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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
4349.0: Tuesday, December 13, 2005 - 8:35 PM

Abstract #102212

Tuberculosis management in hard-to-reach populations: A qualitative study in Samburu District, Kenya

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

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 ] Recorded presentation

Rural Health: Reaching the Hard to Reach

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA