Conceptualizing masculinity through a gender-based approach

In July 1993, nongovernmental organizations (NGOs) in Nicaragua expanded their community development work on domestic violence to include a "Group of Men Against Violence" (GMAV). GMAV began by focusing on self-education and expanded to include a movement of male farmers, the Network of Rural Promoters, that encourages men to engage in recreational activities with their children and to help develop family vegetable gardens. GMAV has spread through Nicaragua, and the men support seven youth groups. One NGO, CANTERA, offers a systematic course involving three workshops on masculine identities; gender, power, and violence; and unlearning machismo as well as follow-up workshops on masculinity, sexuality, and communication skills. Another NGO, CISAS, expands the CANTERA courses to include more specific topics and offers a training-of-trainers course to the Army Health Department staff. CISAS supports men's groups that meet weekly to discuss various topics both within and among various communities. CISAS also sponsors national-level meetings, including one with women's groups. The GMAV is currently seeking outside funding to respond to requests for support and training, including a request from the police department for gender sensitivity training. During an evaluation of CANTERA's courses conducted in 1997, many men reported that the workshops resulted in positive transformations in their own lives. CANTERA is now developing a training manual for NGOs interested in working with men.     

Evaluation of an intervention to train health professionals working with Aboriginal and Torres Strait Islander people to provide smoking cessation advice

Objective : To investigate the effectiveness and cultural relevance of Quitskills training tailored for health professionals working with Aboriginal and Torres Strait Islander people who smoke. Methods : A retrospective analysis was conducted with data collected from 860 participants (54% Aboriginal and Torres Strait Islander participants) in tailored Quitskills training from 2012 to 2016. Course participants took part in a survey at pre‐training, post‐training and four‐six weeks post‐training to assess confidence in skills to address tobacco, and perceptions of the strengths, areas for improvement and cultural relevance of the training. Results : Confidence in skills and knowledge to address tobacco increased significantly from pre‐ to post‐training (all indicators of confidence in skills increased p<0.001) and remained high at follow‐up. Tailored Quitskills training was perceived as being culturally relevant by Aboriginal and Torres Strait Islander participants, and the training facilitators were the most commonly cited strength of the training. Conclusions : Quitskills is an appropriate course for increasing skills and confidence among health professionals working with Aboriginal and Torres Strait Islander people who smoke. Implications for public health : Training courses that are tailored for Aboriginal and Torres Strait Islander people can build the capacity of the health workforce in a culturally relevant manner.     

Evaluación de competencias en redacción científica tras dos modalidades diferentes de cursos de formación: protocolo del Estudio SCRIU-B

Scientific writing is one of the competences required and requested by health professionals. There are several course formats designed for acquiring these competences, although the improvement after taking part in these courses is not always demonstrated. Through an open and non-randomized experimental design, the SCRIU-B study aims to evaluate the acquisition of competencies in scientific writing after specific training courses (face-to-face and online) as well as the satisfaction of the participants with these courses. A control group with participants from other training workshops not related to scientific writing is included. Through different questionnaires about knowledge, attitudes and skills we will evaluate and compare the improvement of their scientific writing skills. The results of the study will allow us to assess the usefulness of these courses and improve their format and implementation.     

Provider-initiated symptom screening for tuberculosis in Zimbabwe: diagnostic value and the effect of HIV status

Objective

To assess the diagnostic value of provider-initiated symptom screening for tuberculosis (TB) and how HIV status affects it.

Methods

We performed a secondary analysis of randomly selected participants in a community-based TB–HIV prevalence survey in Harare, Zimbabwe. All completed a five-symptom questionnaire and underwent sputum TB culture and HIV testing. We calculated the sensitivity, specificity, and positive and negative predictive values of various symptoms and used regression analysis to investigate the relationship between symptoms and TB disease.

Findings

We found one or more symptoms of TB in 21.2% of 1858 HIV-positive (HIV+) and 9.9% of 7121 HIV-negative (HIV−) participants (P < 0.001). TB was subsequently diagnosed in 48 HIV+ and 31 HIV− participants. TB was asymptomatic in 18 culture-positive individuals, 8 of whom (4 in each HIV status group) had positive sputum smears. Cough of any duration, weight loss and, for HIV+ participants only, drenching night sweats were independent predictors of TB. In HIV+ participants, cough of ≥ 2 weeks’ duration, any symptom and a positive sputum culture had sensitivities of 48%, 81% and 65%, respectively; in HIV− participants, the sensitivities were 45%, 71% and 74%, respectively. Symptoms had a similar sensitivity and specificity in HIV+ and HIV− participants, but in HIV+ participants they had a higher positive and a lower negative predictive value.

Conclusion

Even smear-positive TB may be missed by provider-initiated symptom screening, especially in HIV+ individuals. Symptom screening is useful for ruling out TB, but better TB diagnostics are urgently needed for resource-poor settings.     

Designing financial-incentive programmes for return of medical service in underserved areas: seven management functions

Background

The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a United Kingdom-based university was contracted by the World Health Organization to design a series of courses for health managers and trainers. This process was also intended to develop the capacity of the National Public Health Management Centre in Tabriz, Iran, to enable it to organize relevant short courses in health management on a continuing basis. A total of seven short training courses were implemented, three in the United Kingdom and four in Tabriz, with 35 participants. A detailed evaluation of the courses was undertaken to guide future development of the training programmes.

Methods

The Kirkpatrick framework for evaluation of training was used to measure participants' reactions, learning, application to the job, and to a lesser extent, organizational impact. Particular emphasis was put on application of learning to the participants' job. A structured questionnaire was administered to 23 participants, out of 35, between one and 13 months after they had attended the courses. Respondents, like the training course participants, were predominantly from provincial universities, with both health system and academic responsibilities. Interviews with key informants and ex-trainees provided supplemental information, especially on organizational impact.

Results

Participants' preferred interactive methods for learning about health planning and management. They found the course content to be relevant, but with an overemphasis on theory compared to practical, locally-specific information. In terms of application of learning to their jobs, participants found specific information and skills to be most useful, such as health systems research and group work/problem solving. The least useful areas were those that dealt with training and leadership. Participants reported little difficulty in applying learning deemed "useful", and had applied it often. In general, a learning area was used less when it was found difficult to apply, with a few exceptions, such as problem-solving. Four fifths of respondents claimed they could perform their jobs better because of new skills and more in-depth understanding of health systems, and one third had been asked to train their colleagues, indicating a potential for impact on their organization. Interviews with key informants indicated that job performance of trainees had improved.

Conclusion

The health management training programmes in Iran, and the external university involved in capacity building, benefited from following basic principles of good training practice, which incorporated needs assessment, selection of participants and definition of appropriate learning outcomes, course content and methods, along with focused evaluation. Contracts for external assistance should include specific mention of capacity building, and allow for the collaborative development of courses and of evaluation plans, in order to build capacity of local partners throughout the training cycle. This would also help to develop training content that uses material from local health management situations to demonstrate key theories and develop locally required skills. Training evaluations should as a minimum assess participants' reactions and learning for every course. Communication of evaluation results should be designed to ensure that data informs training activities, as well as the health and human resources managers who are investing in the development of their staff.     

县级结核病防治机构胸部X线诊断现状分析

目的 分析胸部X线诊断在结核病控制工作中作用，以及结核病防治机构胸部X线诊断能力，培训情况，提高胸部X线诊断水平。方法 分析2003年结核病登记报表资料，2003年底全国结核病人力资源调查数据资料，两个西部省胸部X线诊断培训班课前测试资料，1994～2004年结核病影像文献数据资料。结果 99．9％的初诊结核病疑似患者进行了胸部X线检查，肺结核检出率33．8％。65．5％县级结核病防治机构影像诊断人员，每日阅片少于3张，70．0％为初级职称或无职称，90．8％为本科以下学历。各级举办各类X线诊断培训班次仅占2．7％，接受培训人次仅占0．4％。结论 应重视结核病防治机构X线诊断能力的培训，尤其是县级人员的培训，增加培训的频度，开展形式多样的培训方式，改善培训质量。     

Relaying the message of safer sex: condom races for community-based skills training

This paper describes a community-based HIV prevention program designed to improve confidence in condom use skills by giving community members 'hands-on' experience in using condoms correctly. A condom race activity which had been effective in increasing condom skills confidence among university students in the US was modified and implemented with the general population in rural Northeast Thailand. In addition to providing training in condom use skills, the condom race was part of an integrated condom promotion and distribution campaign which responded to needs identified by the community, built upon the credibility and influence of local leaders and peers, and extended access to condoms into rural communities. Local leaders who had participated in a training-of-trainers program organized condom races in their communities, serving as positive role models for community acceptance of condom use. The condom race stimulated community discussion about condoms and increased participants' feelings of self-efficacy in correct condom use. Participation in the condom race activity was particularly empowering to women, who reported increased confidence in their ability to use condoms and to suggest using condoms with their partners after the race.     

Engagement of non-government organisations and community care workers in collaborative TB/HIV activities including prevention of mother to child transmission in South Africa: Opportunities and challenges

ABSTRACT: BACKGROUND: The implementation of collaborative TB/HIV activities requires interventions beyond facility fences in order to mitigate the impact of the dual epidemic on patients and communities at large. Engagement of Community Care Workers (CCWs) in delivery of integrated TB/HIV services is a potential avenue to enhance universal coverage and treatment outcomes and address human resource for health crisis in sub-Saharan Africa. In South Africa, CCWs are employed by nongovernmental organization (NGO) with Health Department contracts funded by government to provide various TB/ HIV community based activities. Using South Africa as a case, we report on engagement of NGOs and CCWs in the implementation of collaborative TB/HIV/PMTCT activities in rural South Africa, including extent of participation and constraints and opportunities to enhance effective participation. Our mixed method study in Sisonke district, KwaZulu-Natal included facility and NGO audits, a household survey (n=3867), 33 key informants with provincial, district and facility managers, NGOs managers and six CCW focus group discussions. Results: The findings indicate that most contracted NGOs were providing TB or HIV support and care with little support for PMTCT. Only 11% of TB and HIV patients needing care and support at the community level were receiving support from CCWs, while 2% of pregnant women were counseled by CCWs on infant feeding options and HIV testing. Most facilities (83%) did not have referral mechanisms or any linkage with NGOs. Major constraints identified were system-related: structural, organizational and managerial constraints; inadequate CCW training and supervision; limited scope of CCW practice, inadequate funding, and inconsistency in supplies and equipment. Individual and community factors such as lack of disclosure and stigma related to HIV; and cultural beliefs were also identified as constraints. Conclusions: We conclude that sub-optimal NGO/CCW engagement exists in implementation of collaborative TB/HIV/PMTCT activities, despite its potential benefits to enhance provision of integrated TB/HIV/PMTCT services at community level. Effective interventions that address contextual and health systems challenges are required and these interventions should combine systematic skills-building and consistent CCW supervision with a reliable referral and M&E system. Policy review to harmonise and expand the scope of CCW practice with task shifting to include home-based HIV counseling and testing is vital.     

Short course training in epidemiology and biostatistics for graduate and undergraduate public health professionals.

The University of South Florida has developed short courses of 2 to 3 days in epidemiology and biostatistics geared to public health workers. A key focus is providing skills which will assist local and State public health units to assess their status and measure progress with respect to achieving their explicitly stated health objectives for the year 2000. The courses were developed after the identification of the training needs in health departments and other public health settings. The training objectives were (a) to enhance the biostatistics skills of professionals involved in the analysis of health data; (b) to reinforce basic knowledge of epidemiologic methods and its practical applications in public health settings, including measures of disease frequency and association, epidemic outbreak investigations, and the identification and use of surveillance data; and (c) to demonstrate the application of the risk factor approach to select the interventions needed to reach health objectives for year 2000 and how to evaluate such interventions. A total of 43 students have taken this course series. Professional staff in health departments cannot always enroll in formal training in epidemiology and biostatistics because of time limitations or a lack of a bachelor''s degree. However, the need exists. An alternative to such training could be the short course program described in this paper.     

Evaluation of an intensive HIV/AIDS counselling course in Zimbabwe

The anticipated increase in the number of people with HIV infection and AIDS in Zimbabwe, together with those who have associated worries, will place extra demands upon clinical and counselling services in the coming decade. To meet these demands, a wide range of health care staff will have to acquire specialist counselling skills. For this reason, an intensive 2 day HIV/AIDS counselling training course was run at the Family Counselling Unit, Harare, in February 1989. The structure, content and evaluation of the course are presented here. Overall, the course was positively evaluated by the 38 trainees. However, a number of trainees were critical about some of the teaching methods and the degree of emphasis given to some of the objectives. Our experiences may help others in establishing HIV/AIDS counselling courses elsewhere.     

Building peace through participatory health training: A case from Cambodia

Abstract

This qualitative study examines the significance and effectiveness of participatory health training as a tool for peace building. It does so by analysing a case of training for ‘health promoters’ run by a Cambodian government health agency. The authors observed participants during the training and interviewed those involved in the courses. A developing capacity for coexistence and reconciliation between individuals who had been on opposite sides during the years of Khmer Rouge terror and continuous internal war was observed among both participants and trainers. Factors embodied in the training that facilitated favourable changes in self and in relations with others were identified as: (1) ‘space for dialogue’ was created by concrete common public health interests and urgent needs; (2) training took place ‘live-in’ style in a rural setting; (3) course contents and methods were consistent with peace education; (4) trainers had a conscious function as role models; and (5) there was continuity of effort and consequent accumulation of experience. To build peace, as well as conducting training directly on a technical topic, these essential factors need to be incorporated in the training programmes.     

Effectiveness of a training-of-trainers model in a HIV counseling and testing program in the Caribbean Region

Objectives  

To evaluate the effectiveness and sustainability of a voluntary counseling and testing (VCT) training program based on a training-of-trainers (TOT) model in the Caribbean Region, we gathered data on the percentage of participants trained as VCT providers who were providing VCT services, and those trained as VCT trainers who were conducting VCT training.     

Effectiveness of Preventive Therapy for Persons Exposed at Home to Drug-Resistant Tuberculosis,Karachi, Pakistan

In Karachi, Pakistan, a South Asian megacity with a high prevalence of tuberculosis (TB) and low HIV prevalence, we assessed the effectiveness of fluoroquinolone-based preventive therapy for drug-resistant (DR) TB exposure. During February 2016–March 2017, high-risk household contacts of DR TB patients began a 6-month course of preventive therapy with a fluoroquinolone-based, 2-drug regimen. We assessed effectiveness in this cohort by comparing the rate and risk for TB disease over 2 years to the rates and risks reported in the literature. Of 172 participants, TB occurred in 2 persons over 336 person-years of observation. TB disease incidence rate observed in the cohort was 6.0/1,000 person-years. The incidence rate ratio ranged from 0.29 (95% CI 0.04–1.3) to 0.50 (95% CI 0.06–2.8), with a pooled estimate of 0.35 (95% CI 0.14–0.87). Overall, fluoroquinolone-based preventive therapy for DR TB exposure reduced risk for TB disease by 65%.     

The neonatal resuscitation training project in rural South Africa

A paediatrician trainer from Australia (JT) spent 3 months in South Africa to assist with the development of neonatal resuscitation training in rural areas, particularly in district hospitals. The project was initiated by the Rural Health Unit at the University of the Witwatersrand and coordinated through the Family Medicine Education Consortium (FaMEC). The Rural Workforce Agency of Victoria together with General Practice and Primary Health Care Northern Territory covered the salary and international travel costs of the trainer, while local costs were funded by provincial departments of health, participants and a Belgian funded FaMEC project. The trainer developed an appropriate one-day skills training course in neonatal resuscitation (NNR), using the South African Paediatric Association Manual of Resuscitation of the Newborn as pre-reading, and a course to train trainers in neonatal resuscitation. From July to October 2004 he moved around the country running the neonatal resuscitation course, and, more importantly, training and accrediting trainers to run their own courses on an ongoing basis. The neonatal resuscitation course involved pre- and post-course multiple-choice question tests to assess knowledge and application, and, later, pre- and post-course skills tests to assess competence. A total of 415 people, including 215 nurses and 192 doctors, attended the neonatal resuscitation courses in 28 different sites in eight provinces. In addition, 97 trainers were trained, in nine sites. The participants rated the course highly. Pre- and post-course tests showed a high level of learning and improved confidence. The logistical arrangements, through the departments of family medicine, worked well, but the programme was very demanding of the trainer. Lessons and experiences were not shared between provinces, leading to repetition of some problems. A clear issue around the country was a lack of adequate equipment in hospitals for neonatal resuscitation, which needs to be addressed by health authorities. A process of ongoing training has been established, with provincial coordinators taking responsibility for standards and the roll-out of training. A formal evaluation of the project is planned. The project serves as a model for skills training in rural areas in South Africa, and for collaboration between organisations. A number of specific recommendations are made for the future of this NNR training project, which offer lessons for similar programmes.     

Ending neglect: providing effective childhood tuberculosis training for health care workers in Tanzania

Setting: Health care facilities in Dar es Salaam, Pwani, and Arusha, Tanzania.Objective: To assess health care worker (HCW) knowledge and practices 1 year after specialized training in childhood tuberculosis (TB).Design: Using a standardized survey, we interviewed a convenience sample of HCWs providing both general and specialized care to children.Results: We interviewed 117 HCWs in TB clinics, maternal and child health clinics, human immunodeficiency virus (HIV) clinics, out-patient departments, and pediatric in-patient wards at 12 facilities. A total of 81 HCWs (62% of nurses, 74% of clinicians) reported having attended the national childhood TB training course. Most HCWs responded correctly to questions on childhood TB diagnosis, treatment, and TB-HIV co-management, regardless of training history. Most HCWs reported that they routinely obtain chest radiographs, HIV testing, and a TB contact history when evaluating children for TB. Less than half of HCWs reported routinely obtaining sputum for mycobacterial culture or performing a tuberculin skin test. Three times as many trained as untrained HCWs reported having ever prescribed isoniazid preventive therapy (IPT) to a child (P < 0.05).Conclusion: In general, levels of childhood TB knowledge were high and practices were in accordance with national guidance. Specific gaps in diagnosis, treatment and use of IPT were identified for future focused training.     

Developing a competency-based curriculum in HIV for nursing schools in Haiti

Background

Preparing health workers to confront the HIV/AIDS epidemic is an urgent challenge in Haiti, where the HIV prevalence rate is 2.2% and approximately 10 100 people are taking antiretroviral treatment. There is a critical shortage of doctors in Haiti, leaving nurses as the primary care providers for much of the population. Haiti's approximately 1000 nurses play a leading role in HIV/AIDS prevention, care and treatment. However, nurses do not receive sufficient training at the pre-service level to carry out this important work.

Methods

To address this issue, the Ministry of Health and Population collaborated with the International Training and Education Center on HIV over a period of 12 months to create a competency-based HIV/AIDS curriculum to be integrated into the 4-year baccalaureate programme of the four national schools of nursing.

Results

Using a review of the international health and education literature on HIV/AIDS competencies and various models of curriculum development, a Haiti-based curriculum committee developed expected HIV/AIDS competencies for graduating nurses and then drafted related learning objectives. The committee then mapped these learning objectives to current courses in the nursing curriculum and created an 'HIV/AIDS Teaching Guide' for faculty on how to integrate and achieve these objectives within their current courses. The curriculum committee also created an 'HIV/AIDS Reference Manual' that detailed the relevant HIV/AIDS content that should be taught for each course.

Conclusion

All nursing students will now need to demonstrate competency in HIV/AIDS-related knowledge, skills and attitudes during periodic assessment with direct observation of the student performing authentic tasks. Faculty will have the responsibility of developing exercises to address the required objectives and creating assessment tools to demonstrate that their graduates have met the objectives. This activity brought different administrators, nurse leaders and faculty from four geographically dispersed nursing schools to collaborate on a shared goal using a process that could be easily replicated to integrate any new topic in a resource-constrained pre-service institution. It is hoped that this experience provided stakeholders with the experience, skills and motivation to strengthen other domains of the pre-service nursing curriculum, improve the synchronization of didactic and practical training and develop standardized, competency-based examinations for nursing licensure in Haiti.

     

Latent Tuberculosis among Persons at Risk for Infection with HIV, Tijuana, Mexico

Because there is little routine tuberculosis (TB) screening in Mexico, the prevalence of latent TB infection (LTBI) is unknown. In the context of an increasing HIV epidemic in Tijuana, Mexico, understanding prevalence of LTBI to anticipate emergence of increased LTBI reactivation is critical. Therefore, we recruited injection drug users, noninjection drug users, female sex workers, and homeless persons for a study involving risk assessment, rapid HIV testing, and TB screening. Of 503 participants, the overall prevalences of TB infection, HIV infection, and TB/HIV co-infection were 57%, 4.2%, and 2.2%, respectively; no significant differences by risk group (p>0.05) were observed. Two participants had TB (prevalence 398/100,000). Incarceration in Mexico (odds ratio [OR] 2.28), age (OR 1.03 per year), and years lived in Tijuana (OR 1.02 per year) were independently associated with TB infection (p<0.05). Frequent LTBI in marginalized persons may lead to increases in TB as HIV spreads.     

Enhancing Technology Skills of Maternal and Child Health Professionals

Objective: Information technology skills are essential for effective and efficient practice in maternal and child health (MCH). Methods: Prior to the beginning of a web-based analytic skills training course, enrolled MCH professionals confidence in using e-mail and other Internet skills and beliefs about their usefulness were assessed. Results: The assessment showed that participants believed strongly in the value of the specific technology skills but confidence in the ability to use these skills was low. Conclusion: An online technology skills training module was developed based on skills needed for the course to ensure that course participants learned and practiced the technology skills necessary to successfully complete the online analytic skills course. We describe the development, implementation, and results of the online technology skills module.All work for this paper was carried out at the University of North Carolina at Chapel Hill, School of Public Health, Department of Maternal and Child Health, Chapel Hill, North Carolina     

The effects of a practical diabetes prevention training course for public health care providers in Aichi Prefecture

PURPOSE: Lifestyle intervention for high-risk people is one of the most important issues for reduction of diabetic patients. Public health care providers should update their knowledge and enhance their educational skills. The purpose of this study was to evaluate the effects of a diabetes prevention training course for public health care providers in Aichi Prefecture. METHODS: This course included not only lectures about up-to-date knowledge about diabetes but also many practical aspects such as lifestyle assessment and coaching methods. The participants were made aware of an adequate diet by choosing foods in nutrition sessions, and they experienced walking and aerobic exercise with heart-rate monitors and pedometers in an exercise program. They also learned how to interview and provide health guidance to impaired glucose tolerance (IGT) people through role play. There were 373 participants from 90% of municipal health care centers in Aichi Prefecture. We made inquiries about the effectiveness of this practical training course immediately after the training period and 6-months later for all participants. In follow-up inquiries, we asked if the knowledge obtained in this training course had been useful and had improved their services. RESULTS: The aim and methods were well-accepted by more than 90% of participants. The follow-up examination (6 month later) showed improvement with reference to teaching methods (60%), evaluation of the diabetes prevention service (53%), cooperation with other facilities (48%) and survey on municipal health problems related to diabetes (48%). New methods, which they experienced in this course, were adopted in their own services in many municipalities. Many municipal health care centers started the diabetes individual health promotion program, because the health care providers got aware of importance of diabetes prevention by attending this training course. DISCUSSION: In order to make effective interventions, public health care providers should obtain up-to-date knowledge about diabetics and educational skills. Administrative organ can play important roles in diabetes prevention by training public health care providers and setting up a network between related facilities.     

Tuberculosis in the era of infection with the human immunodeficiency virus: assessment and comparison of community knowledge of both infections in rural Uganda

Background

In Uganda, despite a significant public health burden of tuberculosis (TB) in the context of high human immunodeficiency virus (HIV) prevalence, little is known about community knowledge of TB. The purpose of this study was to assess and compare knowledge about TB and HIV in the general population of western Uganda and to examine common knowledge gaps and misconceptions.

Methods

We implemented a multi-stage survey design to randomly survey 360 participants from one district in western Uganda. Weighted summary knowledge scores for TB and HIV were calculated and multiple linear regression (with knowledge score as the dependant variable) was used to determine significant predictors. Six focus group discussions were conducted to supplement survey findings.

Results

Mean (SD) HIV knowledge score was 58 (12) and TB knowledge score was 33 (15), both scores out of 100. The TB knowledge score was statistically significantly (p?<?0.001) lower. Multivariate regression models included age, sex, marital status, education, residence, and having a friend with HIV/TB as independent variables. TB knowledge was predicted by rural residence (coefficient?=??6.27, 95% CI: -11.7 to ?0.8), and age ≥45 years (coefficient?=?7.45, 95% CI: 0.3-14.6). HIV knowledge was only predicted by higher education (coefficient?=?0.94, 95%CI: 0.3-1.6). Focus group participants mentioned various beliefs in the aetiology of TB including sharing cups, alcohol consumption, smoking, air pollution, and HIV. Some respondents believed that TB was not curable.

Conclusion

TB knowledge is low and many misconceptions about TB exist: these should be targeted through health education programs. Both TB and HIV-infection knowledge gaps could be better addressed through an integrated health education program on both infections, whereby TB program managers include HIV information and vice versa.