title: Factors associated with poor knowledge among adults on tuberculosis in Bangladesh: results from a nationwide survey.
abstract: BACKGROUND
  In 2012, Bangladesh continues to be one of the 22 high tuberculosis (TB) burden countries in the world. Although free diagnosis and management for TB is available throughout the country, case notification rate/100,000 population for new smear positive (NSP) cases under the national TB control programme (NTP) remained at around 70/100,000 population and have not changed much since 2006. Knowledge on TB disease, treatment and its management could be an important predictor for utilization of TB services and influence case detection under the NTP. Our objective is to describe knowledge of TB among newly diagnosed TB cases and community controls to assess factors associated with poor knowledge in order to identify programmatic implications for control measures.
  
  
  METHODS
  Embedded in TB prevalence survey 2007-2009, we included 240 TB cases from the TB registers and 240 persons ≥ 15 years of age randomly selected from the households where the survey was implemented. All participants were interviewed using a structured, pre-tested questionnaire to evaluate their TB knowledge. Regression analyses were done to assess associations with poor knowledge of TB.
  
  
  RESULTS
  Our survey documented that overall there was fair knowledge in all domains investigated. However, based on the number of correct answers to the questionnaires, community controls showed significantly poorer knowledge than the TB cases in the domains of TB transmission (80% vs. 88%), mode of transmission (67% vs. 82%), knowing ≥ 1 suggestive symptoms including cough (78% vs. 89%), curability of TB (90% vs. 98%) and availability of free treatment (75% vs. 95%). Community controls were more likely to have poor knowledge of TB issues compared to the TB cases even after controlling for other factors such as education and occupation in a multivariate model (OR 3.46, 95% CI: 2.00-6.09).
  
  
  CONCLUSIONS
  Knowledge on various aspects of TB and TB services varies significantly between TB cases and community controls in Bangladesh. The overall higher levels of knowledge in TB cases could identify them as peer educators in ongoing communication approaches to improve care seeking behavior of the TB suspects in the community and hence case detection.
authors.affiliation: Centre for Equity and Health Systems (CEHS), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, 1212, Bangladesh. shahed@icddrb.org.
authors.forename: Shahed
authors.initials: S
authors.lastname: Hossain
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, 1212, Bangladesh.
authors.forename: Khalequ
authors.initials: K
authors.lastname: Zaman
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, 1212, Bangladesh.
authors.forename: Abdul
authors.initials: A
authors.lastname: Quaiyum
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, 1212, Bangladesh.
authors.forename: Sayera
authors.initials: S
authors.lastname: Banu
authors.affiliation: National TB Control Programme (NTP), DGHS, Dhaka, Bangladesh.
authors.forename: Ashaque
authors.initials: A
authors.lastname: Husain
authors.affiliation: Health Programme, BRAC, Dhaka, Bangladesh.
authors.forename: Akramul
authors.initials: A
authors.lastname: Islam
authors.affiliation: Department of Clinical Epidemiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.|Centre for Infection and Immunity Amsterdam, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.|Public Health Service, Amsterdam, The Netherlands.
authors.forename: Martien
authors.initials: M
authors.lastname: Borgdorff
authors.affiliation: Department of Global health, Academic Medical Centre, Amsterdam Institute for Global Health and Development, University of Amsterdam, Amsterdam, The Netherlands.|KNCV Tuberculosis Foundation, The Hague, The Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: van Leth
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000191:economics / Q000627:therapeutic use; D001459:Bangladesh / Q000453:epidemiology; D016022:Case-Control Studies; D003153:Community Health Services / Q000191:economics; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005191:Family Characteristics; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000191:economics; D006306:Health Surveys; D006801:Humans; D008297:Male; D008483:Medical Assistance / Q000191:economics; D008875:Middle Aged; D015995:Prevalence; D012042:Registries; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents
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