Assessing the knowledge, attitude, and practice measures against tuberculosis in patients in ambulatory department facilities in Pakistan: a cross-sectional analysis

Submitted: December 1, 2022
Accepted: March 22, 2023
Published: April 12, 2023
Abstract Views: 1207
PDF: 261
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Tuberculosis (TB), at present, is the leading infectious etiology of death globally. In Pakistan, there are approximately 510,000 new cases annually, with more than 15,000 of them developing into drug-resistant TB, making the nation the fifth-leading country in TB prevalence in the world. Due to the ongoing COVID-19 pandemic, the focus has drifted away from TB screening, diagnostic and health awareness campaigns, and therapeutic measures endangering knowledge, attitude, and practices (KAP) towards TB in our population. We conducted a cross-sectional descriptive study in Pakistan to assess the KAP of Pakistani residents attending the adult outpatient departments of public hospitals for any health-related concerns. Our sample size was 856 participants, with a median age of 22 years. Occupation-wise, those who were employed had better knowledge of TB than those who were unemployed [odds ratio (OR): 1.011; 95% confidence interval (CI): 1.005-1.8005]. No differences were observed in TB knowledge between those adherents to common preventive practices versus those not adherent (OR: 0.875; 95% CI: 0.757-1.403). More than 90% of participants agreed that TB is dangerous for the community, and the majority opted against stigmatizing TB patients (79.1%). People who could read and write were 3.5 times more likely to have a good attitude towards TB compared to those who could not (OR: 3.596; 95% CI: 1.821-70.230; p=0.037). Similarly, employed subjects had better attitudes compared to unemployed ones (OR: 1.125; 95% CI: 0.498-1.852; p=0.024) and those with better knowledge of TB had a better attitude grade (OR: 1.749; 95% CI: 0.832-12.350; p=0.020). Age, occupation, and educational status were statistically significant among the two groups (p=0.038, p=0.023, p=0.000). Literate subjects had three times better practice towards TB than illiterate subjects (OR: 3.081; 95% CI: 1.869-4.164; p=0.000). Future education and awareness programs should target specific groups, such as the unemployed and illiterate, with practice-focused approaches. Our study outcomes can enable the concerned officials and authorities to take appropriate evidence-based steps to direct the efforts efficiently to curtail the burden of TB in Pakistan and to limit its progression, which could potentially lead our nation to become a multi drug-resistant TB endemic territory.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

National Institute of Allergy and Infectious Diseases. Tuberculosis. Available from: https://www.niaid.nih.gov/diseases-conditions/tuberculosis. Accessed on: 17/07/2022.
Mayo Clinic. Tuberculosis. Available from: https://www.mayoclinic.org/diseases-conditions/tuberculosis/symptoms-causes/syc-20351250. Accessed on: 17/07/2022.
World Health Organization. Tuberculosis. Available from: https://www.who.int/news-room/fact-sheets/detail/tuberculosis. Accessed: 17/07/2022.
Metzger P, Baloch NA, Kazi GN, Bile KM. Tuberculosis control in Pakistan: reviewing a decade of success and challenges. EMHJ 2010;6:S47-253.
World Health Organization Regional Office for the Eastern Mediterranean. Tuberculosis. Available from: http://www.emro.who.int/pak/programmes/stop-tuberculosis.html. Accessed on: 18/07/2022.
Codlin AJ, Khowaja S, Chen Z, et al. Gender differences in tuberculosis notification in Pakistan. Am J Trop Med Hyg 2011;85:514-7.
Millet JP, Moreno A, Fina L, et al. Factors that influence current tuberculosis epidemiology. Eur Spine J 2013;22:539-48.
TB Alert. TB and poverty. Available from: https://www.tbalert.org/about-tb/global-tb-challenges/tb-poverty/. Accessed: 19/07/2022.
Malik AA, Hussain H, Maniar R, et al. Integrated tuberculosis and COVID-19 activities in Karachi and tuberculosis case notifications. Trop Med Infect Dis 2022;7;12.
Fatima R, Akhtar N, Yaqoob A, et al. Building better tuberculosis control systems in a post-COVID world: learning from Pakistan during the COVID-19 pandemic. Int J Infect Dis 2021;113: S88-S90.
Datiko DG, Habte D, Jerene D, Suarez P. Knowledge, attitudes, and practices related to TB among the general population of Ethiopia: findings from a national cross-sectional survey. PLoS One 2019;14:e0224196.
Essar MY, Rezayee KJ, Ahmad S, et al. Knowledge, attitude, and practices toward tuberculosis among hospital outpatients in Kabul, Afghanistan. Front Public Health 2022;10:933005.
Launiala A, Honkasalo ML. Ethnographic study of factors influencing compliance to intermittent preventive treatment of malaria during pregnancy among Yao women in rural Malawi. Trans R Soc Trop Med Hyg 2007;101:980-9.
Kasa AS, Minibel A, Bantie GM. Knowledge, attitude and preventive practice towards tuberculosis among clients visiting public health facilities. BMC Res Notes 2019;12:276.
Bashorun AO, Linda C, Omoleke S, et al. Knowledge, attitude and practice towards tuberculosis in Gambia: a nation-wide cross-sectional survey. BMC Public Health 2020;20:1566.
Tolossa D, Medhin G, Legesse M. Community knowledge, attitude, and practices towards tuberculosis in Shinile town, Somali regional state, eastern Ethiopia: a cross-sectional study. BMC Public Health 2014;14:804.
Angelo AT, Geltore TE, Asega T. Knowledge, attitude, and practices towards tuberculosis among clients visiting Tepi general hospital outpatient departments, 2019. Infect Drug Resist 2020;13:4559-68.
Khan A, Shaikh BT, Baig MA. Knowledge, awareness, and health-seeking behaviour regarding tuberculosis in a rural district of Khyber Pakhtunkhwa, Pakistan. Biomed Res Int 2020;2020:1850541.

Ethics Approval

The study protocol was approved by the Ethical Review Committee of the Punjab Medical College. The Microbiology Department of the Faisalabad Medical University Research Committee provided ethical approval.

How to Cite

Ahmad, Shoaib, Uzzam Ahmed Khawaja, Syed Meeran Haider, Wafaa Binti Mowlabaccus, Anmol Mohan, Asad Ansari, Muhammad Ahmad, Tulika Garg, Hafsa Ahmed, Shkaib Ahmad, Mohammad Yasir Essar, Javier Perez-Fernandez, and George D. Yatzkan. 2023. “Assessing the Knowledge, Attitude, and Practice Measures Against Tuberculosis in Patients in Ambulatory Department Facilities in Pakistan: A Cross-Sectional Analysis”. Monaldi Archives for Chest Disease 94 (1). https://doi.org/10.4081/monaldi.2023.2500.