Socio-cultural and structural factors and their impact on tuberculosis prevention and control for rural African American women in the South East USA

This study explores the influence of socio-cultural and structural factors on behavior that influences tuberculosis (TB) control. It considers the role of response to symptoms, care seeking and diagnosis and the implications for TB prevention among a rural population. Method: Twenty eight African American women with a previous TB diagnosis in the south east are included in this analysis of a cross sectional study using a semi-structured interview format. Results: Fifty percent of respondents were 40-60 years and had a family history of TB. Twenty percent were married and 30% worked in the service industry. Most (86%) had a single diagnosis of tuberculosis and 15% had latent TB previously. Forty percent had a high school education or less and little knowledge of TB. Most had symptoms they identified as serious or very serious. Persistent feelings of hopelessness influence responses to TB and perpetuate stigma. “I guess there for a couple of minutes I just felt like I was just all by myself. I was gonna be alone. You know nobody didn't want to be with me or be around.” Treatment delays were due to mis-diagnosis, lack of health insurance, poor recognition of symptoms by health professionals, and the need for testing. Discussion: Social, cultural and structural factors impact on individual's behavior and prevention and control of tuberculosis. Recommendations to reduce the incidence and prevalence of TB include: community wide activities at multiple levels involving health professionals and members of the community and enforced treatment protocols for persons with latent TB.