Tw. Steen et Gn. Mazonde, Ngaka ya setswana, ngaka ya sekgoa or both? Health seeking behaviour in Batswana with pulmonary tuberculosis, SOCIAL SC M, 48(2), 1999, pp. 163-172
The health seeking behaviour of tuberculosis (TB) patients, and their belie
fs and attitudes with regard to the disease, was studied in 212 Batswana wi
th smear-positive pulmonary TB during 1993/94. There is an apparent resembl
ance between traditional ideas of disease being caused by pollution (breaki
ng of taboos) and modern theories of spread via germs. TB may be regarded a
s a 'European disease' or as a 'Tswana disease' and this has implications f
or health behaviour. Patients who regard TB as a 'Tswana disease' may use m
odern medicine for symptom relief but traditional medicine to treat what th
ey consider the cause of the disease. All patients were eventually diagnose
d and initiated specific antituberculous treatment in a modern health facil
ity. The median number of health facility visits was two, and the median de
lay period was 12 weeks. 95% of patients visited a modern health facility a
s their first step of action. Before start of specific treatment one or mor
e alternative treatments was tried by 52% of patients during the delay peri
od. After starting modern treatment, 47% of patients visited, or planned to
visit, a traditional healer or a faith healer. Traditional explanations of
disease seemed less prevalent in 1993/94 than in a study conducted among T
B patients in Botswana ten years earlier, but few patients had a thorough u
nderstanding of TB from a biomedical point of view. More knowledge about pa
tients' health seeking behaviour and perceptions would be useful for health
workers. The findings of this study could offer suggestions for improvemen
t in the area of health education. (C) 1998 Elsevier Science Ltd. All right
s reserved.