title: Knowledge and attitude of key community members towards tuberculosis: mixed method study from BRAC TB control areas in Bangladesh.
abstract: BACKGROUND
  Bangladesh National Tuberculosis (TB) Control Programme adopted a number of strategies to facilitate TB diagnosis and treatment. 'Advocacy, Communication and Social Mobilization' (ACSM) was one of the key strategies implemented by BRAC (Bangladesh Rural Advancement Committee, a non-governmental development organization) TB control program. The purpose of this study is to assess the knowledge and attitudes of the key community members (KCMs) participated in ACSM in BRAC TB control areas.
  
  
  METHODS
  This study combined quantitative and qualitative methods using a mixed method approach. KCMs in three districts with low TB case detection rates were targeted to assess the ACSM program. The quantitative survey using a multi-stage random-sampling strategy was conducted among 432 participants. The qualitative study included in-depth interviews (IDIs) of a sub sample of 48 respondents. For quantitative analysis, descriptive statistics were reported using frequencies, percentages, and Chi square tests, while thematic analysis was used for qualitative part.
  
  
  RESULTS
  Most (99%) of the participants had heard about TB, and almost all knew that TB is a contagious yet curable disease. More than half (53%) of the KCMs had good knowledge regarding TB, but BRAC workers were found to be more knowledgeable compared to other KCMs. However, considerable knowledge gaps were observed among BRAC community health workers. Qualitative results revealed that the majority of the KCMs were aware about the signs, symptoms and transmission pathways of TB and believed that smoking and addiction were the prime causes of transmission of TB. The knowledge about child TB was poor even among BRAC health workers. Stigma associated with TB was not uncommon. Almost all respondents expressed that young girls diagnosed with TB.
  
  
  CONCLUSIONS
  This study finding has revealed varying levels of knowledge and mixed attitudes about TB among the KCMs. It also provides insight on the poor knowledge regarding child TB and indicate that despite the significant success of the TB program stigma is yet prevalent in the community. Future ACSM activities should engage community members against stigma and promote child TB related information for further improvement of BRAC TB Control Programme.
authors: James P Grant School of Public Health, BRAC Institute of Global Health, BRAC University, 68 Mohakhali, Dhaka, 1212, Bangladesh. sukanta@bracu.ac.bd.
authors: Sukanta
authors: S
authors: Paul
authors: James P Grant School of Public Health, BRAC Institute of Global Health, BRAC University, 68 Mohakhali, Dhaka, 1212, Bangladesh. rahima@bracu.ac.bd.
authors: Rahima
authors: R
authors: Akter
authors: James P Grant School of Public Health, BRAC Institute of Global Health, BRAC University, 68 Mohakhali, Dhaka, 1212, Bangladesh. aafzal@bracu.ac.bd.
authors: Afzal
authors: A
authors: Aftab
authors: James P Grant School of Public Health, BRAC Institute of Global Health, BRAC University, 68 Mohakhali, Dhaka, 1212, Bangladesh. drantora@yahoo.com.
authors: Antora M
authors: AM
authors: Khan
authors: James P Grant School of Public Health, BRAC Institute of Global Health, BRAC University, 68 Mohakhali, Dhaka, 1212, Bangladesh. mrittika@bracu.ac.bd.
authors: Mrittika
authors: M
authors: Barua
authors: Health Nutrition and Population Programme, BRAC, 75 Mohakhali, Dhaka, 1212, Bangladesh. shayla.i@brac.net.
authors: Shayla
authors: S
authors: Islam
authors: Health Nutrition and Population Programme, BRAC, 75 Mohakhali, Dhaka, 1212, Bangladesh. akramul.mi@brac.net.
authors: Akramul
authors: A
authors: Islam
authors: National Tuberculosis Control Program, Directorate General of Health Services, Mohakhali, Dhaka, 1212, Bangladesh. ashek.dr@gmail.com.
authors: Ashaque
authors: A
authors: Husain
authors: James P Grant School of Public Health, BRAC Institute of Global Health, BRAC University, 68 Mohakhali, Dhaka, 1212, Bangladesh. malabika@bracu.ac.bd.
authors: Malabika
authors: M
authors: Sarker
mesh_terms: D000328:Adult; D001459:Bangladesh; D003150:Community Health Workers / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015397:Program Evaluation / Q000706:statistics & numerical data*; D036301:Qualitative Research; D012424:Rural Population / Q000706:statistics & numerical data*; D014376:Tuberculosis / Q000517:prevention & control / Q000523:psychology*
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