ASSESSMENT OF FRONTLINE HEALTH WORKERS KNOWLEDGE AND ATTITUDE TOWARDS TUBERCULOSIS SCREENING IN OYO STATE

Abstract

Background: A good knowledge of Tuberculosis (TB) and favourable attitudinal disposition of frontline health workers (FLHWs) would be required to improve TB diagnosis, treatment, and prevention and to reach global eradication targets. This study aims to assess the level of knowledge and attitudinal disposition of frontline health workers towards Tuberculosis screening and case finding in Oyo State, Nigeria. Methods: A cross-sectional study was conducted among FLHWs in Oyo State, Nigeria. Respondents were randomly selected, health workers at DOTS and ART units were excluded from the study. A sample size of 102 was calculated based on results of previous study (Global Fund, 2018). A confidence interval of 95% and absolute precision of 0.05 were used. Eighteen (18) Local Government Areas (LGAs) out of 33 in the State were randomly selected and 5 FLHWs meeting the inclusion criteria across 5 health facilities were selected at each LGA. The study was approved by the Babcock university health research ethical committee (BUHREC). Signed consents were also obtained from the respondents. A semi-structured questionnaire comprising of 43 questions covering socio-demographic information (13), knowledge (15) and attitude (15) of the respondents. It was developed based on WHO Advocacy, communication and social mobilization for TB control: A guide to developing knowledge, attitude and practice surveys instrument(World Health Organization, 2008). Data was analyzed using Statistical Package for Social Sciences (SPSS), version 20. Results were presented in percentages and proportions. The association between knowledge and attitude was tested using chi-square. Significance was considered at a p-value < 0.05. Results Socio-demographic data shows that 71% (71/100) of the respondents were aged 40 years and above, 88% (88/100) were females and the CHOs were the most prominent cadre- 64% (64/100). Total knowledge score ranged from 7 to 13 with an average total knowledge score of 10.7 (SD 1.4) with only 34% (34/100) having good knowledge of Tuberculosis. Attitudinal scores ranged from 5 to 13, mean attitudinal score was 8.59 (SD 2.225). Only 11 percent (11/100) of the respondents had a good attitude towards TB screening, a larger proportion (80%) had fair attitude while 9% had poor attitude. Chi-Square test of association shows a significant relationship between knowledge and attitude X2 (2, N=100) = 9.992, p = .007, effect size was however low 0.25. Conclusion: Knowledge and attitudinal disposition of frontline health workers to TB and TB screening in Oyo State is sub-optimal. Further studies might be needed to examine the effect of structured training towards improving health workers attitude towards TB services including screening.