Hossain Shahed, Zaman Khalequ, Quaiyum Abdul, Banu Sayera, Husain Ashaque, Islam Akramul, Borgdorff Martien, van Leth Frank
Centre for Equity and Health Systems (CEHS), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, 1212, Bangladesh.
International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, 1212, Bangladesh.
J Health Popul Nutr. 2015 May 1;34:2. doi: 10.1186/s41043-015-0002-4.
In 2012, Bangladesh continues to be one of the 22 high tuberculosis (TB) burden countries in the world. Although free diagnosis and management for TB is available throughout the country, case notification rate/100,000 population for new smear positive (NSP) cases under the national TB control programme (NTP) remained at around 70/100,000 population and have not changed much since 2006. Knowledge on TB disease, treatment and its management could be an important predictor for utilization of TB services and influence case detection under the NTP. Our objective is to describe knowledge of TB among newly diagnosed TB cases and community controls to assess factors associated with poor knowledge in order to identify programmatic implications for control measures.
Embedded in TB prevalence survey 2007-2009, we included 240 TB cases from the TB registers and 240 persons ≥ 15 years of age randomly selected from the households where the survey was implemented. All participants were interviewed using a structured, pre-tested questionnaire to evaluate their TB knowledge. Regression analyses were done to assess associations with poor knowledge of TB.
Our survey documented that overall there was fair knowledge in all domains investigated. However, based on the number of correct answers to the questionnaires, community controls showed significantly poorer knowledge than the TB cases in the domains of TB transmission (80% vs. 88%), mode of transmission (67% vs. 82%), knowing ≥ 1 suggestive symptoms including cough (78% vs. 89%), curability of TB (90% vs. 98%) and availability of free treatment (75% vs. 95%). Community controls were more likely to have poor knowledge of TB issues compared to the TB cases even after controlling for other factors such as education and occupation in a multivariate model (OR 3.46, 95% CI: 2.00-6.09).
Knowledge on various aspects of TB and TB services varies significantly between TB cases and community controls in Bangladesh. The overall higher levels of knowledge in TB cases could identify them as peer educators in ongoing communication approaches to improve care seeking behavior of the TB suspects in the community and hence case detection.
2012年，孟加拉国仍是全球22个结核病高负担国家之一。尽管该国各地均可提供免费的结核病诊断和治疗服务，但在国家结核病控制规划（NTP）下，新涂片阳性（NSP）病例的病例通报率/每10万人口仍维持在约70/10万人口左右，自2006年以来变化不大。关于结核病疾病、治疗及其管理的知识可能是利用结核病服务的重要预测因素，并影响国家结核病控制规划下的病例发现。我们的目标是描述新诊断结核病病例和社区对照人群对结核病的了解情况，评估与知识匮乏相关的因素，以便确定控制措施的规划意义。
在2007 - 2009年结核病患病率调查中，我们纳入了结核病登记册中的240例结核病病例以及从开展调查的家庭中随机选取的240名年龄≥15岁的人员。所有参与者均使用经过预测试的结构化问卷进行访谈，以评估他们对结核病的了解情况。进行回归分析以评估与结核病知识匮乏的关联。
我们的调查表明，在所调查的所有领域总体知识水平尚可。然而，根据问卷正确答案数量，社区对照人群在结核病传播（分别为80%和88%）、传播方式（分别为67%和82%）、知晓≥1种包括咳嗽在内的提示症状（分别为78%和89%）、结核病可治愈性（分别为90%和98%）以及免费治疗可获得性（分别为75%和95%）等领域的知识明显不如结核病病例。即使在多变量模型中控制了教育和职业等其他因素后，与结核病病例相比，社区对照人群更有可能对结核病问题了解不足（比值比3.46，95%置信区间：2.00 - 6.09）。
在孟加拉国，结核病病例和社区对照人群在结核病及结核病服务各方面的知识存在显著差异。结核病病例总体较高的知识水平可使其成为正在进行的沟通方法中的同伴教育者，以改善社区中结核病疑似患者的就医行为，从而提高病例发现率。
