPs identifying and referring Presumptive tuberculosis patients to formal health services in the resources-constrained setting of Sumbawanga District.
Methods: A community-based cross-sectional design was employed to assess the role of traditional healers in identifying and referring active presumptive tuberculosis patients was conducted from June to October 2023. The study was conducted in the Western part of Tanzania, specifically Sumbawanga district, Rukwa region. A total of 227 traditional healers were identified, and a systematic random sampling method was used to select 145 practitioners who met the eligibility criteria. Data collection involved a standardized questionnaire, pre-tested for validity and usability, and administered in Swahili. Statistical analysis was conducted using IBM SPSS version 20. Continuous variable were summarized using mean or median, while categorical variables were summarized using frequencies and proportions. Bivariate logistic regression was initially performed for each independent variable, multivariate logistic regression was used to identify factors associated with the identification and referral of Presumptive tuberculosis patients. Variable having p-Values lower than 0.05 at 95%CI were considered statistically significant. The primary outcome measured was the practice of identifying and referring Presumptive tuberculosis patients by traditional healers, with socio-demographic characteristics and general knowledge on TB among the explanatory variable. Attitude towards TB detection and referral was assessed using Likert scale questions.
Results: Approximately 113(80%) of TMPs reported attending Presumptive tuberculosis patients, but only 35(25%) practiced referrals to nearby health facilities. Attending TB training sessions (aOR=6; 95%CI 2.10-17.17; p=<0.001) and maintaining a positive attitude towards TB infection and treatment (aOR=6.38; 95% CI 2.09-19.49; p= <0.001) were associated with TB identification. Similarly, factors associated with referring Presumptive tuberculosis patients included having access to referral forms (aOR=5.28; 95% CI 1.03-27.07; p=0.05) and attending TB training sessions (aOR=3.55; 95% CI 1.28-9.83; p=0.02).
Conclusion: While a significant percentage of TMPs in Sumbawanga attend to presumptive TB patients, there is a gap in referring these presumptive to healthcare facilities. The study highlights to positive impact of TB training sessions on both identifying and referring Presumptive tuberculosis patients. It also emphasizes the significance of a positive attitude towards TB infection and treatment. Furthermore, having access to referral forms plays a crucial role in the referral of Presumptive tuberculosis patients. Addressing these factors can enhance collaboration between TMPs and formal healthcare providers.
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