Knowledge, attitude and practice towards tuberculosis in Gambia: a nation-wide cross-sectional survey
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RESEARCH ARTICLE
Open Access
Knowledge, attitude and practice towards tuberculosis in Gambia: a nation-wide cross-sectional survey Adedapo Olufemi Bashorun1* , Christopher Linda1†, Semeeh Omoleke1†, Lindsay Kendall1, Simon D. Donkor1, Ma-Ansu Kinteh1, Baba Danso1, Lamin Leigh1, Sheriff Kandeh1, Umberto D’Alessandro1 and Ifedayo Morayo O. Adetifa1,2
Abstract Background: Early diagnosis and treatment of tuberculosis (TB) are the mainstay of global and national TB control efforts. However, the gap between expected and reported cases persists for various reasons attributable to the TB services and care-seeking sides of the TB care cascade. Understanding individual and collective perspectives of knowledge, attitudes, beliefs and other social circumstances around TB can inform an evidence-based approach in engaging communities and enhance their participation in TB case detection and treatment. Methods: The study was conducted during the Gambian survey of TB prevalence. This was a nationwide crosssectional multistage cluster survey with 43,100 participants aged ≥15 years in 80 clusters. The study sample, a random selection of 10% of the survey population within each cluster responded to a semi-structured questionnaire administered by trained fieldworkers to assess the knowledge, attitudes and practice of the participants towards TB. Overall knowledge, attitude and practice scores were dichotomised using the computed mean scores and analysed using descriptive, univariable and multivariable logistic regression. Results: All targeted participants (4309) were interviewed. Majority were females 2553 (59.2%), married 2614 (60.7%), had some form of education 2457 (57%), and were unemployed 2368 (55%). Although 3617 (83.9%) of the participants had heard about TB, only 2883 (66.9%) were considered to have good knowledge of TB. Overall 3320 (77%) had unfavourable attitudes towards TB, including 1896 (44%) who indicated a preference for staying away from persons with TB rather than helping them. However, 3607(83.7%) appeared to have the appropriate healthseeking behaviours with regard to TB as 4157 (96.5%) of them were willing to go to the health facility if they had symptoms suggestive of TB. Conclusions: About 3 in 10 Gambians had poor knowledge on TB, and significant stigma towards TB and persons with TB persists. Interventions to improve TB knowledge and address stigma are required as part of efforts to reduce the burden of undiagnosed TB in the country. Keywords: Tuberculosis, Knowledge, Attitude, Practice, Stigma, Prevalence survey, Africa
* Correspondence: [email protected] † Christopher Linda and Semeeh Omoleke contributed equally to this work. 1 Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O. Box 273, Banjul, The Gambia Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, shar
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