A study of the knowledge, attitudes and practices of primary health care workers in the south-east region of Jamaica concerning the DOTS strategy for the control of tuberculosis

ABSTRACT

Tuberculosis is an infectious disease caused by the micro-organism Mycobacterium tuberculosis. This micro-organism can be found in about one third of the world population and cause more deaths than any other infectious agent globally. To control this deadly disease, persons ill with TB need to take a combination of medications for a period of 6 to 8 months. Most of those suffering from TB find this difficult, and to aid in the adequate treatment of persons with the disease and protect others from it, the World Health Organization along with others concerned about the situation, developed the directly observed treatment, short-course (DOTS) strategy. This cost effective method of treatment requires that health workers world wide observe infected persons while they take their tablets. The aim of this study was to assess the knowledge, attitudes and practices of primary health workers about the treatment and control of TB using the directly observed treatment, short-course (DOTS) strategy. Data were collected using a questionnaire administered to a sample of selected categories of health workers in the study area. Additionally, three selected key informants from the Jamaican health services were interviewed. One hundred and seventy respondents from five categories, (medical officers, nurses, public health inspectors, community health aids and contact investigators) completed questionnaires. The study found that primary health care workers in Jamaica are very willing to participate in this global effort. They feel confident that once they are given the right tools to work with they can contribute in some way to ridding the world of this ancient killer. The most important workers in the execution of the activities of the strategy in the South East Region of Jamaica, where the study was done were the community health aids, contact investigators and the nurses. Their basic knowledge about TB and DOTS was very limited despite the fact that the Ministry of Health has implemented the strategy about four years ago. The in-depth interviews, however, revealed that there are some challenges in the implementation of the strategy and questioned its usefulness in Jamaica presently. The study recommends a review of the progress of the implementation program, preparation of a revised plan of action with all involved in TB control activities and institution of training programs throughout the health service on this "health breakthrough of the 1990's".(Au)