If the pain is too much, you go to a hospital: a qualitative study on health-seeking behaviour for human brucellosis in Nakasongola cattle corridor, Uganda.

Abstract

Objective: Brucellosis ranks fourth among the top seven priority zoonotic diseases for control in Uganda. The effect of individual actions on controlling the spread of infectious diseases in humans and the choices people make regarding symptoms and suspicions must be given a critical role in the management of zoonotic diseases. Understanding the experiences that shape response to brucellosis is crucial if we are to effectively control the spread of brucellosis in the human population. This study aimed to explore people's experiences and health-seeking behaviour for human brucellosis and elucidate any challenges as perceived by the affected population. This study involved exploring the facilitating factors for seeking healthcare from the perspectives of the affected population and the potential barriers in accessing health services in Nakasongola.

Design: Descriptive qualitative study.

Setting: The study was conducted in the cattle corridor of Nakasongola District within three sub-counties of Nabiswera, Wabinyonyi and Nakitoma, which were purposively selected because of the large herd number (150 cattle per square km and 30-50 cattle per household), high prevalence of brucellosis in humans, thus extensive human-animal interaction, and the community's susceptibility to brucellosis. Data were collected from November 2023 to January 2024.

Participants: Semi-structured, face-to-face interviews were conducted by the first author with 15 participants for in-depth interviews, who included the people who were recovering/had recovered and their caretakers, and 20 key informants including medical personnel, village health team members and social leaders who were purposively selected.

Analysis: Thematic analysis was conducted to group themes originating in the data into higher-order themes using inductive and deductive approaches.

Results: Key themes were identified in line with literature and the healthcare systems model. The findings highlighted a series of factors that influence and inhibit health-seeking behaviour for human brucellosis. Participants identified the role of sex and religion as some of the social factors, barriers to health information and perceptions of healthcare quality, accessibility and availability of treatment. These insights show the importance of understanding broader social norms and health system constraints to improve timely diagnosis, treatment adherence and overall disease control.

Conclusion: Addressing the factors identified requires a diverse approach that includes improving the quality of health services, promoting health education, challenging societal norms around gender and illness and leveraging the role of religious communities in health promotion. Such efforts could ultimately improve health outcomes in the affected community.