Study On Block Factors Of Tuberculosis Case Detection In Rural Area According To TB Suspects' KABP Survey

Objective: To probe IEC strategy to raise the case detection rate according to the research of objective people's KABP (knowledge, attitude, belief & practice) and social support about tuberculosis control.Methods: 1 Data collection: several methods were used in data collection including questionnaire study, key informant interview and in-depth interview; 2 Data analysis: quantitative data analysis approach with SPSS13.0; and framework analysis method was used in qualitative data analysis approach with MAX-qda software.Result:1 Problems during health care seeking: only 9.0% suspects thought that they might be caught with TB; most people (36.2%) thought that they might be caught with cold. Only 66.3% suspects chose to seek health care, 17.6% hadn't done anything. The reasons of not to seek health care were mostly because of financial difficult (63.2%) and ignore. The facility they chose for first visit was village level clinics (46.1%) and the township hospitals (35.2%). The reasons to chose the facilities were near in geography (55.2%) and cheap (19.7%). And of them who seek health cares, only 7.4% people were transferred to TB dispensaries. The factors to affect the health care seeking delay were: culture level, the distance to the health care, the number of information carriers, the measure to treat the symptoms and the knowledge about TB program.2 The knowledge about TB: the knowledge answer right rate was very low (36.0%). The knowledge answer right rate about TB disease (50.3%) was better than that about TB program (21.7%). ANOVO analysis showed that the factors affect the know rate were gender, culture level, health insurance, financial level, interest about health propagandize and the number of information carriers. The stepwise regression analysis showed that the annual income, the interest about health propagandizes and the numbers of information carriers were statistic significantly.3 The interest about media using: 52.1% people said that they were very interest in health propagandize. But 29.2% people were less interest and 18.4% people never. The factors affect the interest about health propaganda were gender, culture level, health insurance, financial level and the number of information carriers. The forms of health propagandize they liked were: the one served by doctors (45.5%), the cause of health lecture programs on TV(26.8%). The information carriers they owned were TV (78.9%), phone (58.9%), CATV (54.7%), DVD/VCD (23.7%) and mobile phone (11.7%). The media they used mostly were TV, phone and VCD/DVD. The most favorite programs were news report (42.28%) and TV series (35.29%). The time to watch TV was mainly at 6 pm to 10 pm. The channels they liked were local province level TV station (48.1%) and CCTV (29.6%).4 Result from qualitive reaserch: current policy wasn't suit for local situation; the pole of village doctor and township hospital in TB control is limited; the TB transfer policy need revised.Conclusions: It's serious that they delayed in seeking health care; The knowledge rate was poor; The media using in health propagandizing should arranged at special time and channels; The role of village doctors and township hospitals in TB control was limited.Policy suggestions: To raise the TB detection rate in poor traffic rural area, it's suggested that: 1 enhance the role of village doctors and township hospitals in TB program; 2 enhance the health propagandize about TB knowledge, especially about TB program; 3 using media properly in health propagandize, enhance the role of government in TB program, health propagandizing should follow the result of social evaluation and the investigation of media using.