Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #102212

Emily Bloss, MPH MA, School of Public Health and Tropical Medicine, Department of International Health and Development, Tulane University, 1440 Canal St, Suite 2200, New Orleans, LA 70112, Kate Macintyre, PhD, Department of International Health and Development, Tulane University, School of Public Health and Tropical Medicine, 1400 Canal Street, Suite 2200, New Orleans, LA 70112, 504-588-5185, kmacint@tulane.edu, and Lesley Carver, BA, Samburu Aid in Africa (SAIDIA), P.O. Box 741, Nanyuki, Kenya.

In Kenya, one of the 22 high burden countries for TB, the Ministry of Health has identified tuberculosis to be a growing concern among adults living in pastoralist areas. Yet, programmatic gaps exist in ways to tackle TB in these hard-to-reach populations, which face many environmental and structural barriers to care. A study conducted in 2004 in Samburu District, Kenya explored these gaps by examining the central features of treatment seeking behavior in a hard-to-reach semi-nomadic population. The community members' understanding of the disease and their own experiences with and responses to the illness were also investigated. Multiple qualitative methods were used to explore factors relating to TB control among patients and their family members, key informants, community members, health care providers and traditional healers. Results indicate respondents perceive TB to be a serious and increasingly common disease that causes significant emotional, financial, social and physical burdens in the community. Misconceptions about the symptoms, causes and transmission of TB and the availability of diagnostic and treatment options are common. A model of a community-based TB program for hard-to-reach populations has been proposed involving traditional healers, community-based distributors, and community health workers for DOT, treatment supporters and community epidemiology for surveillance and mobile clinics for diagnosis and treatment. Implications for TB case detection and treatment adherence among other hard-to-reach-populations, including migrant or semi-migrant populations in the US, will be discussed.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Describe the different ways TB impacts the community in Samburu District, Kenya.
• Discuss the common treatment-seeking pathways pursued by symptomatic TB cases in a semi-nomadic population and their barriers to care.
• Recognize the main components of a community-based TB management program for hard-to-reach populations.

Keywords: Tuberculosis, Community-Based Health Care

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation