The social determinants of knowledge and perception on pulmonary tuberculosis among females in Jakarta, Indonesia
Background: Indonesia has not resolved tuberculosis burden since its prevalence and incidence has remained high. As the capital of Indonesia with a large population and a high number of tuberculosis cases, Jakarta has a distinctive condition of tuberculosis burden. This study aimed to obtain social determinants of knowledge and perception of pulmonary tuberculosis in an urban community.
Methods: This study used 2,323 samples taken by random sampling in Jakarta during February-May 2011. Questionnaires were delivered to assess respondents’ knowledge and perception about pulmonary tuberculosis. Levels of knowledge were categorized into ‘poor’ and ‘good’. Perceptions about tuberculosis were measured by whether respondents perceived tuberculosis as a humiliating disease and a shunned disease.
Results: Most respondents (88.7%) had good level of knowledge about tuberculosis, but misperception remained high (45.9%) in the community. Education level determined level of knowledge. The higher the education level the lower the risk of lack of knowledge. Tuberculosis perceptions were determined by family income and education level. Higher family income and education level were protective factors of misperception about tuberculosis as a humiliating disease and tendency to shun tuberculosis patients.
Conclusion: People in urban area of Jakarta have good level of knowledge about tuberculosis, but it does not necessarily lead to proper perception of tuberculosis. Age, education level and having health insurance determined level of knowledge, while tuberculosis perceptions were determined much more by education level and family income. Tuberculosis control program should consider these determinants prior to developing a comprehensive strategy.
Kementerian Kesehatan Republik Indonesia. Strategi nasional pengendalian TB di Indonesia 2010-2014. Jakarta: Kementerian Kesehatan Republik Indonesia; 2011. Indonesian.
World Health Organization. Global tuberculosis control 2011. Geneva: World Health Organization; 2011.
Kementerian Kesehatan Republik Indonesia [Internet]. Riset Kesehatan Dasar 2011. [cited 2011 October 15]. Available from: http://www.riskesdas.litbang.depkes.go.id/laporan2010/reg.php. Indonesian
Kementerian Kesehatan Republik Indonesia. Survei prevalensi tuberkulosis 2004. Jakarta: Kementerian Kesehatan Republik Indonesia; 2005. Indonesian.
Lönnroth K, Jaramillo E, Williams BG, Dye C, Raviglione M. Drivers of tuberculosis epidemics: the role of risk factors and social determinants. Soc sci med. 2009;68(12):2240-6. http://dx.doi.org/10.1016/j.socscimed.2009.03.041
Mesfin MM, Newell JN, Walley JD, Gessessew A, Madeley RJ. Delayed consultation among pulmonary tuberculosis patients: a cross sectional study of 10 DOTS districts of Ethiopia. BMC Public Health. 2009;9:53. http://dx.doi.org/10.1186/1471-2458-9-53
Finnie RKC, Khoza LB, van den Borne B, Mabunda T, Abotchie P, Mullen PD. Factors associated with patient and health care system delay in diagnosis and treatment for TB in sub‐Saharan African countries with high burdens of TB and HIV. Trop Med Int Health. 2011;16(4):394–411. http://dx.doi.org/10.1111/j.1365-3156.2010.02718.x
Odusanya OO, Babafemi JO. Patterns of delays amongst pulmonary tuberculosis patients in Lagos, Nigeria. BMC Public Health. 2004;4:18. http://dx.doi.org/10.1186/1471-2458-4-18
Ngadaya ES, Mfinanga GS, Wandwalo ER, Morkve O. Delay in tuberculosis case detection in Pwani region, Tanzania. A cross sectional study. BMC Health Serv Res. 2009;9:196. http://dx.doi.org/10.1186/1472-6963-9-196
Sevim T, Aksoy E, Ataç G, Ozmen I, Kapakli N, Horzum G, et al. Treatment adherence of 717 patients with tuberculosis in a social security system hospital in Istanbul, Turkey. Int J Tuberc Lung Dis. 2002;6(1):25-31.
Garner P, Thaver I. Urban slums and primary health care. BMJ. 1993;306(6879):667-8. http://dx.doi.org/10.1136/bmj.306.6879.667
World Health Organization. The stop TB strategy: building on and enhancing DOTS to meet the TB-related Millennium Development Goals. Geneva: World Health Organization; 2006.
Chakaya J, Uplekar M, Mansoer J, Kutwa A, Karanja G, Ombeka V, et al. Public-private mix for control of tuberculosis and TB-HIV in Nairobi, Kenya: outcomes, opportunities and obstacles. Int J Tuberc Lung Dis. 2008;12(11):1274-8.
Lozano-Fuentes S, Elizondo-Quiroga D, Farfan-Ale JA, Loro-o-Pino MA, Garcia-Rejon J, Gomez-Carro S, et al. Use of Google Earth to strengthen public health capacity and facilitate management of vector-borne diseases in resource-poor environments. Bull World Health Organ. 2008;86(9):718-25. http://dx.doi.org/10.2471/BLT.07.045880
Chen SC, Wang JD, Yu JK, Chiang TY, Chan CC, Wang HH, et al. Applying the global positioning system and google earth to evaluate the accessibility of birth services for pregnant women in northern Malawi. J Midwifery Womens Health. 2011;56(1):68–74. http://dx.doi.org/10.1111/j.1542-2011.2010.00005.x
Chang AY, Parrales ME, Jimenez J, Sobieszczyk ME, Hammer SM, Copenhaver DJ, et al. Combining Google Earth and GIS mapping technologies in a dengue surveillance system for developing countries. Int J Health Geogr. 2009;8:49. http://dx.doi.org/10.1186/1476-072X-8-49
Vine MF, Degnan D, Hanchette C. Geographic information systems: their use in environmental epidemiologic research. Environ Health Perspect. 1997;105(6):598-605. http://dx.doi.org/10.1289/ehp.97105598
Conroy GC, Anemone RL, Van Regenmorter J, Addison A. Google Earth, GIS, and the Great Divide: a new and simple method for sharing paleontological data. J Hum Evol. 2008;55(4):751-5. http://dx.doi.org/10.1016/j.jhevol.2008.03.001
Portero NJL, Rubio YM, Pasicatan MA. Socio-economic determinants of knowledge and attitudes about tuberculosis among the general population of Metro Manila, Philippines. Int J Tuberc Lung Dis. 2002;6(4):301-6.
Munro S, Lewin S, Swart T, Volmink J. A review of health behaviour theories: how useful are these for developing interventions to promote long-term medication adherence for TB and HIV/AIDS? BMC Public Health. 2007;7:104. http://dx.doi.org/10.1186/1471-2458-7-104
Obuku EA, Meynell C, Kiboss-Kyeyune J, Blankley S, Atuhairwe C, Nabankema E, et al. Socio-demographic determinants and prevalence of Tuberculosis knowledge in three slum populations of Uganda. BMC Public Health. 2012;12:536. http://dx.doi.org/10.1186/1471-2458-12-536
Hargreaves JR, Boccia D, Evans CA, Adato M, Petticrew M, Porter JD. The social determinants of tuberculosis: from evidence to action. Am J Public Health. 2011;101(4):654-62. http://dx.doi.org/10.2105/AJPH.2010.199505
Baral SC, Karki DK, Newell JN. Causes of stigma and discrimination associated with tuberculosis in Nepal: a qualitative study. BMC Public Health. 2007;7:211. http://dx.doi.org/10.1186/1471-2458-7-211
Macq J, Solis A, Martinez G. Assessing the stigma of tuberculosis. Psychol Health Med. 2006;11(3):346-52. http://dx.doi.org/10.1080/13548500600595277
Latko B, Temporão JG, Frenk J, Evans TG, Chen LC, Pablos-Mendez A, et al. The growing movement for universal health coverage. Lancet. 2011;377(9784):2161-3. http://dx.doi.org/10.1016/S0140-6736(10)62006-5
Moreno-Serra R, Smith PC. Does progress towards universal health coverage improve population health? Lancet. 2012;380(9845):917-23. http://dx.doi.org/10.1016/S0140-6736(12)61039-3
Copyright (c) 2014 Ahmad Fuady, Trevino A. Pakasi, Muchtaruddin Mansyur
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with Medical Journal of Indonesia agree to the following terms:
- Authors retain copyright and grant Medical Journal of Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.