Kaumba Paul Chabala, Siameka Daniel, Kagujje Mary, Chungu Chalilwe, Nyangu Sarah, Sanjase Nsala, Maimbolwa Minyoi Mubita, Shuma Brian, Chilukutu Lophina, Muyoyeta Monde
Centre of Infectious Disease Research in Zambia (CIDRZ), Mass Media, Lusaka, Zambia.
Catholic Relief Services, Ibex, Lusaka.
PLoS One. 2024 Mar 11;19(3):e0287876. doi: 10.1371/journal.pone.0287876. eCollection 2024.
Zambia is among the 30 high-burden countries for tuberculosis (TB), Human Immunodeficiency Virus (HIV)-associated TB, and multi-drug resistant/rifampicin resistant TB with over 5000 children developing TB every year. However, at least 32% of the estimated children remain undiagnosed. We assessed healthcare workers' (HCWs) knowledge, attitudes, and practices (KAP) towards childhood TB and the factors associated with good KAP towards childhood TB.
Data was collected at two primary healthcare facilities in Lusaka, Zambia from July to August 2020. Structured questionnaires were administered to HCWs that were selected through stratified random sampling. Descriptive analysis was done to determine KAP. A maximum knowledge, attitude, and practice scores for a participant were 44, 10, and 8 points respectively. The categorization as either "poor" or "good" KAP was determined based on the mean/ median. Logistic regression analysis was performed to assess the associations between participant characteristics and KAP at statistically significant level of 0.05%.
Among the 237 respondents, majority were under 30 years old (63.7%) and were female (72.6%). Half of the participants (50.6%) were from the outpatient department (OPD) and antiretroviral therapy (ART) clinic, 109 (46.0) had been working at the facility for less than 1 year, 134 (56.5%) reported no previous training in TB. The median/mean KAP scores were 28 (IQR 24.0-31.0), 7 (IQR = 6.0-8.0) and 5 points (SD = 1.9) respectively. Of the participants, 43.5% (103/237) had good knowledge, 48.1% (114/237) had a good attitude, and 54.4% (129/237) had good practice scores on childhood TB. In the multivariate analysis, clinical officers and individuals with 1-5 years' work experience at the facility had higher odds, 2.61 (95% CI = 1.18-5.80, p = 0.018) and 3.09 (95% CI = 1.69-5.65, p = 0.001) of having good attitude respectively, and medical doctors had 0.17 lower odds (95% CI = 0.18-5.80, p = 0.018) of good childhood TB practice. Other participant characteristics didn't show a significant association with the scores.
The study found suboptimal levels of knowledge, attitude, and practices regarding childhood TB among HCWs. Targeted programmatic support needs to be provided to address the above gaps.
赞比亚是结核病、人类免疫缺陷病毒（HIV）相关结核病以及耐多药/耐利福平结核病的30个高负担国家之一，每年有超过5000名儿童患结核病。然而，估计至少32%的儿童仍未被诊断出来。我们评估了医护人员（HCWs）对儿童结核病的知识、态度和实践（KAP）以及与良好的儿童结核病KAP相关的因素。
2020年7月至8月在赞比亚卢萨卡的两个初级卫生保健机构收集数据。通过分层随机抽样选择医护人员，并向他们发放结构化问卷。进行描述性分析以确定KAP。参与者的知识、态度和实践的最高得分分别为44分、10分和8分。根据均值/中位数确定KAP为“差”或“好”的分类。进行逻辑回归分析，以评估参与者特征与KAP之间在0.05%的统计学显著水平上的关联。
在237名受访者中，大多数年龄在30岁以下（63.7%），女性占72.6%。一半的参与者（50.6%）来自门诊部（OPD）和抗逆转录病毒治疗（ART）诊所，109名（46.0%）在该机构工作不到1年，134名（56.5%）报告以前没有接受过结核病培训。KAP得分的中位数/均值分别为28分（四分位间距24.0 - 31.0）、7分（四分位间距 = 6.0 - 8.0）和5分（标准差 = 1.9）。在参与者中？43.5%（103/237）有良好的知识，48.1%（114/237）有良好的态度，54.4%（129/237）在儿童结核病实践方面有良好的得分。在多变量分析中，临床干事和在该机构有1 - 5年工作经验的个人分别有更高的几率，即2.61（95%置信区间 = 1.18 - 5.80，p = 0.018）和3.09（95%置信区间 = 1.69 - 5.65，p = 0.001）有良好的态度，而医生在儿童结核病良好实践方面的几率低0.17（95%置信区间 = 0.18 - 5.80，p = 0.018）。其他参与者特征与得分没有显著关联。
该研究发现医护人员对儿童结核病的知识、态度和实践水平欠佳。需要提供有针对性的项目支持来弥补上述差距。
