Prevalence of self-reported tuberculosis, knowledge and determinants of tuberculosis transmission in India: a national cross sectional household survey

Abstract

Background: Knowledge about Tuberculosis (TB) symptoms and transmission determines health seeking behavior and prevent TB transmission in the community. Such data helps policy makers improve Information, Education and Communication (IEC) about TB. Methods: A secondary data analysis of India Demographic and Health Survey, 2005-06 was carried out. A representative sample of households was selected through a stratified, multistage cluster sampling strategy and trained interviewers administered the survey local languages. Questions about TB asked during the survey were used for this analysis. These include self-reported TB, modes of transmission of TB, and cure for TB. Correct knowledge without misconception about TB transmission was used as dependant variable to assess the determinants of correct knowledge. Explanatory variables were demographic data, education, wealth quintiles, frequency of exposure to media and curability of TB. Univariate andmultivariate analysis was carried out using weighting factor to adjust for complex sampling design. Results: A total 109,070 households (response rate 93.5%) and 198,718 participants (response rate 91.6%) completed the survey. Sample of men and women interviewed was 74, 360 and 124, 358 respectively. Prevalence rate of self-reported TB was 445 per 100,000 usual household residents and 4.60 per 1000 participants. Number of respondents who had “heard of an illness called Tuberculosis was 177, 423 (89.3%). Of these 47,487 (26.8%) did not know and55.5% knewabout correctmode of TB transmission i.e. ‘through the air when coughing or sneezing’. Commonmisconceptionswere TB transmission through food (32.4%), sharing utensils (18.2%), touching a person with TB (12.3%). Only 52, 617 (29.7%) participants had correct knowledge without misconceptions. Being male (OR 1.17, 95% CIs 1.14, 1.21), being a Hindu (OR 1.20, 95% CIs 1.14, 1.26) or Muslim (OR 1.26, 95% CIs 1.18, 1.34), listening to radio (OR, 1.08 95% CIs 1.04, 1.13) and ‘TB can be cured’ (OR 1.47, 95% CIs 1.41, 1.53) were associated with correct knowledge without misconceptions. Conclusion: Though a majority had heard about TB, correct knowledge about TB transmission was poor and misconceptions prevailed. Among traditional mass media only listening to radio was associatedwith knowledge about TB transmission. IECdelivery strategies need improvement.