CAPÍTULO XVI RESERVAS MATERIALES
FUERZAS ARMADAS REVOLUCIONARIAS
8 Do you smoke cigarettes? Never ( ) Currently smoking ( ) Quitted smoking ( )
9 Do you or did you ever live
with somebody World health Organization smokes in the house
Yes ( ) No ( )
10 If currently smoking, for
how long have you been smoking?
Years……..; Months………..
SECTION C: Patient’s characteristics:
No Question Indicate your response
here 11 Before you were diagnosed with TB did you have
any other lung disease?
Yes ( ) No ( )
12 Have you had TB before? Yes ( )
No ( )
13 If yes, how many times before this current TB? Please specify
14 Are you currently on treatment for Drug-resistant TB
Yes ( )
No ( )
15 Were you admitted in a hospital at the time you were diagnosed of TB? Yes ( )
No ( )
SECTION D: Symptoms experienced N o Questions Response 16 Please indicate the “first” symptom you experienced before you were diagnosed of TB (tick as appropriate) Cough less than 2weeks ( )
Cough more than 2weeks ( )
Coughing up blood ( )
Chest pain ( )
Difficulty in breathing ( )
Increased sweating at night, even during cold days ( )
Fever ( )
Fatigue ( )
Unintentional weight loss ( )
Loss of appetite ( )
Others (specify)……….
………
17 Please list all the other symptoms you had before you were diagnosed of TB……….
………
………
………..
SECTION E: Types of care sought, reason for choice of first consultation, and care received
N o
Question Indicate your response here
1 8
What did you think was wrong with you when you had TB related symptoms?
I thought it was HIV ( )
I thought I had cold or flu ( )
I thought it was TB ( )
I thought it was another medical condition ( )
I thought I was bewitched ( )
I thought I had psychological distress ( )
I did not know what was wrong with me ( )
Others (specify)……….………
……….
1 9 Did you seek medical care immediately you had your first TB related symptoms Yes ( )
No ( )
2 0 If “No” what made you to wait before seeking medical attention? (you can tick more than one if applicable) Thought I will get better without treatment ( )
Fear of being diagnosed with TB ( )
Fear of social isolation(stigma) if diagnosed with TB ( )
Lack of money ( )
Fear of a compulsory HIV test ( )
No specific reason ( ) I was busy ( ) Others (Specify)……… …. 2 1 Which one of these health facilities did you visit FIRST when you had TB related symptoms? Clinic
( )
Government hospital
Private health facility
( )
2 2 Please indicate ALL the reasons for visiting this health facility you ticked above first? ( you may tick more than one) The health facility was located close to my residence ( )
I was confident of getting cured there ( )
Was advised by friends and relatives ( )
I was referred by other health services ( )
The services were free ( )
I had no reason ( ) Others (specify)……… ……….. 2 3 Please indicate ALL the reasons for NOT visiting the other health facilities first? ( you may tick more than one if applicable) I did not think I would get any help there ( )
It was far from my place of residence ( )
There is always a long queue there ( )
I had a previous bad experience there ( )
I do not like the staff attitude there ( )
I had no reason ( ) Others (Specify……… ……… 2 4 How long after you had FIRST TB related symptom did you make this first visit to this health facility you chose in question 21? I-6 days ( ) 1- 2weeks ( ) 2-4 weeks ( ) 1 -2 months ( ) 2-4months ( ) >4months ( ) If >4months specify ……….
2 5
Please Tick all the symptoms that you told the health care provider during this your first visit
Cough less than 2weeks ( )
Cough more than 2weeks ( )
Coughing up blood ( )
Chest pain ( )
Difficulty in breathing ( )
Increased sweating at night, even during cold days
( )
Fever ( )
Fatigue ( )
Unintentional weight loss ( )
Loss of appetite ( )
Others (specify)………. ………
2 6
What actions took place during your initial visits to the health facility you chose in question 22 (Tick where appropriate) (you may tick more than one)
I did not tell the health worker all the symptoms I experienced
( )
I was initially given repeated courses of antibiotics
( )
I was asked to give a sputum specimen for TB test
( )
I had two Negative sputum smear results ( )
I was sent for chest X-ray ( )
I cannot remember ( )
Others(Specify……… ……….
2 7
How long after you submitted your sputum for test were you given your TB test results?
Within 2 days ( ) More than two days ( )
2 8
If your answer is “ more than two days”, please indicate the reason for your answer
Ye s
No
I did not go back to the clinic after the sputum was collected I did not go back to the clinic on time to fetch my result
The date I was given to come and collect my result was more than two days
Others(
specify)………
2 9
At which of these three health facilities were you finally diagnosed of TB
Clinic ( )
Government hospital ( )
Private health facility ( )
3 0
How long after your first visit to the health facility you chose in question 21 were you started on TB treatment Within 2 days ( ) 3-6days ( ) 1-2weeks ( ) 2-4weeks ( ) 1-2months ( ) 2-4months ( ) >4months ( ) If >4months specify ……… 3 1
How many times (in-total) did you visit health facilities for your TB symptoms before you were diagnosed of TB? ……….
3 2
When you had TB related symptoms, did you take any of the actions below before you visited a health facility? (please mark them in the order you took the actions (example 1st , 2nd, etc)
Visited traditional healer ( )
Visited spiritual healer ( )
Used oral Herb ( )
Used medication at pharmacy shops ( )
I did not take any of the actions above ( )
Others (Specify)………...
....
SECTION F: Role of health system in raising community awareness about TB disease/ patient’s perception about TB N o Questions Indicate your response here 33 Did you know there is a disease called TB before you were diagnosed of TB? Yes ( )
No ( )
34 If YES, how did you get information about TB disease before you were diagnosed of TB? (Tick more than one if applicable) Friends/relatives ( )
Media ( )
Health care worker in the community ( )
Health talks in the health care facility ( )
Others (Specify) ………. 35 Which of the following is true about TB? (Please
tick Yes/No/Don’t know)
Yes No Don’t know TB is caused by bacteria
TB is caused by evil spirit TB is curable
TB is infectious TB is hereditary
Males are expected to take care of their own health (especially when symptoms are mild)
SECTION G: TB STIGMA (please tick either Yes, No, or I don’t know to these questions)
No Question YES NO I DON’T KNOW
36 I feel ashamed of having TB
I do not want other people to know that I have TB
TB affects my relation with other people Tb affects my work performance
Every person World health Organization has TB has HIV
The chance of a girl getting married is limited if she had TB
I will not want to be near someone who has TB
There is stigma associated with visiting a TB clinic
I would feel embarrassed if a family member has TB
SECTION H: Access to health care
No Question Indicate your response
here 37 What mode of transport do you usually use to
go to the nearest health facility close to your place of residence?
Walk ( )
Public transport ( )
Own transport ( )
38 How long does it take you to get to this health facility using your usual mode of transport? <15minutes ( )
15-30minutes ( )
30-60minutes ( )
SECTION I: Exploration that findings above pertain to Makana Municipality