Knowledge, Attitudes and Health-seeking behaviour among Patients with Tuberculosis: A Cross-sectional Study

South Africa is hugely overburdened with the cases of Tuberculosis (TB); individual’s lack of knowledge, attitude towards the disease and delays in health-seeking behaviour, are indirectly associated with death. This study assessed the knowledge, attitude and treatment of TB, and further examined the health-seeking behaviour of TB patients.

This cross-sectional study involved 327 conveniently selected participants with TB from three community health centres in Nelson Mandela Bay Health District, Eastern Cape, South Africa. A close-ended questionnaire was used to collect demographic details, knowledge, attitude and health-seeking behaviour variables. Descriptive and multivariate logistic regression analyses were performed. Statistical significance was considered at alpha <0.05 and a confidence interval of 95%.

The majority of these TB patients indicated that cold air (76.5%), a dusty environment (85.9%), TB bacteria in the air (88.4%), and smoking (84.7%) had caused the disease. About 87.2% of the respondents indicated that TB treatment duration took six months or longer. Participants thought that follow-up sputum tests are an important part of TB treatment (70.6%); non-adherence to TB treatment might lead to drug-resistant TB or death (80%); TB disease could turn into HIV if not properly treated (77.4%) and that individuals with TB disease have HIV (59.9%). About 56.9% participants felt that TB treatment is difficult, takes a long time, is unpleasant, interferes with work or marriage, and people who drink and smoke are to blame for its spread (60.6%). The majority of the participants (74.0%) disagreed with TB being an African disease and 53.5% did not associate TB with poverty. The majority of the participants (92%) indicated that follow-ups at clinics were avoided because of stigmatisation. In the multivariate logistic regression analysis, the informal housing scheme was a statistically significant (p<0.05) factor determining the correct knowledge of TB (AOR=0.556; 95% CI: 0.316-0.977). There was a statistically significant association among TB knowledge, attitude and health-seeking behaviour.

The participants generally had good knowledge about TB; however, there were misconceptions regarding its spread by cold air and dusty environments. The majority of participants did not attend follow-up TB treatment because of fear of stigmatisation. Formal settlements are associated with the correct knowledge of TB. Measures aimed at addressing the misconceptions about TB and its treatment are needed.