School of Public Health, Ningxia Medical University, Yinchuan, 750001, China.
Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, No. 1160 Shengli Street, Xingqing District, Yinchuan, Ningxia, 750001, China.
BMC Health Serv Res. 2024 Aug 20;24(1):948. doi: 10.1186/s12913-024-11336-x.
Tuberculosis (TB) remains a serious global public health problem in China. The right knowledge, attitude, and practice (KAP) towards TB are indispensable to appropriate healthcare-seeking behaviors and treatment services timely. However, there are few studies that addressed the KAP towards TB in high-risk and under-developing regions in China. This study aims to evaluate the KAP towards TB in Ningxia Northwest, China, and identify factors that influence it. The findings can guide future health education and promotion interventions.
A stratified multistage random sampling method was used to conduct a face-to-face questionnaire survey with 33 items for selected residents. The composite score of Knowledge, Attitudes, and Practices (KAP) was divided into two groups, which are poor (scores below the average) and good (scores above the average). A two-level logistic model with a random intercept equation accounted for the similarity of residents within communities to examine the association between individual-level KAP and demographic and socioeconomic factors.
A total of 2,341 residents were recruited, the mean age was 50, and 41.2% were female. The percentages of residents who were total awareness of TB knowledge and had positive attitudes and behavior toward TB were 51.9%, 75.3%, and 76.2%, respectively. The two-level logistic model demonstrated that residents with a high annual family income, urban living, primary school education or higher, occupation of teacher or doctor, a very good self-perceived status, medical insurance, knowing DOTS, and family members or friends with TB history had better knowledge of TB (P < 0.05). Residents living in urban areas, with junior and senior high school education, a very good self-perceived status, health insurance, knowing DOTS, and family members or friends with TB history had positive attitude of TB (P < 0.05). Residents living in urban areas, a primary school education or higher, occupation of teacher, doctor and workers, a very good self-perceived status, medical insurance, knowing DOTS, and family members or friends with TB history had positive practice of TB (P < 0.05).
Favorable demographic (higher education levels, teachers or doctors) and socioeconomic (high income, living in urban area) factors are associated to better knowledge, attitudes and practices toward TB in Northwest China. Interventions to improve KAP at the community level are required to speed up the TB reduction rate, which may benefit to ensure the End TB Strategy will be achieved.
结核病（TB）仍然是中国一个严重的全球公共卫生问题。对结核病的正确知识、态度和实践（KAP）对于及时寻求适当的医疗保健和治疗服务是必不可少的。然而，在中国的高风险和欠发达地区，很少有研究涉及结核病的 KAP。本研究旨在评估中国宁夏西北地区的结核病 KAP，并确定影响其的因素。研究结果可以为未来的健康教育和促进干预措施提供指导。
采用分层多阶段随机抽样方法，对选定的居民进行了 33 项面对面的问卷调查。知识、态度和实践（KAP）的综合评分分为两组，即差（评分低于平均值）和优（评分高于平均值）。采用两级逻辑模型和随机截距方程，考虑居民在社区内的相似性，以检验个体 KAP 与人口统计学和社会经济因素之间的关系。
共招募了 2341 名居民，平均年龄为 50 岁，41.2%为女性。对结核病知识有全面认识、对结核病持积极态度和行为的居民比例分别为 51.9%、75.3%和 76.2%。两级逻辑模型表明，家庭年收入高、居住在城市、小学及以上学历、职业为教师或医生、自我感觉状态良好、有医疗保险、了解直接督导下的短程化疗（DOTS）、有结核病家族史的居民对结核病的认识更好（P<0.05）。居住在城市、初中及以上学历、自我感觉状态良好、有医疗保险、了解 DOTS、有结核病家族史的居民对结核病的态度更积极（P<0.05）。居住在城市、接受过小学及以上教育、职业为教师、医生和工人、自我感觉状态良好、有医疗保险、了解 DOTS、有结核病家族史的居民对结核病的实践更积极（P<0.05）。
有利的人口统计学（较高的教育水平、教师或医生）和社会经济因素（高收入、居住在城市地区）与中国西北地区对结核病的知识、态度和实践较好有关。需要在社区层面进行改善 KAP 的干预措施，以加快结核病减少速度，这可能有助于确保实现终止结核病战略。
