Kigozi N Gladys, Heunis J Christo, Engelbrecht Michelle C, Janse van Rensburg André P, van Rensburg H C J Dingie
Centre for Health Systems Research & Development, University of the Free State, P.O. Box 399, Bloemfontein, 9300, South Africa.
BMC Public Health. 2017 Oct 10;17(1):795. doi: 10.1186/s12889-017-4825-3.
Health education is important to empower patients and encourage their contribution towards tuberculosis (TB) control. In South Africa, health education activities are integrated into services provided at the primary health care (PHC) level. This study was conducted in a high TB burden metropolitan area in South Africa. The objective was to assess TB-related knowledge, attitudes and infection control practices of patients attending PHC facilities.
In September and October 2015, a cross-sectional survey using fieldworker-administered questionnaires was conducted among patients older than 17 years attending 40 PHC facilities in the Mangaung Metropolitan. Convenience sampling was used to select patients. Participation in the study was voluntary. Descriptive, inferential and multivariate logistic regression analyses were performed. Statistical significance was considered at alpha <0.05 and 95% confidence interval.
A total of 507 patients' data were included in the analysis. Most of the patients knew that TB transmission is facilitated by crowded conditions (84.6%) and that pulmonary TB is contagious (73.0%). Surprisingly, the majority of patients also believed that one can get TB from sharing toothbrushes (85.0%) or kissing (65.0%). An overwhelming majority of patients perceived TB to be serious (89.7%), and concurred that taking treatment (97.2%) and opening windows to prevent transmission in PHC facilities (97.0%) are important. Being employed (AOR: 11.5; CI: 4.8-27.6), having received TB infection control information from a PHC facility (AOR: 2.2; CI: 1.5-3.4), and being a TB patient (AOR: 1.6; CI: 1.02-2.46) increased the likelihood of adopting good infection control practices.
These findings highlight the need for health education efforts to strengthen accurate information dissemination to promote sound TB knowledge and attitudes among patients attending PHC facilities. Health education efforts should also capitalise on the positive finding of this study that information dissemination at PHC facilities increases good infection control practices.
健康教育对于增强患者能力并鼓励他们为结核病控制做出贡献至关重要。在南非，健康教育活动被纳入初级卫生保健（PHC）层面提供的服务中。本研究在南非一个结核病负担较重的大都市地区开展。目的是评估在初级卫生保健机构就诊患者的结核病相关知识、态度及感染控制措施。
2015年9月和10月，在曼加昂大都市的40家初级卫生保健机构中，对17岁以上的就诊患者进行了一项由现场工作人员管理问卷的横断面调查。采用便利抽样法选择患者。参与研究是自愿的。进行了描述性、推断性和多变量逻辑回归分析。统计学显著性以α<0.05和95%置信区间来考量。
共有507例患者的数据纳入分析。大多数患者知道拥挤环境会促进结核病传播（84.6%）以及肺结核具有传染性（73.0%）。令人惊讶的是，大多数患者还认为共用牙刷（85.0%）或亲吻（65.0%）会感染结核病。绝大多数患者认为结核病很严重（89.7%），并认同接受治疗（97.2%）以及在初级卫生保健机构开窗以防止传播（97.0%）很重要。就业（比值比：11.5；可信区间：4.8 - 27.6）、从初级卫生保健机构获得结核病感染控制信息（比值比：2.2；可信区间：1.5 - 3.4）以及是结核病患者（比值比：1.6；可信区间：1.02 - 2.46）会增加采取良好感染控制措施的可能性。
这些发现凸显了开展健康教育工作以加强准确信息传播的必要性，从而在初级卫生保健机构就诊患者中促进正确的结核病知识和态度。健康教育工作还应利用本研究的积极发现，即初级卫生保健机构的信息传播可增加良好的感染控制措施。
