Knowledge, Attitude and Practice on Tuberculosis among Health Workers in Tribal Community
Authors: Chakma Anirban , Sultana Rebeca , Islam MD Ziaul , Chakraborty Shovon , hossain irin 
Published: February 2025

Background: The research "Knowledge, Attitude and Practice on Tuberculosis among Health Workers in Tribal Community" aims to identify and address the gap for improvement on the knowledge, attitude and practice on tuberculosis management and services by health workers in tribal community of the hilly regions of Bangladesh.

Methods: The study employed a cross-sectional design, conducted over twelve months from January to December 2022, by surveying 170 health workers from three upazilas in Rangamati district of Bangladesh. A simple random sampling technique was used to select study area, and participants were selected by cluster sampling. A semi-structured questionnaire (both open and close ended) was used to collect data by face-to-face interview after obtaining informed written consent.

Results: Among the 170 respondents, 146 (85.9%) were female and 24 (14.1%) were male health workers, aged between 30–40 years. More than half (53%) had TB-specific training. The average knowledge score was 9.13 (SD ±2.35), with 52.9% scoring between 60–80% on knowledge about tuberculosis (TB) transmission, symptoms, treatment, and prevention. Most respondents (86%) knew TB is caused by bacteria, and 89.4% identified airborne droplet transmission. Close contacts were recognized as high-risk by 60%, while 86.5% identified cough lasting over two weeks as a symptom. About 60% understood the difference between TB infection and disease. Chest X-ray (61.8%) and sputum AFB smear (50.6%) were commonly mentioned diagnostics. Most (76.5%) correctly identified the need for two sputum samples, though 78.9% believed sputum must be tested immediately. Only 33.5% knew four drugs are used in first-line treatment, while 78.2% knew the treatment duration of six months and 82% were aware of directly observed therapy (DOTS). Awareness of multidrug-resistant tuberculosis (MDR-TB) was low at 14.7%. Among participants, 160 (94%) knew at least one preventive measure for TB, with early diagnosis (61.2%) being the most recognized. A majority (93.5%) expressed a positive attitude toward new TB case detection, community engagement, treatment barriers, stigma, training, and prevention. About 96.5% agreed that TB patients should be asked if anyone in their household has a chronic cough, while 90% emphasized the importance of community engagement in identifying TB cases, and 97.7% supported informing the community about TB problems, treatment, and prevention. Most participants (69%) believed family members should avoid sharing utensils with TB-infected individuals, but only 47.7% agreed that TB patients face greater denial in the community than those with HIV. Prioritizing coughing patients was practiced by 41.2%, while 53.5% ensured coughing patients wore masks, and 25.9% separated them. For confirmed TB cases, 63% of health workers consistently wore masks. Overall, 52.9% of participants had good knowledge (60–80% score), 44.1% showed a positive attitude (≥70% score), and 90% demonstrated good practices (≥60% score).

Conclusion: The study highlights both strengths and areas for improvement in the knowledge, attitude, and practices of health workers managing tuberculosis (TB) in tribal communities of Bangladesh. While many participants demonstrated adequate knowledge of TB transmission, symptoms, and preventive measures, gaps remain in advanced areas like MDR-TB awareness and the implementation of infection control measures such as separating coughing patients and consistent mask usage. Strengthening targeted training programs and promoting community engagement are crucial to bridging these gaps and enhancing TB management and prevention efforts in tribal and hilly regions.