Craciun Oana Marilena, Torres Malen Del Rosario, Llanes Agustín Benito, Romay-Barja María
National Centre of Tropical Medicine, Institute of Health Carlos III, Madrid, Spain.
Andrés Isola Hospital, Puerto Madryn, Chubut, Argentina.
J Trop Med. 2023 Jun 24;2023:1014666. doi: 10.1155/2023/1014666. eCollection 2023.
Tuberculosis (TB) is the leading cause of death from an infectious agent in the world. Most tuberculosis cases are concentrated in low- and middle-income countries. The aim of this study is to better understand tuberculosis-related knowledge about TB disease, prevention, treatment and sources of information, attitudes towards TB patients and their stigmatization and prevention, diagnosis and treatment practices in the general population of middle- and low-income countries, with a high tuberculosis burden, and provide evidence for policy development and decision-making. A systematic review of 30 studies was performed. Studies reporting on knowledge, attitudes, and practices surveys were selected for systematic review through database searching. Population knowledge about TB signs and symptoms, prevention practices, and treatment means was found inadequate. Stigmatization is frequent, and the reactions to possible diagnoses are negative. Access to health services is limited due to difficulties in transportation, distance, and economic cost. Deficiencies in knowledge and TB health-seeking practices were present regardless of the living area, gender, or country; however, it seems that there is a frequent association between less knowledge about TB and a lower socioeconomic and educational level. This study revealed gaps in knowledge, attitude, and practices in focused in middle- and low-income countries. Policymakers could take into account the evidence provided by the KAP surveys and adapt their strategies based on the identified gaps, promoting innovative approaches and empowering the communities as key stakeholders. It is necessary to develop education programs on symptoms, preventive practices, and treatment for TB, to reduce transmission and stigmatization. It becomes also necessary to provide communities with innovative healthcare solutions to reduce their barriers to access to diagnosis and treatment.
结核病是全球因感染性病原体导致死亡的首要原因。大多数结核病病例集中在低收入和中等收入国家。本研究的目的是更好地了解结核病负担较高的低收入和中等收入国家普通人群中与结核病相关的疾病、预防、治疗及信息来源知识，对结核病患者的态度及其污名化与预防，以及诊断和治疗实践，为政策制定和决策提供依据。对30项研究进行了系统综述。通过数据库检索，选择报告知识、态度和实践调查的研究进行系统综述。发现人群对结核病症状、预防措施和治疗方法的了解不足。污名化现象频繁发生，对可能诊断的反应是负面的。由于交通、距离和经济成本方面的困难，获得卫生服务的机会有限。无论居住地区、性别或国家如何，知识和结核病就医行为都存在不足；然而，似乎对结核病了解较少与较低的社会经济和教育水平之间经常存在关联。本研究揭示了低收入和中等收入国家在知识、态度和实践方面的差距。政策制定者可以考虑知识、态度和实践调查提供的证据，并根据已确定的差距调整战略，推广创新方法并赋予社区作为关键利益相关者的权力。有必要开展关于结核病症状、预防措施和治疗的教育项目，以减少传播和污名化。还必须为社区提供创新的医疗保健解决方案，以减少其获得诊断和治疗的障碍。
