Staff and patient attitudes to tuberculosis and compliance with treatment: an exploratory study in a district in Vietnam.

SETTING: The study, a collaboration between the National Tuberculosis Institute, Hanoi, Vietnam and the Karolinska Institutet, Stockholm, Sweden, was carried out in a district of Quang Ninh Province in North Vietnam. OBJECTIVES: To describe tuberculosis (TB) services, attitudes of staff, and attitudes of patients considered as defaulters to TB treatment. DESIGN: Two focus group discussions were carried out with staff at the district hospital. Ten defaulter patients were interviewed in their homes. RESULTS AND CONCLUSIONS: This exploratory study has revealed some important aspects of staff and patients' attitudes to TB and its treatment. Tuberculosis is considered a 'dirty' disease, which mainly affects poor people. There is a tendency to avoid telling others about it. Obvious symptoms are explained as 'being overworked'. A patient with TB feels 'less respected' by others. The social stigmatization leads to delays in seeking medical care, often only after self-medication: anti-tuberculosis drugs can be bought without prescription in various pharmacies. The patient's economic situation is also an important determinant of compliance and non-compliance. These factors need to be taken into consideration in TB control in Vietnam.