Knowledge, attitudes, and practices related to TB among the general population of Ethiopia: Findings from a national cross-sectional survey

Datiko, Daniel Gemechu; Habte, Dereje; Jerene, Degu; Suarez, Pedro

doi:10.1371/journal.pone.0224196

Cited by 52 publications

(93 citation statements)

References 44 publications

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“…We also conducted qualitative interviews to understand the reasons for delay. The details of the methods are described in a published paper on Knowledge Attitude and Practice about TB in Ethiopia in 2017 [39].…”

Section: Study Design and Samplingmentioning

confidence: 99%

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Patient and health system delay among TB patients in Ethiopia: Nationwide mixed method cross-sectional study

Datiko¹,

Jerene²,

Suarez

2020

BMC Public Health

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Background: Effective tuberculosis (TB) control is the end result of improved health seeking by the community and timely provision of quality TB services by the health system. Rapid expansion of health services to the peripheries has improved access to the community. However, high cost of seeking care, stigma related TB, low index of suspicion by health care workers and lack of patient centered care in health facilities contribute to delays in access to timely care that result in delay in seeking care and hence increase TB transmission, morbidity and mortality. We aimed to measure patient and health system delay among TB patients in Ethiopia. Methods: This is mixed method cross-sectional study conducted in seven regions and two city administrations. We used multistage cluster sampling to randomly select 40 health centers and interviewed 21 TB patients per health center. We also conducted qualitative interviews to understand the reasons for delay. Results: Of the total 844 TB patients enrolled, 57.8% were men. The mean (SD) age was 34 (SD + 13.8) years. 46.9% of the TB patients were the heads of household, 51.4% were married, 24.1% were farmers and 34.7% were illiterate. The median (IQR) patient, diagnostic and treatment initiation delays were 21 (10-45), 4 (2-10) and 2 (1-3) days respectively. The median (IQR) of total delay was 33 (19-67) days; 72.3% (595) of the patients started treatment after 21 days of the onset of the first symptom. Poverty, cost of seeking care, protracted diagnostic and treatment initiation, inadequate community based TB care and lack of awareness were associated with delay. Community health workers reported that lack of awareness and the expectation that symptoms would resolve by themselves were the main reasons for delay. Conclusion: TB patients' delay in seeking care remains a challenge due to limited community interventions, cost of seeking care, prolonged diagnostics and treatment initiation. Therefore, targeted community awareness creation, cost reduction strategies and improving diagnostic capacity are vital to reduce delay in seeking TB care in Ethiopia.

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Section: Study Design and Samplingmentioning

confidence: 99%

“…Was imported to Open Code software and analyzed using thematic content analysis technique. Direct verbatim and results from the coding and categorization were used to develop the narrative, triangulated and synthesized with the quantitative results [39,40].…”

Section: Qualitative Datamentioning

confidence: 99%

Patient and health system delay among TB patients in Ethiopia: Nationwide mixed method cross-sectional study

Datiko¹,

Jerene²,

Suarez

2020

BMC Public Health

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“…[25]. Studies from different settings have examined the predictors of self-reported correct knowledge about TB transmission and found that age [26] [27], gender [11] [26] [27] [28], education levels [26] [27][28] [29], household wealth [28], occupation [29], religion [11], exposure to mass media [11] [26] [30], geographical region [26] [27] [28], and perception that TB can be cured [11] were the most signi cant predictors. Understanding knowledge of TB in general and its determinants can inform policy developers and implementers of effective community based health promotion programs.…”

Section: Read Full Licensementioning

confidence: 99%

Determinants of Self-Reported Correct Knowledge About Tuberculosis Transmission Among Men and Women in Malawi: Evidence from a Nationwide Household Survey.

Ntenda

Mussa

Gowelo

et al. 2020

Preprint

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Background: Correct knowledge about transmission of tuberculosis (TB) can influence better health-seeking behaviors, and in turn, it can aid TB prevention in society. Therefore, this study aimed to examine the prevalence and predictors of self-reported correct knowledge about TB transmission among adults in Malawi.Methods: We conducted a secondary analysis of the data obtained from the Malawi Demographic and Health Survey, 2015/16 (MDHS 2015/16). Questions regarding self-reported TB transmission were computed to evaluate the correct knowledge about TB transmission. The factors associated with the correct knowledge about Tb were assessed using univariate and multivariable logistic regression.Results: Overall, the prevalence of correct knowledge about TB transmission in the general population of Malawian adults was 61.5%. Specifically, the prevalence of correct knowledge about TB transmission was 63.6% and 60.8% in men and women, respectively. Those aged 35–44 years, having secondary or high education, belonging to the richest household, being exposed to mass media, being in professional/technical/managerial, having knowledge that “TB can be cured’, and those living in urban areas were significantly associated with correct knowledge about TB transmission.Conclusions: The findings of this study show that if appropriate strategies for TB communication and education to address the rural masses, young individuals, poor individuals, and individuals in the agriculture sector are put it place, can enhance TB prevention in Malawi.

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“…Based on the analysis of seven consecutive years of PTB records, the zonal cumulative annual CNR of PTB cases was 58 per 100 000 population ranging from 47 in 2019 to 69 in 2014 per 100 000 population. The CNR of PTB cases varied across districts and kebele s. This might be related to low TCD performance due to poor community awareness level, lack of TB diagnostic services, geographic locations, and poor access to transportation facilities [ 7 – 9 , 29 , 30 ]. The current CNRs were found to be lower compared to CNRs reported from the Amhara region (107 per 100 000 people) [ 9 ], Gurage zone (91.7 per 100 000 people) [ 10 ] and Sidama zone (76 per 100 000 people) [ 8 ], Ethiopia.…”

Section: Discussionmentioning

confidence: 99%

“…The detected PTB clusters were stable over the reporting years. The clustered distribution of PTB cases indicated that there is a need to have targeted anti-TB measures including regular community awareness creation, availing TB diagnostic and treatment services, employing active TCD to prioritized areas, improving TB service quality and avoiding TB service delays [ 29 , 30 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Spatial-temporal clustering of notified pulmonary tuberculosis and its predictors in East Gojjam Zone, Northwest Ethiopia

2021

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Background Tuberculosis (TB) remains a key health menace in Ethiopia and its districts. This study aimed to assess the spatial-temporal clustering of notified pulmonary TB (PTB) cases in East Gojjam Zone, Northwest Ethiopia. Methods A retrospective study was conducted among all PTB cases reported from 2013–2019. Case notification rates (CNRs) of PTB cases at Kebele (the lowest administrative unit), woreda, and zone levels were estimated. The PTB clustering was done using global Moran’s I statistics on Arc GIS 10.6. We used Kulldorff SaTScan 9.6 with a discrete Poisson model to identify statistically significant spatial-temporal clustering of PTB cases at Kebele level. Similarly, a negative binomial regression analysis was used to identify factors associated with the incidence of PTB cases at kebele level. Results A total of 5340 (52%) smear-positive and 4928 (48%) smear-negative PTB cases were analyzed. The overall mean CNR of PTB cases at zone, woreda and Kebele levels were 58(47–69), 82(56–204), and 69(36–347) per 100,000 population, respectively. The purely spatial cluster analysis identified eight most likely clusters (one for overall and one per year for seven reporting years) and 47 secondary clusters. Similarly, the space-time scan analysis identified one most likely and seven secondary clusters. The purely temporal analysis also detected one most likely cluster from 2013–2015. Rural residence, distance from the nearest health facility, and poor TB service readiness were factors (p-value <0.05) to PTB incidence at kebele level. Conclusion The distribution of PTB cases was clustered. The PTB CNR was low and showed a decreasing trend during the reporting periods. Rural residence, distance from the health facilities, and poor facility readiness were factors of PTB incidence. Improving accessibility and readiness of health facilities mainly to rural and hotspot areas is vital to increase case detection and reduce TB transmission.

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Knowledge, attitudes, and practices related to TB among the general population of Ethiopia: Findings from a national cross-sectional survey

Cited by 52 publications

References 44 publications

Patient and health system delay among TB patients in Ethiopia: Nationwide mixed method cross-sectional study

Patient and health system delay among TB patients in Ethiopia: Nationwide mixed method cross-sectional study

Determinants of Self-Reported Correct Knowledge About Tuberculosis Transmission Among Men and Women in Malawi: Evidence from a Nationwide Household Survey.

Spatial-temporal clustering of notified pulmonary tuberculosis and its predictors in East Gojjam Zone, Northwest Ethiopia

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