Knowledge, attitudes and practices on tuberculosis infection prevention and associated factors among rural and urban adults in northeast Tanzania: A cross-sectional study.

Method Kazaura,Switbert Rwechungura Kamazima,Sanghyuk Shin

doi:10.1371/journal.pgph.0000104

Method Kazaura, Switbert Rwechungura Kamazima + Show 1 more

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https://doi.org/10.1371/journal.pgph.0000104

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Abstract

Almost 10 million of the global population was infected with tuberculosis (TB) in 2017. Tanzania is among countries with high incidence of TB. Although control measures of TB are multi factorial, it is important to understand the individual's knowledge, attitudes and practices (KAP) in order to control TB infection. We conducted a cross-sectional study in northeast Tanzania; recruited and interviewed 1519 adults from two districts, one rural and another urban. We scored each participant using several questions for each construct of KAP. A study participant scoring at least 60% of the possible maximum scores was considered as having a good knowledge, positive attitude or good practices. And herein, a participant having positive TB attitude would mean they acknowledge TB exist, recognizes its impact on health and would seek or advise TB-infected individuals to seek the correct remedies. We applied multiple linear regression analysis to assess independent individual-level factors related to TB on KAP scores in the rural and urban populations. Overall, less than half (44%) of the study participants had good overall knowledge about TB infection and significantly more urban than rural adult population had good overall knowledge (p<0.001). Almost one in ten, (11%) of all study participants had positive attitudes towards TB infection. More urban study participants, (16%) had positive attitudes than their rural counterparts, 6%). Almost nine in ten (89%) of all study participants had good practices towards TB prevention and control; significantly more adults in urban, (97%) than the rural populations (56%) (p<0.01). Predictors of KAP scores were individual's education and main source of income. Adults in rural and urban northeast Tanzania have poor knowledge, attitudes and practices for TB infection and prevention. Strategies focusing on health education are important for control of TB, especially among rural communities.

Highlights

Human tuberculosis (TB) is a chronic infectious disease mainly caused by a family of organisms known as Mycobacterium tuberculosis
726 (47.8%) of all study participants reported business being their main source of income
The majority, 349 (46.0%) of study participants from rural areas reported peasantry and livestock keeping being their main sources of income

Summary

Introduction

Human tuberculosis (TB) is a chronic infectious disease mainly caused by a family of organisms known as Mycobacterium tuberculosis. In view of the fact that HIV-infected people are more likely to develop TB [3,4], there are more TB cases in less developed countries where the burden of HIV&AIDS is high [5,6]. Tanzania is among sub-Saharan countries with high burden of TB [8]. In 2011, the World Health Organization (WHO) estimated the prevalence of TB infection in Tanzania to be 0.2% with a more recent estimate of 295 per 100,000 adult populations [10,11,12]. A higher burden is seen in children, whereby in 2016 almost 14% of children under the age of 15 years from Central and Eastern Tanzania were detected as having TB infection [13]. Data from some subSahara African countries suggest higher burden of TB in urban than from the rural settings [14]

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