Perception and management of tuberculosis symptoms in Addis Ababa, Ethiopia

Management of early tuberculosis (TB) symptoms and adherence to medical treatment are main challenges in controlling TB. The aim of this study is to explore how symptoms of TB are perceived and managed, from the onset of symptoms and during the course of treatment, in Addis Ababa, Ethiopia. We conducted a qualitative interview study, including 50 in-depth interviews and 2 focus groups, with TB patients, their relatives, and health personnel. We found that a patient's perceptions and self-treatment of early symptoms could cause diagnostic delay. Stigma associated with TB and public health services made many patients approach private clinics, causing further delay. Both private and public clinics often labeled and managed symptoms according to lay explanatory models. Lack of adequate knowledge about TB's etiology and cure caused patients to continue relating to symptoms by reference to their own understanding. This affected patients' ability to manage TB and its treatment.