Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
McGill International TB Centre, Montreal, Quebec, Canada.
PLoS One. 2018 Oct 30;13(10):e0206245. doi: 10.1371/journal.pone.0206245. eCollection 2018.
Improving patients' tuberculosis (TB) knowledge is a salient component of TB control strategies. Patient knowledge of TB may encourage infection prevention behaviors and improve treatment adherence. The purpose of this study is to examine how TB knowledge and infection prevention behaviors change over the course of treatment.
A matched patient-health worker dataset (n = 6,031) of publicly treated TB patients with NGO-provided treatment support health workers was compiled in nine Indian cities from March 2013 to September 2014. At the beginning and end of TB treatment, patients were asked about their knowledge of TB symptoms, transmission, and treatment and infection prevention behaviors.
Patients beginning TB treatment (n = 3,424) demonstrated moderate knowledge of TB; 52.5% (50.8%, 54.2%) knew that cough was a symptom of TB and 67.2% (65.6%, 68.7%) knew that TB was communicable. Overall patient knowledge was significantly associated with literacy, education, and income, and was higher at the end of treatment than at the beginning (3.7%, CI: 3.02%, 4.47%). Infection prevention behaviors like covering a cough (63.4%, CI: 61.2%, 65.0%) and sleeping separately (19.3%, CI: 18.0%, 20.7%) were less prevalent. The age difference between patient and health worker as well as a shared language significantly predicted patient knowledge and adherence to infection prevention behaviors.
Social proximity between health worker and patients predicted greater knowledge and adherence to infection prevention behaviors but the latter rate remains undesirably low.
提高患者的结核病（TB）知识是结核病控制策略的一个重要组成部分。患者对结核病的了解可能会鼓励他们采取感染预防措施并提高治疗依从性。本研究旨在探讨在治疗过程中TB 知识和感染预防行为如何变化。
在 2013 年 3 月至 2014 年 9 月期间，在印度九个城市，从非政府组织提供治疗支持的卫生工作者那里，收集了一组与公开治疗的结核病患者相匹配的患者-卫生工作者数据集（n = 6031）。在结核病治疗的开始和结束时，患者被问及他们对结核病症状、传播和治疗以及感染预防行为的了解。
开始结核病治疗的患者（n = 3424）对结核病有中等程度的了解；52.5%（50.8%，54.2%）知道咳嗽是结核病的症状，67.2%（65.6%，68.7%）知道结核病具有传染性。总体而言，患者的知识与读写能力、教育程度和收入密切相关，并且在治疗结束时比开始时更高（3.7%，CI：3.02%，4.47%）。咳嗽时捂住嘴（63.4%，CI：61.2%，65.0%）和分开睡觉（19.3%，CI：18.0%，20.7%）等感染预防行为则不太普遍。患者和卫生工作者之间的年龄差异以及共同的语言显著预测了患者的知识和对感染预防行为的遵守。
卫生工作者与患者之间的社会接近度预测了更高的知识和对感染预防行为的遵守，但后者的比率仍然不理想。
