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Factors affecting tuberculosis control : decision-making at the household level.

OBJECTIVE
To explore the factors influencing decision-making process at household level vis-a-vis decision to seek health care, decision regarding the type of care and the decision to continue treatment.


DESIGN
Cross-sectional study.


PLACE AND DURATION OF STUDY
Government TB Center, Rawalpindi, from 16th January 2002 to 28th February 2002.


SUBJECTS AND METHODS
In total, 100 smear positive patients were included in the study. First questionnaire was administered to first 50 randomly selected patients. The ethnographic decision models (EDM) were developed from the responses. The second questionnaire, derived from these models, was administered to the second group of randomly selected 50 patients to test the predictive ability of the EDM.


RESULTS
Decision-making regarding treatment of tuberculosis was influenced by patients' knowledge about the disease itself as well as its severity, infectivity and curability. Close relatives were found to play a critical role at all the decision-making levels. The EDM developed on these results had 80-90% ability to predict the decision-making in tuberculosis patients.


CONCLUSION
Effective health education, easy accessibility to treatment centres and trained and motivated health care providers can go a long way in making national Tb control program a success.