Sputum collection and disposal among pulmonary tuberculosis patients in coastal South India

A Study of Respiratory Hygiene Among Patients With Respiratory Manifestations in a Selected Primary Healthcare Setting in India

BACKGROUND

Tuberculosis is the second leading infectious killer disease, mainly transmitted through undiagnosed presumptive and inadequately treated pulmonary tuberculosis (PTB) cases in the community.

OBJECTIVE

This study was conducted to assess the knowledge, attitude, and practices (KAP) related to respiratory hygiene and sputum disposal methods and to estimate the proportion of presumptive PTB cases among patients with clinical features of respiratory manifestations.

METHODOLOGY

A hospital-based cross-sectional study was conducted among 80 adult patients with respiratory manifestations at an urban health centre in Goa using a validated, pre-tested, semi-structured questionnaire by interview method.

RESULTS

Among 80 study participants, 10 (12.5%) presumptive PTB cases were found. The knowledge regarding the exact cause and transmission of tuberculosis was 55% (44) and 72.4% (58), respectively. Around 32.5% (26) of participants were not following cough etiquette and they studied only up to middle school. Regarding the attitude towards ideal sputum disposal methods, more than three-fourths (81.3%, 65) of the responses were towards unsafe sputum disposal methods.

CONCLUSION

There is a need for health education regarding proper respiratory hygiene and sputum disposal methods, especially among patients with low educational and socio-economic groups.

Sputum Collection and Disposal Perceptions and Practices Among Pulmonary Tuberculosis Patients from Northern India

INTRODUCTION

Even a single case of pulmonary Tuberculosis (TB) can infect many others. Hence, to ensure better control of the disease, it is imperative that all patients dispose their sputum safely. Outcomes of this study would highlight the gaps need to be bridged in order to curtail transmission of TB.

AIM

To analyse and ascertain perceptions about the disease and determine the sputum collection and disposal practices followed by sputum-positive TB patients.

MATERIALS AND METHODS

In this cross-sectional study, 422 sputum-positive TB patients aged more than 15 years registered in the Tuberculosis Unit Ambala city from January 2012 - September 2012 formed the study population. After enrolment, at the end of one month, they were assessed for sputum collection and disposal practices by a trained person at their place of residences. Questionnaire was framed to collect relevant data.

RESULTS

Safe sputum disposal was practised by 46.4% of the study subjects. More females than males disposed of sputum safely (70.4% vs. 29.6%), as did more subjects of low than middle socio-economic status (74.1% vs. 25.9%). 70.9% (n=66) of the subjects with a family history of TB practiced safe sputum disposal methods as compared to 39.5% (n=130) subjects without a family history of TB practiced the same. Similarly more literate than illiterate subjects (n=150, 57.5% vs. n=46, 28.6%) practiced safe sputum disposal methods. (p< 0.001). Regarding knowledge of causation of TB only 63% of the study subjects were in the view that this disease is caused by germs.

CONCLUSION

The study demonstrated that a large number of pulmonary TB patients practiced unsafe sputum disposal. Unsafe sputum disposal was higher among males, illiterate patients and those belonging to the lower socio-economic group. Therefore, it is need of the hour to launch Information, Education and Communication (IEC) activities so as to improve the sputum disposal practices among tuberculosis patients.