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Tuberculosis Knowledge, Attitude and Practice (TBKAP) Follow-up Survey in Nigeria

Did you know that in 2016, there were an estimated 10.4 million new (incident) cases of tuberculosis in the world? That’s 5 times more people than the entire population of Slovenia and a little over 10 times the population of the Bahamas. Did you also know that TB tends to affect more men than women and those in the economic productive age range (15 -59 years) are the most affected?

In Africa currently, Nigeria has the most number of TB incidents, and in order to combat this, the Federal Government through the National Tuberculosis and Leprosy Control Programme (NTBLCP) a body under the Ministry of Health set up to control TB and Leprosy in Nigeria and with the support of organizations like the World Health Organization, and the Global Fund for AIDS, Tuberculosis and Malaria (GF), in 2007/2008 conducted a baseline study to determine the true burden of TB and refine her strategy for improved programme implementation and outcomes. This study was conducted in Benue, Ebonyi and Ondo states. Following this another survey was carried out in 2012, this time to determine the Knowledge, Attitude and Practice of people in urban and rural communities across the country regarding TB. This survey was carried out in 6 states across the 6 geo-political zones of the country.

This report gives a summary of results from a 2017 study conducted by AHEAD in conjunction with the Association for Reproductive and Family Health (ARFH) and NTBLCP, done on the same topic in a bid to compare current levels of knowledge, attitude and practice with the results of the 2012 study. The study was carried out in 48 urban and rural communities and a total of 448 healthcare facilities across Benue, Plateau, Adamawa, Gombe, Katsina, Kaduna, Ebonyi, Imo, Akwa-Ibom, Delta, Ondo and Lagos states were sampled.

Results show that there was no appreciable change in awareness of the general population about TB although Katsina showed an appreciable increase in awareness and Ondo showed a noticeable decline. While there was moderate improvement in the knowledge that persistent cough is a symptom of TB among the general population, there was a decline in other knowledge parameters evaluated.

Among patients with TB, there was an increase in those who self-medicated and a marked decline in patients’ knowledge of risk-factors. Even though, there was only a very slight decline in the proportion of TB patients who know that HIV infection is a risk factor for TB. And the figures show that compared to baseline, some people in Ebonyi state still believe witchcraft is a cause of TB.

Among patients with HIV, there was an improvement in the knowledge of the causes of TB although patients who identified casual contact such as kissing as a cause of TB showed an increase compared to baseline. And there was a 40% jump in the number of patients who were at the facility for follow-up sputum examination.

The proportion of health workers trained in the management of TB cases showed significant increase although knowledge of this management is still low. Also the proportion of health workers with knowledge about the drugs used in the management of TB showed a decline.

Overall, there has been progress in some areas, but there is still some work to be done in the prevention, diagnosis, and management of tuberculosis and the achievement of the goal of a Nigeria free of TB.