Perceptions and practices of tuberculosis patients and non-adherence to therapy in Chiapas, Mexico.

Objective. To identify hearth perceptions and practices and non-adherence to therapy among tuberculosis patients. Material and methods. Qualitative research work consisting of I I group interviews with 62 tuberculosis patients during 1997-1998 in the Central, Highlands, and Border Regions of Chiapas, Mexico. Results Perceived causes of tuberculosis included contagion via food utensils, excess work, malnutrition, and cold, as well as other causes unrelated to person-to-person conragion.`rhe resulting incapability to work resulted in an economic crisis for both the patients and their family members. As a result of the social stigma imposed by the disease, patients perceived a negative : impact on their personal life,Family, work, and community. Conclusions. Lack of knowledge regarding tuberculosis is an important factor in the selection of and adherence to different care alternatives. Inadequate care provided by health services, including an unsatisfactory physician-patient relationship, resulted in diagnostic delay and non-adherence to therapy. Education programs to promote basic knowledge regarding tuberculosis and its treatment are necessary in this region.