Wongchana Thanyarat, Songthap Archin
Department of Community Health, Faculty of Public Health, Naresuan University, 99 Village 9, Thapho Subdistrict, Muang District, Phitsanulok, 65000, Phitsanulok Province, Thailand.
BMC Infect Dis. 2024 Dec 18;24(1):1429. doi: 10.1186/s12879-024-10327-x.
Pulmonary tuberculosis can spread by airborne transmission when an infected person coughs, sneezes and speaks via expectorates. Therefore, household contacts who are close to a tuberculosis patient are at the highest risk of contracting the disease. This analytical cross-sectional study aimed to determine the factors affecting prevention behaviors among household contacts in Phitsanulok Province, northern Thailand.
The study sample included 193 household contacts with pulmonary tuberculosis in Phitsanulok Province. They were randomly selected using a multistage sampling technique. Data were collected by a self-administered questionnaire consisting of 8 parts: (1) sociodemographic characteristics, (2) tuberculosis knowledge, (3) perceived susceptibility of tuberculosis infection, (4) perceived severity of tuberculosis, (5) perceived self-efficacy of tuberculosis prevention, (6) perceived outcome of tuberculosis prevention, (7) social support of tuberculosis prevention, and (8) tuberculosis prevention behaviors. Frequencies, percentages, means, standard deviations, and multiple regression analysis were explored for data analysis.
Most participants (91.2%) had tuberculosis prevention behaviors at a high level (scores of 4.35). Factors that significantly affected tuberculosis prevention behaviors included perceived self-efficacy in tuberculosis prevention (β = 0.474), social support (β = 0.220), current smoker (β = -0.171), driving to the hospital (β = 0.150), unknown history of tuberculosis vaccination (BCG) (β = -0.122), and those who were older siblings, aunts, uncles, younger siblings, or nephews of participants (β = -0.116). These 6 factors explained 38.5% of tuberculosis prevention behaviors.
Household contacts to pulmonary tuberculosis should be educated about the perceived self-efficacy of tuberculosis prevention, and receive more social support to prevent the disease. The focus should be on current smokers, those who drive to the hospital, those who do not know the history of tuberculosis vaccination, and relatives of patients (older sibling, aunt, uncle, younger sibling, nephew) to reduce the risk of pulmonary tuberculosis in the future.
肺结核患者咳嗽、打喷嚏及说话时通过飞沫经空气传播。因此，与肺结核患者密切接触的家庭成员感染该病的风险最高。本分析性横断面研究旨在确定影响泰国北部彭世洛府家庭接触者预防行为的因素。
研究样本包括彭世洛府193名肺结核家庭接触者。采用多阶段抽样技术随机选取。通过一份由8部分组成的自填式问卷收集数据：（1）社会人口学特征，（2）结核病知识，（3）结核病感染易感性认知，（4）结核病严重性认知，（5）结核病预防自我效能感认知，（6）结核病预防结果认知，（7）结核病预防社会支持，（8）结核病预防行为。采用频数、百分比、均值、标准差及多元回归分析进行数据分析。
大多数参与者（91.2%）的结核病预防行为处于高水平（得分4.35）。显著影响结核病预防行为的因素包括结核病预防自我效能感（β = 0.474）、社会支持（β = 0.220）、当前吸烟者（β = -0.171）、开车去医院（β = 0.150）、卡介苗（BCG）接种史不明（β = -0.122）以及参与者的哥哥姐姐、姑姑姑父、叔叔婶婶、弟弟妹妹或侄子侄女（β = -0.116）。这6个因素解释了38.5%的结核病预防行为。
应向肺结核家庭接触者宣传结核病预防自我效能感，并给予更多社会支持以预防该病。重点应放在当前吸烟者、开车去医院的人、不了解卡介苗接种史的人以及患者亲属（哥哥姐姐、姑姑姑父、叔叔婶婶、弟弟妹妹、侄子侄女）身上，以降低未来患肺结核的风险。
