Date of Conferral

2023

Degree

Ph.D.

School

Public Health

Advisor

Ndetan N. Harrision

Abstract

The utilization of tuberculosis (TB) health care services in a Nigerian state has not been optimal. Many residents do not utilize available health care resources when they experience symptoms of TB. Although much is known about the determinants of health seeking behavior (HSB), there is a gap on how TB knowledge and TB related stigma among traders in one main market contribute to HSB. This study examined the effect of TB knowledge and TB related stigma on HSB among traders. The health stigma and discrimination and health belif models served as the theoretical foundation. A quantitative cross-sectional analytical survey design was implemented on a convenient sample of 230 traders at the main market. Results of a binary logistic regression model showed a statistically significant relationship between TB knowledge and HSB (OR = 3.30, 95% CI [1.56, 6.97], p = 0.002). Based on multiple variable logistic regression, adjusting for stigma (attitude) strengthened the observed relationship between TB knowledge and HSB (adjusted OR = 3.77, 95% CI [1.71, 8.35], p < 0.001), and further adjusting for sociodemographics (age, gender, marital status and level of education) reduced the magnitude of the relationship slightly (adjusted OR = 3.32, 95% CI [1.20, 8.72], p = 0.02) but increased variability in both cases. The social change implication for this study and its findings is that, by implementing policies and strategies that specifically address TB knowledge and stigma, policymakers and National Tuberculosis and Leprosy Program in the state may increase HSB among traders at this populated market and thus advance TB control and prevention efforts.

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