Influence of tuberculosis knowledge on acceptance of preventive treatment and the moderating role of tuberculosis stigma among China’s general population: cross-sectional analysis
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SUBMITTER: Wang N
PROVIDER: S-EPMC11344443 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundWith the increasing enrollment scale of colleges, the number of students on campus has risen sharply in China. The number of students with tuberculosis (TB) and rifampicin-resistant TB in colleges has increased significantly. Preventive treatment of latent tuberculosis infection (LTBI) is an important means for TB prevention and control in colleges. At present, the acceptance of LTBI treatment among college students remains unclear. In addition, evidence shows stigma may be one of the key factors affecting acceptance of LTBI treatment. To date, there is little direct evidence on the gender-specific association between perceived stigma toward TB and acceptance of LTBI treatment among college students.ObjectiveThis study aimed to describe the acceptance of LTBI treatment among college students in an eastern province of China to explore the association between perceived stigma toward TB and acceptance of LTBI treatment and to examine the moderating effect of gender on the association.MethodsData were derived from the project on the evaluation of LTBI treatment and its effectiveness among college students in Shandong, China. In total, 1547 college students were included in the analysis. We considered covariates at the individual and family levels. Multilevel mixed-effects logistic regression was used to examine the moderating role of gender and also explore the association between perceived stigma toward TB and acceptance of LTBI treatment.ResultsThe acceptance rate of LTBI treatment among the diagnosed college students was 46.7% (n=723). The proportion of female students (n=361, 51.5%) accepting LTBI treatment was higher than that of male students (n=362, 42.8%; P=.001). There was an interaction between perceived stigma toward TB and gender (OR 0.93, 95% CI 0.87-1.00; P=.06). Among college students with LTBI, perceived stigma toward TB was positively associated with acceptance of preventive treatment (OR 1.03, 95% CI 1.00-1.08, P=.05). Perceived stigma toward TB was positively associated with accepting LTBI treatment only among male students (OR 1.07, 95% CI 1.02-1.12; P=.005).ConclusionsThe acceptance rate of preventive treatment among college students with LTBI was low. Contrary to our expectations, perceived stigma toward TB was positively associated with acceptance of preventive treatment. Gender moderated this association; high perceived stigma toward TB was associated with acceptance of preventive treatment only in male gender. Gender-specific strategies are effective in improving the acceptability of LTBI treatment in colleges.
| S-EPMC10337361 | biostudies-literature
Project description:BackgroundPublic awareness of monkeypox is critical in the fight against this infectious disease. However, at present a survey of the Chinese population on monkeypox is lacking. This study was conducted to compensate for the lack of knowledge and identify a vaccination intention assessment for monkeypox in China.MethodsThe questionnaire comprised 20 items with the following three aspects: basic information, knowledge, and willingness to vaccinate or pay. For this study, 521 valid respondents were recruited. Utilizing logistic regression, the researchers identified the factors related with knowledge and vaccination intentions.ResultsThe average total score for knowledge of monkeypox was 5.6 (score range 0-10), and 309 (59.3%) participants were categorized as having greater knowledge based on a total score of 6. Most participants (76.4%) were willing to accept a monkeypox vaccination. The average acceptable cost of the monkeypox vaccine was CNY261.2. Factors such as level of education, and working within the healthcare profession were related to monkeypox knowledge. An increased knowledge of monkeypox was related to a higher willingness to vaccinate. Participants who were willing to pay more for vaccines included those with high incomes, who suffered from chronic diseases, and healthcare workers.ConclusionsThe Chinese population had relatively high knowledge of monkeypox and demonstrated a willingness to receive the vaccine.
| S-EPMC9759477 | biostudies-literature
Project description:BackgroundMany governments encouraged generic use to enhance health equality and minimise health expenditure. The lack of knowledge and acceptance of generic medicines are the main barriers to their use.ObjectivesThis study aimed to assess population knowledge and perception towards generic drugs, identify their primary sources of information and examine which variables are independently related to their acceptance.DesignAn observational cross-sectional study was performed targeting the Lebanese adult population.MethodsOverall, 385 patients participated in the study. Data were collected using a uniform survey from six public healthcare centres.ResultsThe participants reported a distrust towards generic drugs; they either said that they were not as effective as the brand (36.9%), were of less quality than the brand (38.5%) or had more side effects than the brand (38.4%). Around 52% said they would never buy a generic drug, and two-thirds (68.6%) preferred using a brand drug over a generic one. After adjusting for socio-demographics, a high income (odds ratio (OR) = 3.7), knowing that brands and generics have the same active ingredients (OR = 2.28) and that brands and generics were equally effective (OR = 6.46) were the strongest independent predictors for the willingness to buy generic drugs.ConclusionA lack of knowledge and misperceptions about generic drugs limited the use of generic drugs, and therefore must be addressed.
| S-EPMC9850132 | biostudies-literature
Project description:BackgroundTuberculosis (TB) elimination requires treatment of millions of persons with latent M. tuberculosis infection (LTBI). LTBI treatment acceptance depends on population-wide TB knowledge and low stigma, but limited data are available on the relationship between stigma and knowledge. We assessed knowledge of TB disease and LTBI throughout Brazil and examined their association with TB stigma and incidence.MethodsWe performed a nationwide survey with multi-stage probability design through AmericasBarometer from April-May 2017; the sample was representative of Brazil at regional and national levels. Knowledge of and stigma toward TB were assessed by validated survey questions.ResultsSurvey-weighted responses of 1532 individuals suggest that 57% of the population knew LTBI can occur, and 90% would seek treatment for it. Regarding active TB, 85% knew TB symptoms, 70% reported they should avoid contact with someone with active TB, and 24% had stigma toward persons with TB (i.e., thought persons with tuberculosis should feel ashamed, or deserved their illness). In regression models adjusting for clinical and demographic variables, knowledge of LTBI was associated with increased stigma toward persons with TB (adjusted odds ratio [OR] = 2.13, 95% confidence interval [CI]: 1·25-3.63, for "should feel ashamed"; OR = 1·82, 95% CI: 1·15-2·89, for "deserve illness"). Adjusting for regional TB incidence did not affect this association.ConclusionsHigh proportions of this representative Brazilian population had knowledge of LTBI and were willing to seek treatment for it. However, such knowledge was associated with TB-specific stigma. Strategies to educate and implement treatment of latent tuberculosis must include efforts to decrease TB stigma.
| S-EPMC7285569 | biostudies-literature
Project description:Tuberculosis remains one of the major causes of morbidity and mortality in Equatorial Guinea, with an estimated incidence of 280 per 100,000 inhabitants, an estimated mortality rate of 96 per 100,000 inhabitants, and a treatment non-adherence rate of 21.4%. This study aimed to identify the factors associated to TB-related knowledge, attitudes, and stigma in order to design community intervention strategies that could improve TB diagnostic and treatment adherence in Equatorial Guinea. A nationwide cross-sectional survey of 770 household caregivers was conducted in Equatorial Guinea about TB knowledge, attitudes, and practices. Knowledge, attitude, and stigma scores were calculated through correct answers and the median was used as cut-off. Associated factors were analyzed calculating prevalence ratio (PR) and a 95% confidence interval (95% CI) through Poisson regression with robust variance. The percentage of women was 53.0% and median age was 46 years (IQR: 33–60). The percentage of caregivers with high TB related knowledge was 34.9%, with a bad attitude (52.5%) and low stigma (40.4%). A greater probability of having good knowledge was observed in those 45 years old or less (PR: 1.3, 95% CI: 1.1–1.6), those with higher education level (PR: 1.4, 95% CI: 1.1–1.8) and higher wealth (PR: 1.4, 95% CI: 1.0–2.0), while sex (PR = 0.8, 95% CI: 0.6–0.9), religion (PR = 1.4, 95% CI: 1.0–1.8), and good knowledge (PR = 1.4, 95% CI: 1.2–1.7) were associated with good attitudes. Wage employment (PR = 95% CI: 1.2–1.4), feeling well informed (PR = 0.7, 95% CI: 0.6–0.8), having good TB knowledge (PR = 1.3, 95% CI: 1.1–1.7), and some sources of information were associated with having lower TB-related stigma. This study found that a high percentage of caregivers in Equatorial Guinea lack important knowledge about TB disease and have bad attitudes and high TB-related stigma. Given the epidemiological situation of TB in the country, it is urgent to improve TB knowledge and awareness among Equatorial Guinea’s general population.
| S-EPMC9324553 | biostudies-literature
Project description:BackgroundEthiopia is ninth among the world high tuberculosis (TB) burden countries, pastoralists being the most affected population. However, there is no published report whether the behavior related to TB are different between pastoralist and the sedentary communities. Therefore, the main aim of this study is to assess the pastoralist community knowledge, attitude and perceived stigma towards tuberculosis and their health care seeking behavior in comparison to the neighboring sedentary communities and this may help to plan TB control interventions specifically for the pastoralist communities.MethodA community-based cross-sectional survey was carried out from September 2014 to January 2015, among 337 individuals from pastoralist and 247 from the sedentary community of Kereyu district. Data were collected using structured questionnaires. Three focus group discussions were used to collect qualitative data, one with men and the other with women in the pastoralist and one with men in the sedentary groups. Data were analyzed using Statistical Software for Social Science, SPSS V 22 and STATA.ResultsA Lower proportion of pastoralists mentioned bacilli (bacteria) as the cause of PTB compared to the sedentary group (63.9% vs. 81.0%, p<0.01), respectively. However, witchcraft was reported as the causes of TB by a higher proportion of pastoralists than the sedentary group (53.6% vs.23.5%, p<0.01), respectively. Similarly, a lower proportion of pastoralists indicated PTB is preventable compared to the sedentary group (95.8% vs. 99.6%, p<0.01), respectively. Moreover, majority of the pastoralists mentioned that most people would reject a TB patient in their community compared to the sedentary group (39.9% vs. 8.9%, p<0.001), respectively, and the pastoralists expressed that they would be ashamed/embarrassed if they had TB 68% vs.36.4%, p<0.001), respectively.ConclusionThe finding indicates that there is a lower awareness about TB, a negative attitude towards TB patients and a higher perceived stigma among pastoralists compared to their neighbor sedentary population. Strategic health communications pertinent to the pastoralists way of life should be planned and implemented to improve the awareness gap about tuberculosis.
| S-EPMC5513437 | biostudies-literature
Project description:BackgroundTuberculosis (TB) remains the prime killer disease among infectious diseases. TB control depends on early case detection and treatment in a directly observed treatment short course (DOTS) programme. The success of DOTS depends on the ability of the health care system to identify and properly manage TB cases. The present study aims to assess healthcare provider (HCP) knowledge, attitude and perceived stigma regarding TB and perception about traditional healers.MethodsA descriptive cross sectional study was conducted among 108 HCPs using a semi-structured, self-administered questionnaire from September 2014 to January 2015. The study district has a high TB burden area with one district hospital, 4 health centres, and 18 health posts. All health facilities and HCPs available during the study period in the district were included in the study. Statistical software for social science (SPSS) version 22 and STATA version 14 were used to enter and analyse data, respectively.ResultsThe majority (64%) of the HCPs had poor overall knowledge regarding TB, and 67.6 and 57.6% had poor knowledge regarding TB diagnosis and nature of the disease, respectively. Moreover, most 66.7 and 55.6% of the HCPs had an unfavourable attitude towards TB and TB control systems, respectively. Slightly under half (49.1%) of the HCPs had a favourable attitude towards TB patients, and the majority (88.9%) had low perceived stigma. The majority (87.0%) of the HCPs indicated the importance of community involvement in TB control activity. Moreover, most (60.2%) of the HCPs showed willingness to collaborate with traditional healers (THs) on TB control activity.ConclusionsHealthcare workers' knowledge gap and unfavourable attitude towards TB control systems reported in this study may cause poor TB care delivery. HCPs' perception of the importance of community involvement in TB control and willingness to collaborate with THs on TB management could be an opportunity to strengthen the World Health Organization's (WHO's) component of End TB strategy through community engagement. Training and workshops could be used to address the knowledge gap and the unfavourable attitude regarding TB among HCPs.
| S-EPMC6325851 | biostudies-literature
Project description:Tuberculosis remains a significant global health concern, especially for People Living with HIV, who are at an increased risk of severe TB disease. Despite the availability of TB Preventive Treatment, knowledge gaps persist among People Living with HIV regarding its importance, accessibility, and administration. The study aimed to assess TPT knowledge levels and determinants among People Living with HIV in Tanzania. A cross-sectional survey was conducted from April to May 2023 in 12 regions of mainland Tanzania. The study included PLHIV aged 18 years and above, receiving HIV care in selected Care and Treatment Centers. Data were collected through face-to-face interviews using a semi-structured questionnaire covering sociodemographic characteristics and Tuberculosis preventive treatment knowledge. Descriptive statistics, chi-square tests, and logistic regression analyses were employed for data analysis. Out of the 391 People Living with HIV interviewed, 71.4% demonstrated adequate Tuberculosis preventive treatment knowledge. Female participants, those attending urban health facilities, and individuals with longer durations of HIV care exhibited higher Tuberculosis preventive treatment knowledge levels. However, knowledge disparities persisted based on demographic characteristics such as gender and location of health facilities. While a considerable portion of People Living with HIV demonstrated adequate higher Tuberculosis preventive treatment knowledge, addressing gaps among those with lower understanding is crucial. Targeted education campaigns tailored to the needs of People Living with HIV, especially in rural areas and among male populations, are essential. Collaborative efforts between national health programs and community organizations are vital to integrate Tuberculosis preventive treatment awareness effectively into comprehensive HIV care programs, ultimately reducing the burden of Tuberculosis among People Living with HIV and the general population.
| S-EPMC11293724 | biostudies-literature
Project description:The outbreak of Coronavirus Disease 2019 (COVID-19) posed a powerful threat to human life. The preventive behaviors of individuals (e.g., home quarantine, disinfection, and wearing masks) play a key role in preserving and controlling the disease. In this case, as a motivational psychological system oriented toward avoiding infection, the behavioral immune system (BIS) may be activated and link to preventive behaviors. This study investigated the mechanisms through which emotional and cognitive processes resulted by BIS have promoted preventive behaviors in relation to COVID-19. We collected data on 22,005 active Sina Weibo users from 31 December 2019 to 8 February 2020 to measure their emotions (including disgust, happiness, and fear), cultural values (individualism and collectivism), moral concern (including purity vice, fairness vice, and authority virtue), and behavioral intentions (including isolation intention, protection intention, and aid intention) using Text Mind software and related dictionaries. Multiple regression and mediation analyses were performed to explore the relationships among variables. The results showed seven complete mediation paths (such as disgust-purity vice-protection intention). Each of these paths describes the effects of cognitive processes caused by BIS on preventive behaviors. We inferred that there may be path mechanisms such as disgust-cognitive processes-preventive behaviors. Using these results, policy makers can take appropriate measures to intervene in preventive behaviors (e.g., by posting disgusting images on social media to evoke disgust). The results can be used to explain differences in preventive behaviors among populations even in the face of similar thread levels. Furthermore, our research provides empirical evidence for the hypothesis of pathogen prevalence.
| S-EPMC7728355 | biostudies-literature
Project description:BackgroundTuberculosis preventive therapy (TPT) effectively reduces TB incidence among people living with HIV, but implementation remains suboptimal and data on community knowledge of TPT is needed. We sought to understand community members' knowledge of TB and TPT to facilitate implementation of TPT.MethodsIn rural Msinga, KwaZulu Natal, South Africa, a cross-sectional study was conducted at community events during an HIV and TB testing initiative. Participants ≥ 18 years old who were residents of Msinga were anonymously surveyed. We evaluated Knowledge of TB and TPT, generating separate scores for each domain. Descriptive statistics, chi-square testing, Kruskal-Wallis, linear regression, and exploratory factor analysis (EFA) were performed.ResultsAmong 104 respondents, median age was 32.5 years, 65% were female, and 23% completed secondary school. EFA identified two factors for TB knowledge: cultural beliefs of TB's origin and transmission and understanding TB as a disease. Overall, TB knowledge was poor (median 10, IQR 8-12.5). Over one-third (N = 39, 37.5%) were unaware of TPT. Those who had heard of TPT had good knowledge of TPT, with a median score of 4 (IQR 4-4) out of 4. Factors associated with higher TPT knowledge on multivariate linear regression included being motivated to stay healthy to care for one's family and knowing that TB can be avoided.ConclusionsRural South African community members demonstrated poor TB knowledge. Community members with good knowledge of TB were also aware of TPT. Greater community-level public health education and individual-level counseling efforts are needed to facilitate TPT expansion and implementation.
| S-EPMC11889810 | biostudies-literature