Research & Capacity Building of Tribal Community for Tuberculosis Management in Goa

TB remains one of the most important public health problems, and India is determined to eliminate Tuberculosis by 2025. India is the highest TB burden country in the world. There is undisputable evidence that TB is a poverty-related disease that concentrates in the most vulnerable, marginalised and hard-to-reach populations, hence the programme has prioritized Tribal Action Plans to confront this challenge. Tribal communities are especially vulnerable to TB, being already disadvantaged on account of intergenerational poverty and poor access to healthcare leading to a greater degree of social devastation. Tribal population would require universal and free of costs access to TB services, in the absence of stigma. 

Tribal people have higher prevalence (432/ per lakh population) of TB, in the most recent study, as compared to national average (256 per lakh population), which may indicate that the disease becomes concentrated in those who are at the lower end of the socio-economic scale and belong to socially excluded populations. 10.4% of all TB notified patients are from tribal communities. Current reporting status of smear ear positives indicates that only 11% of Tribal TB patients get treated. Besides stigma associated with TB hampers health seeking behaviour of this population group. In the light of the above statistics, tailored approaches are needed within the framework of the Programme, to facilitate effective prevention and control of active TB among these groups, whose socioeconomic conditions or lifestyle make it difficult to recognise TB symptoms, access health services, self-administer treatment and attend regular healthcare appointments.

Background of the Tribal Population in Goa 

In Goa, the tribal population amounts to 1, 49, 275 individuals, which comprises 10.23% of the total population, scattered all over the State with high density in Canacona and Quepem Taluka. More than 90% of this population live in rural areas, hamlets in hilty, forested areas where illiteracy, trying physical environments, malnutrition, inadequate access to potable water, and lack of personal hygiene and sanitation make them more vulnerable to disease. Although these groups have seen considerable progress over the years, 40.6% of tribal population still lives below poverty line as against 20.5% of general population in India. They have far worse health indicators than the general population. To estimate the prevalence of microbiologically confirmed pulmonary TB among persons aged ≥15 years in the tribal population of Goa. 

Objectives 

• To study select variables (comorbidities, addictions, environmental) associated with TB among persons aged 215 years in the tribal population of Goa. 
• To study health care seeking behaviour among persons aged ≥15 years in the tribal population of Goa.  
• To study utilization of TB care services among Persons with TB (PWTB) in the tribal population of Goa