INTRODUCTION:

In human life certain things will happen without our knowledge or consent, certain things will happen with our knowledge or by our choice. The sudden occurrence of disease, accidents, tragedies each person will go through a process of labeling, stereotyping, separation, loss of status and discrimination in a power situation, will call it as a stigma. Stigma is increasingly recognized as having a major impact on human life especially if one person is contract with certain communicable disease like TB, HIV and AIDS. Stigma and discrimination usually hinter from seeking health services, prolonged risk of transmission, poor adherence and increased risk of disability. In the case of women, the stigma cause more burden in their life.¹ (Moya et al 2014)

Tuberculosis is the second most common cause of death from infectious disease. The route of tuberculosis transmission is air borne and it increases the chance of infection to someone staying close to someone with TB² (Kalu and Jimmy, 2015). The perceived risk of transmission from an infected TB individual is the main cause of stigma.³ (Courtwright and Turner 2010). It also considered that TB is a disease of the poor and slum people. A study conducted by Muniyandi et al (2006) revealed that the majority of patients registered under RNTCP were poor and it made a burden and impact on families. TB is still considered a shameful disease, and there is a tendency to hide the disease and avoid telling others about it⁴. Patients who complete the course of treatment and cured may not experience strong stigmatization and they are ready to disclose the disease to others to impart support and knowledge.⁵ (Wu et al 2009) The personal experience of a girl aged 19 years is also shows these facts in her life. One day I met her in the medical ward, by talking with her she revealed her concern about her tension and mental struggles she experienced after diagnosing TB. She explains her own experience in her own word.

Sharing Personal experience- A case report

It was a difficult condition when I heard that I am diagnosed with TB. I could not accept this diagnosis in the beginning. Since the coughing and night fever was not reducing in spite of the medicines, I went a second time for the consultation. So doctor ordered blood and urine tests. The result showed ESR-171mm/hr and sign s of urinary infection. Since the ESR level was high doctor advised for admission in the hospital. During the first week of admission some more blood test like thyroid function test, peripheral smear, Mantaux test he ordered. I was in great tension. I was continuously watching the progress of eruption at the site of Mantux test on my hand. Mean while doctors were frequently asking about the history of TB in my life and in my family and the history of exposure to TB. I also overheard that doctors were discussing TB symptoms This further increased my tension along with that the size of indurations is increasing and they had doubt about that I had a right side pneumonia that gave me a bit of consolation.

I was so afraid about the attitude of others if I am diagnosing with TB. Every second the tension was increasing because I have observed the attitude and behavior of people towards TB patients. I often cried and thought about my future. Even I thought of discontinuing my studies, and how the people will look at me. Doctors again suggested to take a CT of thorax to confirm the diagnosis as the sputum microscopy showed negative for tuberculosis bacillus. Later, they confirmed the diagnosis after taking a chest X-ray. Really I was under shock. I did not know what to do. I was deeply sad about my family and my future. The pain and agony which I had undergone in these days was unbearable for me. But I could overcome these struggles with everyone’s’ support and prayers. Then I could realize that the life is perishable and nothing. A life without sorrow and problems, we could not enjoy the happiness of life in its full measure. Doctor advised me to take DOTS without losing many classes. The only fact which consoling me that the result of sputum microscopy was negative, so I can live with others without spreading the disease to others. After one month leave I again joined in the class. A s I a nursing student, during my second year I studied about TB in detail. So again another thought came to my mind that if anybody from my classes come to know about my sickness but I could manage it without knowing by others with the help of my authorities.

Although I was told that there will be side effects for the TB medications., there was not much problem. When I went for the review, I got another shock. Eventhouh the cure will be complete doctors said that the changes in the chest x-ray will be permanent. It was a childhood dream to work in abroad. I felt that all my dreams and family desires are shattered; I felt the earth is turning upside down. But I entrusted everything in the hands of God and I completed my treatment without much problem. I feel to cry even now when I think of all these I cannot understand why this happened to me. I feel all these are like illusions and find difficulty to believe that I am a TB patient. I am trying to live in the reality as we cannot run away from the truth and the support from my friends and family had helped me to get through this. From my experience I would say don’t be afraid of having TB. I came to realize as I shared my story that TB was more common than I had first thought. Positive attitude, healthy diet, strong will and good support will help you get through this. At the end you will see that it is a great achievement that you have got through this, be proud.

Through the understanding of personal experience of a TB patient, we could realize that still there is stigma about TB in our society. The consequences of stigma are far reaching, destroying the quality of life of number of people and affecting the effectiveness of public health program like DOTS. The personal impact of stigma on individuals affects psychologically. The self esteem is reduced and keep aloof themselves from social activities. (Brakel 2005)⁶. Another study done by Baral et al (2007) also identified the cause of self discrimination, are the fear of transmitting TB, avoiding gossip and potential discrimination.⁷

CONCLUSION:

One thing to be understood is that we don’t have to travel to get TB, it is around and will always be around. Once we contract with TB we have to pay a price for it. The knowledge regarding TB is very important factor to prevent the transmission of disease. This is a disease which can only control by the affected person because if he/she is aware about the routes of transmission, he /she has to follow the preventive methods effectively.

ACKNOWLEDGEMENT:

I would like to thank my patient who shared her experience with Tuberculosis.

CONFLICT OF INTEREST:

None

FUNDING:

Self

Ethical clearance:

Not required.

REFERENCES:

1. E M Moya, A. Biswas, S M Chavez Baray, O Martinez, B Lomeli. Assessment of stigma associated with tuberculosis in Mexico; Public Health Action, Vol 4 No4, December 2014.

2. Osonwa Kalu O, Eko Jimmy E. Assessment of knowledge, attitude and tuberculosis-related social stigma among school adolescent in a semi-urban town in Cross River State, Nigeria. International Journal of Education and research. Vol.3 No 2 February 2015

3. Courtwright A, Turner N A. Tuberculosis and stigmatization, Pathways and interventions; Public health reports Suppl 4 Vol 125

4. M. Muniyandi, R. Ramachandran, R. Balasubramanian and P K. Narayanan. Socio-economic dimensions of tuberculosis control: Review of studies over two decades from tuberculosis research center. Journal of communicable disease 38 (3) 2006:204-2`15

5. Ping-Sheny Wu, Pesus Chou, Nien-Tzu Chang, Wen –Jung Sun, Hsu-sung Kuo. Assessment of changes in knowledge and stigmatization following tuberculosis training workshops in Taiwan. J Formos Med Asso/2009.Vol108.No5

6. Wim H. van Brakel. Measuring health related stigma- a literature review. September 2005

7. Sushil C Baral, Deepak K. Karki, James N Newell. Causes of stigma and discrimination associated with tuberculosis in Nepal;, a qualitative study. BMC Public Health, 2007 7:211 August.

Received on 31.03.2018 Modified on 11.04.2018

Int. J. of Advances in Nur. Management. 2018; 6(4): 290-292.

DOI: 10.5958/2454-2652.2018.00066.5