National Consultancy for Assessment of the knowledge, Attitude and Practices of Tuberculosis in Communities of Belize. (примерный перевод: Национальное консультирование по оценке знаний, отношения и практики туберкулеза в сообществах Белиза.) (Белиз - Тендер #3301637)

Tuberculosis (TB) is an infectious disease that is transmitted by the Tuberculosis Mycobacterium. The disease is transmitted through infected air droplets, when we cough and sneeze and these air droplets are inhaled by healthy individuals. This disease is treatable and preventable and is said to be the second most common cause of death due to infectious diseases in under developed and developing countries. The World Health organization (WHO) has reported that approximately 9 million persons were diagnosed with active tuberculosis in 2013, of which 16% (1.5 million) deaths were attributed to.

The endemic nature of Tuberculosis is presently considered a chronic health problem as this re-emerging disease mostly affects individuals of lower socio-economic status, and is impacted negatively by cultural beliefs, practices and other community issues. The most affected by tuberculosis are those within the productive ages (20-49 years old) and represent the larger proportion of those affected by Tuberculosis disease. The NTP reports between 85-100 new and relapse cases of TB annually but WHO estimates that there should be approximately 140-160 new cases being diagnosed yearly in Belize.

Epidemiological drivers of TB in Belize are poverty, a high HIV prevalence, and poor treatment outcome of TB cases. The burden of TB mortality is influenced largely by an uncontrolled HIV epidemic and late access of these individuals to care and treatment within the health care system.

A person with active Pulmonary Tuberculosis (PTB) can infect an average of 10–15 people (1). In poor communities the risk of TB spread can be high due to low levels of education, lack of awareness on how TB disease is spread, its mode of transmission. Medical and social conditions such as persons infected with the Human Immune Deficiency Virus (HIV), smoking and poor nutritional status increase the risk in infants and elderly people. These individuals are infected readily by a bacterium that is highly contagious due to the presence of a large and increasing dose of bacilli that act as substantial contributors to the development of the disease and its epidemiological burden.

The most described and important contributing factors are, poverty and lack of awareness regarding TB disease. Other additional factors are, poor access to health facilities, high population density, lack of financial resource, lack of knowledge about the cause and transmission, signs and symptoms, where to get appropriate treatment for TB in the area and community. The health seeking behavior of patients can be influenced by visiting traditional healers, which may contribute to lack of adherence to TB medications, late diagnosis and treatment which are challenges in the control and for the National Tuberculosis Program (NTP).

Furthermore, communities with strong negative opinions and beliefs of TB disease contribute and influence in a negative manner the relationship between an infected person and healthcare providers who work towards TB control in the community.

It is with this in mind that the NTP seeks to find ways of creating and improving TB awareness in the community and advocates for increasing community participation in the control of this disease that is one of the pillars and main component of TB control as described in the Stop TB Strategy of the WHO.

Belize is a small and impoverished country in development where little is known about how factors such as knowledge, attitude and practices of communities towards TB affect and contribute to the national tuberculosis epidemic. Therefore, the study to be conducted and the first of its kind should capture the KAP of our multi ethnic society which includes most of our mixed villages and communities.