Tuberculosis, poverty, and "compliance": lessons from rural Haiti.

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ID: 63351
1991
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Abstract
Tuberculosis (TB) is the leading cause of death among rural Haitian adults, and TB control in Haiti is widely acknowledged to be a failure. The causes of both the endemicity of TB and the failure of attempts to address it are briefly reviewed before data from a study conducted in rural, central Haiti are presented. Members of one group of patients with active TB were given free medical care; members of a second group were given free care as well as financial aid, incentives to attend a monthly clinic, and aggressive home follow-up by trained village health workers. Comparing the two groups shows significant differences in mortality, sputum positivity after 6 months of treatment, persistent pulmonary symptoms after 1 year of treatment, average amount of weight gained, ability to return to work, and cure rate. The roles of human immunodeficiency virus and cultural factors are also examined. When adequate nutrition and access to free care were assured, drug-dependent and patient-dependent factors were shown to be of secondary importance in determining treatment outcome. Based on these data from a small, community-based TB-control project, the authors conclude that high cure rates can be achieved if the primacy of economic causes of TB is acknowledged and addressed.
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Authors Farmer, P;Robin, S;Ramilus, S L;Kim, J Y;
Journal seminars in respiratory infections
Year 1991
DOI
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URL URL not found
Keywords
Biology adult Culture behavior body weight health services mortality developing countries treatment physiology health poverty primary health care communication policy americas demographic factors economic factors north america population population dynamics socioeconomic factors haiti diseases research methodology viral diseases population characteristics delivery of health care age factors organization and administration obstacles latin america studies incentives hiv infections methodological studies rural population health personnel infections signs and symptoms caribbean case control studies community workers prospective studies food supplementation home visits nutrition programs tuberculosis--etiology user compliance

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