INTRODUCTION:

Tuberculosis is spread from person to person through the air. When people with lung Tuberculosis cough, sneeze or split, they propel the Tuberculosis germs into the air. A person needs to inhale only a few of these germs to become infected. [World health organization, 18 September 2018]

Tuberculosis is a specific infection disease caused by M. Tuberculosis. The disease primarily Affects lung and causes pulmonary tuberculosis. It can also affect intestine meanings bones and joints, lymph glands, skin and other tissues of body¹.

In India tuberculosis is mainly a disease of poor. The majority of Victim Are slum, dwellers, resistance of backward areas and tribal pockets. Poor living conditions, malnutrition sandy housing and overcrowding are the main reasons of spread of the disease. People living with HIV accounted for 1.2 million [11%] of all new T.B cases six countries accounted for 60% of the new cases: India, Indonesia, China, Nigeria, Pakistan and South Africa Global progress depend on major advances in T.B Prevention and care in these countries. Worldwide, the rate of decline in the T.B incidence remained at only 1.5% from 2014 to 2015 to reach the first milestone of the End TB strategy².

India accounted for 27% of the 10 million people who developed tuberculosis in 2017, highest among the top 30 high TB burden countries in the world, accounting to atleast report by the world Health Organization Though India is the second-most populous country in the world, one fourth of the global incident Tuberculosis [T.B] cases Occurs in India annually. In 2012, out of the estimated global annual incidence of 8.6 Million T.B cases, 2.3 million were estimated to have occurred in India³.

Tuberculosis is the seventh most common causes of mortality World Wide⁴

Since 1992, RNTCP [Received National Tuberculosis Control Program] is essentially a patient focused program for control of tuberculosis in India. The program beliefs that cured patient act as one of the best motivators promoting case detection and patient adherence to treatment. The current focus of the RNTCP of government of India uses directly observed treatment short causes [DOTS] to achieve and maintain a cure rate of over 85% and augmentation of case finding activities to detect at last 70% of estimated cases⁵.

Achieving these goals requires active community participation by creating awareness on etiology, management, preventive measures, and information of availability of services, etc. Lack of knowledge about the disease and stigmatization causes underutilization of the services, delay in seeking diagnosis and poor treatment adherence⁶.

Non-adherence to treatment often results from in adequate knowledge or understanding of the disease and its treatment⁷. On the other hand, greater knowledge about T.B may be increasing the acceptance to the control measures with the resultant decrease in the spread of the disease⁸.

By Educating the patient and reviewing their misconception, patient compliance with therapy and spread of disease is likely to improve⁹.

In 2017 there were a total of 1, 600, 000 TB related death. Also, an estimated 234, 000 children died of TB in 2017. There were an estimated 10.0 million new cases of TB disease (also known as active TB) in 2017 TB affect all countries and age groups but overall, the best estimates for 2017 were that 90%t were adults, 64% were male, in 2017 an estimated one million and ten thousand children become ill with TB¹⁰.

Tuberculosis [Tb] is one of the major communicable disease afflicting Mankind. The prevention of TB is a major challenge as one infected person can infect up to fifteen people through coughing. TB prevalence is increasing with increasing Human Immunodeficiency Virus (HIV) infection .Despite TB being a preventable and curable disease, it is still a major global heath burden as 10.4 million new (incident) TB cases were reported worldwide in 2015 and among this number, 1.2million were co-infected with HIV .In 2015, 1.4million people died from TB of whom 0.4 million were infected with HIV. TB is ranked among the top five causes of mortality among adult women aged 20-54year. Men are also equally effected as, 890, 000 men died from TB and 5.4 million had acquired TB infection in 2014. Approximately one million children were infected with TB and 400, 000 died of TB in 2015¹¹.

Pulmonary tuberculosis is a chronic communicable bacterial disease caused by Mycobacterium tuberculosis. it is a major public health problem worldwide with India having the highest prevalence of pulmonary tuberculosis in the world¹².

In our country, every year there are more than 2 million incidence tuberculosis causes, which is more than one –fifth of the global burden.

In order to combat tuberculosis, the National tuberculosis program of India was started in 1962, which was renamed to Revised National Tuberculosis Control Program (RNTCP). The role of this program is to decrease the mortality and morbidity owing to TB and reduce the transmission of infection until it ceases to be a major public health problem.

Although tuberculosis has only 11%of the world population, Africa accounts today for more than quarter of the global burden with an estimated 2.4 million Tuberculosis cases and 540, 000 Tuberculosis deaths annually.

Ethiopia ranks seventh among the world 22 high burden Tuberculosis countries. according to WHO global Tuberculosis report 2013, The country has an estimated incidence rate of 224 cases per 100, 000 population. A Studied showed that a low knowledge score was more likely to be observed among the illiterate, female’s rural residence, low income, and youngest age group.

METHODOLOGY:

A non-Experimental descriptive research design was used to assess the knowledge and prevention in family members of pulmonary tuberculosis Patients Selected hospital Rohilkhand college and hospital Bareilly.40 family members of pulmonary tuberculosis patients were selected by non-probability convenient sampling technique. Interview-Self structured questionnaire tools, with the help of interview method used in this study.

Tool for Data Collection:

The tool consisted of 2 sections. Section A dealt with demographic details of family members such as age, gender, education, monthly income, duration of illness of patients, dietry pattern, monthly income, family history and section B consisted of structured questionnaire to assess the knowledge of tuberculosis and its prevention among family members of tuberculosis diagnosed patients. Each question given 4 options. Each correct answer awarded score 1 and incorrect answer awarded score 0.

Research hypothesis of the study based on:

H1: There will be significance association between knowledge and prevention in family members of pulmonary tuberculosis patients pulmonary with the selected demographic variables.

Ethical consideration:

The research proposal was approved by research committee of Rohilkhand college of nursing Bareilly Uttar Pradesh. Permission obtained from Principal Rohilkhand college of nursing and medical superintendent, Rohilkhand medical college and hospital Bareilly. Informed Consent was obtained from the study participants, after explaining the nature and duration of the study. Assurance was given to the individual that report will kept confidential.

RESULTS:

Descriptive and inferential statististcs were used to assess knowledge on pulmonary tuberculosis patient’s family members.

SECTION-A:

Table-1: Frequency and Percentage of Pulmonary Tuberculosi Patient Family Member According to Demographic Variable N=40

S.no

Demographic variable

Frequency

Percentage

Age

a) 25-33 year

b) 34-42 year

c) 43-50 year

d) 51-62 year

42.5%

27.5%

7.5%

22.5%

Duration of illness

a) Less than 1 year

b) 1 to 2 year

c) 2 to 3 year

d) More than 3 year

60%

20%

2.5%

17.5%

Marital status

a) Married

b) Unmarried

c) Widow / Widower

d) Divorce

90%

2.5%

Monthly income of family

a) Less than 5000

b) 5001 to 10, 000

c) 10001 to 20, 000

d) 20, 001 or more

70%

25%

2.5%

Religion;

a) Hindu

b) Muslim

c) Christian

d) Others

92.5%

2.5%

Dietary pattern;

a) Vegetarian

b) Non vegetarian

c) Mixed

77.5%

12.5%

10%

Education status;

a) High school

b) Inter mediate

c) Graduate

d) Post Graduate

65%

27.5%

2.5%

Family history of Pulmonary tuberculosis

a) Yes

b) No

c) Unknown

20%

77.5%

2.5%

Age:

Percentage wise distribution of middle adulthood in their age group depicts that highest adulthood where in a age group 25-33years (42.5%), in 34to 42year (27.5%), in 43to 50year (7.5%), in 51to 62 year it was (22.5%).

Duration of illness:

Percentage wise distribution of middle adulthood 25 to 62 years in relation to their duration of illness (60%) are less than 1 year are, (20%) are 1 to 2 year, (2.5%) are 2 to 3 year (17.5) are more than 3 year.

Marital status:

Percentage wise distribution of middle adulthood 25 to 62 years in relation to their marriage (90%) are married, (5%) are unmarried, (2.5%) are widow and (2.5%) are divorced.

Monthly income of family:

Percentage wise distribution of middle adulthood 25 to 62 years in relation to their income represent that (70%) have below 5000 income, (25%) having 5000 to 10000 income, (2.5%) having 10, 001 to 20, 000 income and (2.5%) having above 20, 000 income.

Religion:

Percentage wise distribution of middle adulthood 25 to 62 years in relation to their religion represent that are (92.5%) are Hindu, (2.5%) are Muslim, and (2.5%) are Christian, (2.5%) are others.

Dietary pattern:

Percentage wise distribution of middle adulthood 25 to 62 years in relation to their diet (77.5%) are vegetarian, (12.5%) are non vegetarian, and (10%) are mixed.

Education status:

Percentage wise distribution of middle adulthood 25 to 62 years in relation to their education Shows that percentage (65%) are high school, (27.5%) are Intermediate, (5%) are graduate and (2.5%) are post graduate.

Family history of pulmonary tuberculosis:

Percentage wise distribution of middle adulthood 25 to 62 years in relation to their family history of pulmonary tuberculosis represent that (77. 5%) not having Family history of pulmonary tuberculosis, (20%) having family history of pulmonary tuberculosis, (2.5%) unknown.

SECTION B:

Table 2: Level of knowledge scoring among pulmonary tuberculosis patient family members regarding knowledge and prevention on pulmonary tuberculosis.

LEVEL OF KNOWLEDGE	KNOWLEDGE SCORE
LEVEL OF KNOWLEDGE	SCORE	N	%	MEAN	MEAN %
Inadequate	0 to 14	6	6%	15	15%
Moderate	15to 27	34	34%	85	85%
Adequate	28 to 40	0	0%	0	0%

Table 2: Reveals that out of 40 pulmonary tuberculosis family members. 6% inadequate knowledge mean 15%, 34% family member having moderate level of knowledge mean 85% and 0% having adequate knowledge regarding Tuberculosis and its prevention.

Maximum Scores = 40 Minimum Scores =0

Table 3: Association Between Label of Knowledge And selected Demographic Variable Among Pulmonary Tuberculosis Patient Family Members Regarding Knowledge and Prevention

Demoraphic variables

Inadequate

Moderate

Adequate

Degree

of freedom (DF)

Chi square test

(x2)

Tabulated

Value

Level of significant

Age

a) 25-33 year

b) 34-42 year

c) 43-50 year

d) 51-62 year

2.5%

10%

35%

20%

7.5%

20.03

12.59

Not significant

Marital status

a) Married

b) Unmarried

c) Widow / Widower

d) Divorced

7.5%

20%

2.5%

62.5%

2.5%

0.96

12.59

Not significant

Monthly income of family

a) Less than 5000

b) 5001 to 10, 000

c) 10001 to 20, 000

d) 20, 001 or more

2.5%

17.5%

45%

20%

2.5%

2.27

12.59

Not significant

Religion;

a) Hindu

b) Muslim

c) Christian

d) Others

7.5%

22.5%

62.5%

2.5%

1.71

12.59

Not significant

Dietary pattern;

a) Vegetarian

b) Non vegetarian

c) Mixed

2.5%

20%

2.5%

52.5%

12.5%

6.42

9.49

Not significant

Family history of Pulmonary tuberculosis

a) Yes

b) No

c) Unknown

2.5%

17.5%

10%

57.5%

2.5%

8.08

9.49

Not significant

*Significant at p<0.05 level

Table 3: Reveals that there is no statistically association between level of knowledge and selected demographic variables. On analysis there is no statistically significant association between age and level of knowledge as evidenced by chi-square value 20.03, degree of freedom(6) at 0.005 level of significance .while calculated marital status degree of freedom (6) & chi-square value 0.96, calculated value of monthly income of family as evidenced by degree of freedom(6) & chi-square value 2.27 at level of significant 0.05, religion degree of freedom (6) and chi square value 1.71, calculated value of dietary pattern degree of freedom (4) chi square value 6.42, calculated value of family history of pulmonary tuberculosis degree of freedom (4) and chi square value is 8.08.

DISCUSSION:

To assess the knowledge regarding pulmonary tuberculosis and its prevention patient’s family member. The present study revels out of 40 pulmonary tuberculosis family members. *6% inadequate knowledge, 34% family member having moderate level of knowledge and 0% having adequate knowledge regarding Tuberculosis and its prevention. So patients’s family member had inadequate and moderate knowledge.

· To find the association between knowledge and prevention with the selected demographic data.

The objective is supported by finding shown in table:3 reveals the association level of knowledge and selected demographic variables. On analysis there was a statistically no significant association between age, marital status, income of family member, dietary pattern, religion and family history of pulmonary tuberculosis. Class and source evidenced by chi square value of X = 20.03, 0.96.2.27, 1.71.6.42, 8.08 at 0.05 level of significant.

Hence it can be concluded that there is no impact of age, marital status, income of family member, dietary pattern, religion and family history of pulmonary tuberculosis.

CONCLUSION:

The researcher concluded that majority of patient’s family member had inadequate and average knowledge regarding pulmonary tuberculosis and its prevention. So, the investigator develops an informational guide sheet and provide information.

REFERENCES:

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Received on 09.06.2020 Modified on 27.07.2020

Int. J. Nur. Edu. and Research. 2020; 8(4):512-516.

DOI: 10.5958/2454-2660.2020.00114.3