"We found that the voices of these people, especially those who have already experienced TB, can play a crucial role in prevention. We need to recruit and train lay health educators to work as mediators in clinics and in high-risk communities," said Dr. Nancy Gibson, a professor of Human Ecology at the University of Alberta, and one of the study's authors
A three-year study was conducted to identify better practices for prevention and treatment in the populations of immigrants and Aboriginal peoples, which are experiencing the highest rate of tuberculosis in Canada.
The findings are published in the September issue of Social Science & Medicine.
The prevalence of TB in immigrants jumped from 35 per cent in 1980 to 57 per cent in 1994, and that of Aboriginal people went from 14 to 19 per cent in the same time period, while in the non-Aboriginal population in Canada, the proportion of cases decreased from 49 per cent to 21 per cent. Past studies have shown that immigration to Canada in the 1950s and 1960s was mainly from countries whose TB rates were similar to those in Canada, but now immigration is from countries in Africa and Asia where the prevalence of TB can be 50 per cent or higher.
"The study found that although patients with active disease learn about TB from health professionals, people in high-risk populations need to learn more about TB transmission and prevention prior to contact," said Dr. Gibson. "This is especially important, given that lack of knowledge of TB was strongly associated with negative attitudes towards TB and a worse experience of the disease."
Knowledge of TB is needed in the high-risk populations, but health professionals tend to meet patients only in the active stages of the disease. Employing people recovered from TB, family members of recovered patients and lay health communicators could offer valuable information in fostering community awareness, the study suggests.
The study included new Canadians from China, Hong Kong, east India, Vietnam, the Philipinnes, Eastern Europe and four Aboriginal communities in Canada. Interviews with them revealed how they felt about TB. Some believed TB was a result of irresponsible lifestyle or overwork. Others didn't tell people they had the disease, for fear of stigma.
The study revealed that people who had been able to learn enough about the disease were more positive and had better experiences with TB than those who did not know much about it.
The study was funded by the Alberta Heritage Foundation for Medical Research.
Journal
Social Science & Medicine