Knowledge of International Standards for Tuberculosis Care among Private Non-NTP Providers in Lagos, Nigeria: A Cross-Sectional Study

Abstract

Studies specifically evaluating tuberculosis knowledge among private non-NTP providers using the International Standards for Tuberculosis Care (ISTC) framework are scarce. We evaluated the knowledge of ISTC among private non-NTP providers and associated factors in urban Lagos, Nigeria. We performed a cross-sectional descriptive study using a self-administered questionnaire to assess different aspects of tuberculosis management among 152 non-NTP providers in Lagos, Nigeria. The association between the dependent variable (knowledge) and independent variables (age, sex, qualifications, training and years of experience) was determined using multivariate logistic regression. Overall, the median knowledge score was 12 (52%, SD 3.8) and achieved by 47% of the participants. The highest knowledge score was in TB/HIV standards (67%) and the lowest was in the treatment standards (44%). On multivariate analysis, being female (OR 0.3, CI: 0.1–0.6, p < 0.0001) and being a nurse (OR 0.2, CI: 0.1–0.4, p < 0.0001) reduced the odds of having good TB knowledge score, while having previously managed ≥100 TB patients (OR 2.8, CI: 1.1–7.2, p = 0.028) increased the odds of having good TB knowledge. Gaps in the knowledge of ISTC among private non-NTP providers may result in substandard TB patient care. Specifically, gaps in knowledge of standard TB regimen combinations and Xpert MTB/RIF testing stood out. The present study provides evidence for tailored mentorship and TB education among nurses and female private non-NTP providers.

Insights, beliefs, and myths surrounding tuberculosis among pulmonary patients with delayed healthcare access in a high-burden TB state in Nigeria – a qualitative inquiry

“…Insights from healthcare professionals about the community's inclination to perceive TB as more spiritual than physical underscore potential barriers to timely medical intervention. Addressing these notions through targeted health education, cultural and behavioral improvements are critical (Adepoju et al, 2022;Amare et al, 2022). This is essential because according to health belief model, individual health behaviors are influenced by perceptions of susceptibility, severity, benefits of action, and barriers to action (Limbu et al, 2022).…”

“…In the year 2022, the state documented 11,934 confirmed TB cases out of a total presumptive count of 136,222 cases (Oguntola, 2023). Successful TB control initiatives are contingent not only on medical interventions but also on a comprehensive understanding of the diverse factors shaping the lived experiences of those directly affected (Adepoju et al, 2022;Sharma and Khokhar, 2022). Factors contributing to the persistence of TB include socioeconomic disparities, limited access to healthcare, and sociocultural influences that shape community perceptions and behaviors (Du et al, 2022;Olarewaju et al, 2022;Kaaffah et al, 2023).In social psychology, the health belief model posits that individual choices to see health practitioners (registered doctors and nurses) are influenced by perceptions of susceptibility, severity, benefits of action, and barriers to action (Rosenstock, 1974;Limbu et al, 2022).…”

Trends of Xpert MTB/RIF in the diagnosis of Mycobacterium tuberculosis and rifampicin resistance in Southwest Nigeria: A 4-year retrospective study

“…[2,9] Undernutrition, diabetes, smoking, harmful alcohol consumption, poor treatment adherence to anti-TB drugs; previous haphazard or poor implementation of isoniazid prophylaxis and previous ineffective TB treatment, especially in private practice; increasing treatment failure and loss to follow-up, poor Xpert MTB/RIF diagnostic coverage; and a high burden of human immunodeficiency virus (HIV) coinfection in low-resource settings, including Nigeria, are potential drivers for the high prevalence of resistant TB. [13][14][15][16][17][18][19][20][21][22] Higher prevalence of social determinants such as poverty, inequality, unsafe housing, discrimination, and social stigma in low-resource settings such as Nigeria also plays a significant role in the spread of DR-TB. [13,14,20] According to the 2019 WHO global TB report, Nigeria has one of the highest burdens of MDR/RR-TB, accounting for 4.2% of new cases and 15% of previously treated MTB.…”