An understanding of the socioeconomic and cultural realities of persons
infected with tuberculosis (TB) in communities is important to re-strategizing
control programs because these realities often come as constraints to the use
of the directly observed therapy short-course (DOTS) in Nigeria. In-depth
interviews and focus group discussion were used to study barriers to
attendance at DOTS clinics for both prompt diagnosis and treatment of
smear positive cases in Nigerian communities. A number of common and
interrelated factors form barriers to use of DOTS clinics. These include
perceived causes of the infection, for example witchcraft, that mitigate
against an orthodox solution to TB and thereby affect perceived efficacy
of DOTS. Another factor is perceived high cost in resource poor settings.