Study On The Knowledge, Attitude And Practice About Tuberculosis And Its Influencing Factors Among Key Populations In Yangpu District,Shanghai

ObjectiveTo investigate the knowledge, attitude and practice (KAP) about tuberculosis (TB) and their influencing factors among key populations including college freshman, employees in service industry and physician in community health centers in Yangpu District,Shanghai, and to provide the policy recommendations for health education and health promotion in TB prevention and control.Method1524freshmen in2011grade from9colleges in Yangpu District were randomly sampled using cluster sampling method.1130service industry employees participating in physical examination and no accepting health education in Yangpu District CDC during Apr.2012were recruited through cluster sampling. Community physician included all health workers to TB control and prevention in community health centers.Three different self-completed questionnaires interview were conducted for3key populations. All interviewees should answer the questionnaires face-to-face. Collected the data on demography characters, the KAP about TB.Data were analyzed with univariate and Logistic regression study by SPSS12.0. The quantitative variables were depicted by mean, standard deviation and median. The Student-Newman-Keuls (SNK) was used to exam the differences between each two groups. The qualitative variables were depieted using frequencies, proportions, etc. Chi-square test or Fisher’s exact probability was used to test the differences among groups of those data.Results1. Study on the KAP about TB and its influencing factors among college freshmen in Yangpu District, Shanghai.(1) The general awareness rate of five key informations on TB control was53.9%, but the absolute awareness rate of that was only4.2%.Comparing the general awareness rates between male and female (55.2%:52.7%,P<0.05), no householder in Shanghai and householder in Shanghai (55.8%:48.9%,P<0.001), hampshire and minority (54.5%:46.8%,P<0.001), medical speciality and no medical speciality (59.6%:52.7%,P<0.001), the former was higher for the latter respectively. (2)51.1%freshmen didn’t adopt a correct attitude towards their classmates suffering from TB.60%of them chose self-treatment or nothing if they had like symptoms.(3) In multivariate Logistic regression analysis, it was confirmed that speciality, householder, the approaches of acquainting themself with TB knowledges(broadcast, newspaper, publicity brochures, TV, health education classes) were significantly associated with scores of TB knowledges (P<0.05).2. Study on the KAP about TB and its influencing factors among service industry employees in Yangpu District Shanghai.(1)70%service industry employees were the floating population. Their average age was32.6years old and most concentrated in the20-29years old prone to infect TB.(2) The general awareness rate of five key informations on TB control was61.7%, but only31.5%knew "there are national policies on free TB examination and cure" and38.9%knew "person who has had the symptom of cough and sputum for3weeks or has the symptom of emptysis and blood sputum should go to receive TB examination".(3) The general awareness rates were different among groups of demography characters, especially the age, householder, education and work type (P<0.01).(4) Half of the employees keep themselves aloof from TB patients, but65.5%the interviewees would tell others when they suffered from TB.80.2%the employees would go to hospital when they have the symptom of cough and sputum, and60.7%of them would see a doctor during1to2weeks for having the symptom of cough.(5) The results of Logistic regression analysis shew that the influencing factors associated with tuberculosis knowledge level were work type(cosmetic:food, OR=6.262), TB training(OR=3.160), medical training(OR=1.435) and special promotion (OR=1.545)(P<0.05).3. Study on the KAP about TB and its influencing factors among community physician in Yangpu District, Shanghai.(1) The survey involved a total of10TB knowledge and TB control policy questions, the overall score was20points, and the score greater than or equal to16was set up to grade.The average score of TB knowledge and TB control policy was15.0±3.0among community physician with a pass rate of41.1%.(2) The scores of TB knowledge and TB control policy were different in different positions of community physician(P<0.05, which was highest among radiologists (92.94%), and lowest among clinicians(63.87%), and middle among public health physicians(80.45%).(3) Through Logistic regression, the community physician engaging in public health (OR=5.729) and ever finding suspected cases of TB(OR=4.618) were found to be correlated with the score of TB knowledge and TB control policy(P<0.01).(4) The awareness rates of community clinicians were poor towards the TB case referral subsidy policy and supervision and management reward policy,49.3%and58.7%respectively.(5)55.0%community physician spoke TB knowledge when asked or spoke rarely or never spoke.47.2%community physician propagated TB national relief policy when requested or propagated rarely or never propagated.Conclusion and Suggestions(1) The KAP of college freshmen about TB is poor. The general awareness rate of five key informations on TB control was low, especially for very important key informations. Above half of the freshmen have discrimination on TB patients. The college freshmen are lack of enough attention on the symptom of cough and sputum, so they will not go to the doctor in time. College freshmen’s knowledge about tuberculosis is incoherent with their education levels, therefore, it is an urgent task to carry out health education on TB among college freshmen.(2) The service industry employees are most the floating population. Most of them are young and prone to suffere from TB. The knowledge level about TB among service industry employees in Yangpu District, Shanghai should be improved. Although they want to know more about TB, they could not now. We should offer them health education about TB by different ways and contents. The employees engaging in drinking water and food-processing and sale should be followed with interest.(3) The KAP of community physician especially the clinicians is not comprehensive enough, so it’s necessary to strengthen the TB knowledge and TB control policy training especially the TB case referral subsidy policy and supervision and management reward policy.The community physician are more passive in TB health education work, so the disease prevention and control institutions should strengthen to examinate the frequency and effect of health education activities in community health centers, and promote the leadship to attach importance to health education work.