title: Tuberculosis knowledge, attitudes, and practices among northern Ethiopian prisoners: Implications for TB control efforts.
abstract: BACKGROUND
  Although awareness is an important component in tuberculosis (TB) control, we do not know how much Ethiopian prisoners know about TB. This study assessed the level of knowledge, attitudes, and practices (KAP) of prisoners about TB in eight northern Ethiopian prisons.
  
  
  METHODS
  Data were collected cross-sectionally from 615 prisoners using a standardized questionnaire between March and May 2016. The outcome variables were defined considering the basic elements about TB.
  
  
  RESULTS
  Out of 615 prisoners, only 37.7% mentioned bacteria as a cause of TB while 21.7% related TB to exposure to cold wind. Eighty-eight per cent correctly mentioned the aerial route of TB transmission and 27.3% had perceived stigma towards TB. The majority (63.7%) was not aware of the possibility of getting multi-drug-resistant strains when they would not adhere to treatment. Overall, only 24% knew the basic elements about TB, 41% had favorable attitudes, and 55% had a good practice. Prisoners who were urban residents were generally more knowledgeable than rural residents (adjusted OR = 2.16; 95% CI = 1.15-4.06). Illiterates were found to be less knowledgeable (adjusted OR = 0.17; 95% CI = 0.06-0.46), less likely to have a favorable attitude (adjusted OR = 0.31; 95% CI = 0.15-0.64), and less good practice (adjusted OR = 0.35; 95% CI = 0.18-0.69). Significant differences were also observed between the different study prisons.
  
  
  CONCLUSIONS
  Knowledge of prisoners regarding the cause of TB and consequences of non-adherence to TB treatment was low. Knowledge on the transmission, symptoms, and prevention was fairly high. Health education interventions, focused on the cause and the translation of the knowledge to appropriate practices, are needed in all the study prisons. Special attention should be given to less educated prisoners, and to prisons with a high number of prisoners and those in remote areas.
authors.affiliation: Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.|Maastricht University/CAPHRI School for Public Health and Primary Care, Department of Family Medicine, Maastricht, the Netherlands.
authors.forename: Kelemework
authors.initials: K
authors.lastname: Adane
authors.affiliation: Maastricht University/CAPHRI School for Public Health and Primary Care, Department of Family Medicine, Maastricht, the Netherlands.
authors.forename: Mark
authors.initials: M
authors.lastname: Spigt
authors.affiliation: Maastricht University, Faculty of Health, Medicine and Life Sciences, Maastricht, the Netherlands.
authors.forename: Laturnus
authors.initials: L
authors.lastname: Johanna
authors.affiliation: Maastricht University, Faculty of Health, Medicine and Life Sciences, Maastricht, the Netherlands.
authors.forename: Dorscheidt
authors.initials: D
authors.lastname: Noortje
authors.affiliation: Department of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
authors.forename: Semaw Ferede
authors.initials: SF
authors.lastname: Abera
authors.affiliation: Maastricht University/CAPHRI School for Public Health and Primary Care, Department of Family Medicine, Maastricht, the Netherlands.
authors.forename: Geert-Jan
authors.initials: GJ
authors.lastname: Dinant
mesh_terms: D044383:Black People; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011329:Prisoners; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology