Disciplining sexual and reproductive behaviour of tuberculosis patients in Bangladesh: a mixed method study exploring divergent messages

Figures & data

Table 1. Socio-demographic information of patients with tuberculosis

Characteristic	Frequency (percentage) (n = 116)
Type of patient
Current	57 (60%)
Cured	59 (40%)
Type of TB
Pulmonary	86 (74%)
Extra-pulmonary	26 (22%)
Missing	4 (4%)
Sex
Female	67 (58%)
Male	49 (42%)
Age
16–25	39 (34%)
26–35	41 (35%)
36–45	26 (22%)
46 and above	10 (9%)
Educational level
Never went to school	38 (33%)
Primary (until grade 5)	37 (32%)
Secondary (grade 6–10)	27 (23%)
Secondary school certificate and above	11 (9%)
Missing	3 (3%)
Marital status
Married	107 (92%)
Separated	4 (3%)
Widow/widower	5 (5%)
Occupation
Day labourer	6 (5%)
Rickshaw/van driver	3 (3%)
Employee (shopkeeper/companies)	18 (16%)
Shop owner	13 (11%)
Driver (car/bus/truck)	2 (2%)
Farmer/fishermen	5 (4%)
Housewife	50 (43%)
Student	2 (2%)
Other	11 (9%)
Unemployed	6 (5%)
Family income (BDT - 1000BDT = US$11.8)
≤5000	9 (8%)
>5000–≤10,000	31 (27%)
>10,000–≤20,000	41 (35%)
>20,000–30,000	10 (9%)
Above 30,000	6 (5%)
Missing	19 (16%)

Table 2. Frequency of terms related to SRH appearing in policy documents

Term	NGOMTC^a	NGTIC^b	GPOTCP^c	GOSTCP^d	Total n (%)
Pregnancy/ pregnant	2	1	4	5	12 (48%)
Contraception/ contraceptive	1	0	5	0	6 (24%)
Breastfeeding	2	0	3	0	5 (20%)
Reproductive/ reproduction	0	0	0	1	1 (4%)
Infertility	1	0	0	0	1 (4%)
Sexual	0	0	0	0	0 (0%)
Intercourse	0	0	0	0	0 (0%)
Abstinence	0	0	0	0	0 (0%)
Total	6	1	12	6	25 (100%)

^a National Guidelines and Operational Manual for Tuberculosis Control.

^b National Guidelines for Tuberculosis Infection Control.

^c Guidelines for Programme Organisers of the Tuberculosis Control Programme.

^d Guidelines for Orientation Seminars of the Tuberculosis Control Programme.

Table 3. Instructions mentioned in the guidelines and given by health workers

	Guidelines	Health workers
Pregnancy	A woman should be asked if she is pregnant. If she is, she must not take streptomycin injection. She should be treated according to “CAT II” treatment regimen	No pregnancy
Contraceptive use	Women on pills either should take a pill of higher dosage or use a different contraceptive method	[To women] Use condom to prevent pregnancy
Breastfeeding	Mother should wear a mask when breastfeeding. Her child should be administered a prophylaxis	Wear a mask when breastfeeding
Sexual intercourse	Not addressed	Full abstinence
		Partial abstinence
		[To women and men] Have sex with condom
		[To women by shebika] Have sex with head turned away or by covering mouth
		[To women by program officials] Do not use any contraceptive method. Your husband should also not use any method. Conceiving during treatment is dangerous
		[To men by program official] Keep distance from your wife
Sleeping arrangement	Not addressed	[Program officials only to smear-positive] do not share bed
		[Shebikas] If sleeping alone is not possible, sleep with your back to the person next to you
		Sleep together but use mask
		[EPTB] You can share bed
Eating arrangement	Not addressed	[All except EPTB] Do not share plate and/or glass
Interaction with household members	Wear mask	Wear mask
	People with DR-tuberculosis must be isolated in separate room	[All] Keep distance from your household members
	People with DR-tuberculosis must not interact with children aged under 5	[All] Keep children away. Do not kiss them
	Visitors to the household of DR-tuberculosis patients must be restricted	Not mentioned
Coughing/sneezing	Cough/sneeze etiquette: Cover nose and mouth with hands, arm (sleeve), tissue, cloth, saree, orna or face mask when coughing and sneezing* When coughing and sneezing, turn head away from others. Use the nearest bin to dispose of the tissue, cloth after use Spit in a cloth or a container with lid Perform hand hygiene (e.g.) wash hands with soap and water, antiseptic hand wash after having contact with respiratory secretions	Cover mouth when coughing/sneezing. Turn away from others when doing so
Sputum disposal	Dispose of sputum, saliva in a pot and bury underground or burn it*	Dispose of sputum, saliva in a pot and bury underground or burn it
Personal hygiene	Clothes worn and bed sheets and pillows used by patients must be clean at all times and sometimes should be put out in the sun	Keep clothes clean. Wash clothes daily with hot water and soap
		Don’t let others wear your clothes
Others	Patient must not smoke	[To men] Quit smoking
	Patient must not take any tobacco*	[All] Do not eat betel leaves
	No restrictions on any food is needed*	Eat nutritious food. Avoid food that can cause allergic reaction in body

*BRAC guideline for program organisers contain this information only.

Data availability

The data that support the findings of this study are available on request from the corresponding author, [MB]. The data are not publicly available due to sensitive nature of the data that could compromise the privacy of research participants.