Knowledge about tuberculosis among tribal population in Kerala in the backdrop of TB elimination goal by 2025.

INTRODUCTION: Kerala is one among the States in India with least prevalence of tuberculosis and is reportedly aiming to be the first State to reach the target of 'Zero TB' by 2025. But knowledge about TB among the vulnerable groups plays a critical role in controlling the spread and achieving the target of eliminating TB. MATERIALS AND METHODS: Drawing on a collaborative research program in India to estimate the burden of TB among tribal population, the level of knowledge and its possible links between life style of tribals, their customs and practices is examined Multi stage cluster sampling technique was adopted and 3 wards were selected in three districts in Kerala: Wayanad, Idukki and Palakkad which encompasses major share of the tribal population by probability proportional to size sampling method to draw a sample of 2600 individuals. RESULTS: Awareness about TB among Tribal population in Kerala is impressive. However, in-depth knowledge on how TB is caused and spread, the symptoms, place of treatment and the cost are not so appreciable. Misconceptions and also lack of knowledge still prevail on who is prone to TB, how TB is spread and the causative agent. The IEC activities have had its effect in sensitizing the tribal population on how to identify the symptoms of TB. The average knowledge score was 5.06 points (72.2 percent, SD: 1.81) out of a total possible score of 7 points. The individual mean knowledge score is 0.65 overall considering all the knowledge domains where the maximum value is 1 and minimum is 0. The mean knowledge score among the Malayarayan Christians and Hindus is relatively higher but poor among Kattunayaka and Irular tribes. Mean knowledge score decreases significantly with increasing age. Gender differential in mean knowledge score is absent but greater educational attainment is associated with higher knowledge scores. However knowledge is not translated to practice of all preventive aspects of TB. CONCLUSION: Knowledge deficit poses challenges in the efforts to eliminate TB in Kerala because the State is progressing towards zero TB target. Hence spreading awareness on these vital aspects need better focus among the tribal population.

Mycobacterium tuberculosis strain lineage in mixed tribal population across India and Andaman Nicobar Island.

In India, the tribal population constitutes almost 8.6% of the nation's total population. Despite their large presence, there are only a few reports available on Mycobacterium tuberculosis (M. tb) strain prevalence in Indian tribal communities considering the mobile nature of this population and also the influence of the mainstream populations they coexist within many areas for their livelihood. This study attempts to provide critical information pertaining to the TB strain diversity, its public health implications, and distribution among the tribal population in eleven Indian states and Andaman & Nicobar (A&N) Island. The study employed a population-based molecular approach. Clinical isolates were received from 66 villages (10 states and Island) and these villages were selected by implying situation analysis. A total of 78 M. tb clinical isolates were received from 10 different states and A&N Island. Among these, 16 different strains were observed by spoligotyping technique. The major M. tb strains spoligotype belong to the Beijing, CAS1_DELHI, and EAI5 family of M. tb strains followed by EAI1_SOM, EAI6_BGD1, LAM3, LAM6, LAM9, T1, T2, U strains. Drug-susceptibility testing (DST) results showed almost 15.4% of clinical isolates found to be resistant to isoniazid (INH) or rifampicin (RMP) + INH. Predominant multidrug-resistant (MDR-TB) isolates seem to be Beijing strain. Beijing, CAS1_DELHI, EAI3_IND, and EAI5 were the principal strains infecting mixed tribal populations across India. Despite the small sample size, this study has demonstrated higher diversity among the TB strains with significant MDR-TB findings. Prevalence of Beijing MDR-TB strains in Central, Southern, Eastern India and A&N Island indicates the transmission of the TB strains.

The tribal community's perception on tuberculosis: A community based qualitative study in Tamil Nadu, India.

BACKGROUND AND OBJECTIVE: Tuberculosis is a highly contagious bacterial infection. It is a major public health issue with India being the highest prevalent country in the world. The nation has a large and heterogeneous tribal population of approximately 104 million people which accounts for 8.6% of the total population. This study focuses on assessing the tuberculosis scenario amongst the tribal population their perceptions on risk factors of TB, general health problems, health seeking behavior, and challenges faced by them. METHODS: The study was conducted using in-depth interviews and focus group discussions in the three sampled study districts namely Nilgiris, Namakkal, and Villipuram of Tamil Nadu, India. A thematic analysis was performed to identify the major emerging themes. Following thematic analysis, an interventional strategy for improving the overall knowledge and awareness among the community health education was imparted. RESULTS: The conducted in-depth interviews and focus group discussions identified major themes that emerged from the codes which included stigma and discrimination, association with HIV, detection of symptoms, health seeking behavior, knowledge and awareness of TB, acculturation, treatment adherence and lack of lab facility. CONCLUSION: This qualitative study has captured the overall perception towards tuberculosis from the tribal community as a whole as well as from the health workers. The tribal community stigmatized and discriminated people suffering from TB which had an impact on the health seeking behavior as well as on the treatment adherence. The primary care providers were aware of the situation of TB in tribes but were poorly equipped. Primary healthcare providers should in fact, have a crucial role in identification of at-risk subjects, for prompt referrals, and delivery of treatment services.