Medical and social consequences of tuberculosis in rural Ethiopia.

An institution based cross sectional study was conducted in June 1996 at a rural health centre in South Gonder Administrative Zone of Northern Ethiopia. Interview and respective review of medical records of patients were done. A total of 211 tuberculosis (TB) patients were included in the study, 133 (63%) males and 78 (37%) females. Majority (79.6%) of patients had pulmonary disease. Clinical observation based on symptoms and signs suggestive of tuberculosis was used as a sole criteria to prescribe anti-tuberculosis treatment in 54.1% (114/211) of all the patients. Acid fast staining of sputum was done for 51.2% (86/168) of the pulmonary patients out of whom only 31.4% were smear positive. Social ostracism was observed to have been affecting tuberculosis patients and their families to a great extent. Divorce rate due to tuberculosis among patients was 29.1% (37/127). Patients have reported loss or threat to lose their job. Dietary misconceptions were rampant. The TB control activities were ineffective and poorly organised. Starting anti-tuberculosis treatment without proper diagnosis was observed to have negative consequences on the patients and the control programme. Appropriate counselling service along with the medical treatment was provided to patients with eventual family reunions. Patients were also organised into local 'TB clubs' by their residential locations so as to improve treatment adherence and the level of TB awareness among the patients and the community. It is strongly recommended that the political system and health authorities of Ethiopia should have to give much more attention and commitment to the TB control activities in Ethiopia.