Jul-Sep, 2012 - Indian Journal of Pharmacy Practice

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Munsab Ali - Associated socioeconomic status with illness behavior in tuberculosis patients undergoing DOTS therapyfemale in the family and come in contact with undiagnosedTB patients at their working place and during the travel.Perhaps the reason why more men than woman get TB isbecause they work and live in crowded and unsanitary22conditions.2. Distribution of Illness behavior in group I and IIpatients according to educationTable 2 shows the distribution of TB patients according totheir education status. As per the RNTCP Report, TB is mostprevalent in less educated and poor people. Education playsan important role to change the patient's health behavior byproviding them with information that motivate them to follow12the treatment plan. Tuberculosis was observed in primaryschool educated people which is more (57.32%) as comparedto graduate (3.66%) and none in post graduation and abovequalified patients. So the illness behaviour is more in lesseducated people.3. Distribution of Illness behaviour in group I and IIpatients according to occupationTable 3 indicates the distribution of TB patients as peroccupation. According to RNTCP Report, TB is mostlyprevalent in less educated and poor people, similarly illnessbehaviours were observed highest in unskilled worker(36.59%) too and in semiskilled worker is (29.27). Lowoccupation status was associated with poor physical healthand a poor coping style was associated with psychiatricillness. Therefore, the illness behavior is inverselyproportional to better occupation of patients. A positivecorrelation between occupation and occurrence of depressionhas also been observed by Natani et al., 1985.4. Distribution of Illness behavior in group I and IIpatients according to family incomeTable 4 represents the distribution of TB patients according toincome of the family. According to RNTCP Report, TB ismost prevalent in low income peoples. In the present study TBis most common in patients who have family income betweenRs. 2,041 to Rs. 6,100 (53.66%) than in patient who haveincome between Rs.6,101 to Rs.10,161 (28.05%). As theincome per month increases the illness behaviour ratedecreases. A reduced status in the family and their smallcontribution to family income, due to ill-health, may be theTable 2: Distribution of Illness behaviour in group I and II patients according to educationGroup Professional Graduate Intermediate/ High school Primary school Illiterate Totaldegree PG & Postabove high schoolNo. of Patients No. of patients No. of patients No. of patients No. of patients No. of patients No. of patients% (%) (%) (%) (%) (%) (%)Group I 0(0) 3 (3.66) 8 (9.75) 20 (24.39) 47 (57.32) 4(4.88) 82(100)Group II 2(2.44) 6(7.32) 14(17.07) 24(29.27) 34(41.46) 2(2.44) 82 (100)P< 0.05, statistically significantTable 3: Distribution of Illness behaviour in group I and II patients according to occupationGroup Professional Semi Clerk, shop Skilled Semi Unskilled Unemployed Totalprofessional owner, worker skilled worker workerfarm ownerNo. of No. of No. of No. of No. of No. of No. of No. ofPatients % Patients (%) Patients (%) Patients (%) Patients (%) Patients (%) Patients (%) Patients %Group I0(0) 1(1.22) 8(9.76) 14(17.06) 24(29.27) 30(36.59) 5(6.10) 82(100)Group II0(0) 0(0) 10(12.19) 31(37.80) 26(31.71) 11(13.42) 4(4.88) 82(100)P< 0.05, statistically significantTable 4: Distribution of Illness behaviour in group I and II patients according to family incomeGroup >40,407 20,361 to 15,281 to 10,161 to 6,101 to 2,041 to
Munsab Ali - Associated socioeconomic status with illness behavior in tuberculosis patients undergoing DOTS therapy23reasons for their frustration and dissatisfaction. Thus, illnessbehaviour is inversely related to income per month.CONCLUSIONThe present study concludes that the illness behavior is mostprominent in male gender patients. Frequency of tuberculosiswas found to be decreased very rapidly as the degree ofeducation increases and was zero in case of postgraduates.Occupation status has a great role in illness behavior as thelow occupation status triggers the obsession. The per capitaincome of an individual has great impact on his social status aswell as satisfaction. Thus, socioeconomic status has atremendous role in illness behaviour of tuberculosis patientsundergoing DOTS therapy.ACKNOWLEDGMENTSAuthors are highly thankful to medical and DOTS providerand social workers of the DOTS Centre for their enthusiasticcooperation. We are also thankful to Mr. Brijesh for hisvaluable contribution and Sanjay Saroj, Babita for theirsecretarial help. We are very grateful to the projectcoordinator and staff of all the centers of LRS Institute fortheir full cooperation and support.REFERENCES1. Dye C, Scheele S, Dolin P, Pathania V, Raviglione MC.Consensus statement. Global burden of tuberculosis:estimated incidence, prevalence and mortality by country. WHOGlobal Surveillance and Organization project. JAMA 1999;282:677-86.2. Epidemiology, strategy, financing: WHO report, Geneva: WorldHealth Organization; 2009 (WHO/HTM/TB/2009.411).3. RNTCP Communication Strategy for a health. Published byCentral TB Division Directorate General of Health ServiceMinistry of Health and Family Welfare Government of India,2008.4. Global Tuberculosis Control Report 2009, Available from; URL.http: //www.who.int/tb/ Publications/ global_report/2009/pdf/full_ report. Pdf. Accessed November 30, 2009.5. http://www.tbcindia.nic.in/pdfs/TB%20India%202009.pdf.6. Chauhan, L.S, Agarwal, S.P. Revised national TuberculosisControl Programme. Tuberculosis in India chapter 3, 2008: 23-34.7. Tones K. Health education, behaviour change and publicrdhealth. Oxford textbook of public health (ed. 3 ), vol 2, NewYork: Oxford University Press, 1997: 786.8. Rabin D, Schach E. Medicaid, Morbidity and Physician. MedicalCare 1975; 13:68-73.9. Yee D, Valiquette C, Pelletier M, Parisien I, Rocher I, Menzies D.Incidence of serious side effects from first- line antituberculosisdrugs among patients treated for active tuberculosis. Am JRaspir Crit Care Med 2003; 167:1472-7.10. Yamada S, Caballero J, Matsunaga DS, Agustin G, Magana M:Attitudes regarding tuberculosis in immigrants from thePhilippines to the United States. Fam Med 1999; 31:448-77.11. Peterson TJ, Castle White M, Young JA, Meakin R, Moss AR:Street talk: knowledge and attitudes about tuberculosis andtuberculosis control among homeless adults. Int J Tuberc LungDis 1999; 3:528-33.12. Babcock DE and Miller MA. Client Education: Theory andpractice. Baltimore: Mosby Year Book Inc.; 1994.13. Kunik ME, Roundy K, Veazey C, et al. Surprisingly highprevalence of anxiety and depression in chronic breathingdisorders. Chest 2005; 127(4):1205-11.14. Aydin IO, Ulusahin A. Depression, anxiety, comorbidity anddisability in tuberculosis and chronic obstructive pulmonarydisease patients: Applicability of GHQ-12. Gen Hos Psych2001; 23(2):77-83.15. Dubey KK, Bhasin SK, Bhatia MS. Psychological reactionsamongst patients, their familymembers and the communityregarding hospitalized tuberculosis patients in Delhi.Psychiatry Today 1998; 11:30-3.16. Moudgil AC, Persadh D. Psychosocial survey of tuberculosispatients in a sanatorium. Indian J Tub 1972; 19:34-7.17. Natani GD, Jain N.K, Sharma TN et al. Depression intuberculosis patients: correlation with duration of disease andresponse to anti-tuberculous chemotherapy. Indian Journal ofTuberculosis 1985; 32(4):195-8.18. Lorant V , Deliège D, Eaton W, Robert A, Philippot P, AnsseauM. Socioeconomic Inequalities in Depression: A Meta-Analysis.American Journal of epidemiology 2002; 157:98-112.19.20.Marmot M, Feeny A. General expression for social inequalitiesin Health. IARC Sci Public 1997; 38:207-8.Prescott E, Vestbo J. Socio economic status and chronicobstructive pulmonary disease. Thorax 1999; 5:737-41.21. Akhtar S, White F, Hassan R et al. Hyperendemic pulmonarytuberculosis in peri-urban areas of Karachi, Pakistan. BMCPublic Health 2007; 3(7):70.22. Bobbin, C. Pathological Basis of Disease, New York,Saunders.1984.23. Arora VK, Johri A, Verma RP. Post treatment adjustment problemand coping mechanism in pulmonary tuberculosis patients. IndJour Tub 1992; 39:181.Indian Journal of Pharmacy Practice Volume 5 Issue 3 Jul - Sep, 2012 48
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