Prevention and control of tuberculosis in workplaces: how knowledgeable are the workers in Bangladesh?

Abstract

BackgroundThe National Tuberculosis (TB) Control Programme (NTP) of Bangladesh succeeded in achieving the dual targets of 70 % case detection and 85 % treatment completion as set by the World Health Organization. However, TB prevention and control in work places remained largely an uncharted area for NTP. There is dearth of information regarding manufacturing workers’ current knowledge, attitudes and practices (KAP) on pulmonary TB which is essential for designing a TB prevention and control programme in the workplaces. This study aimed to fill-in this knowledge gap.MethodsThis cross-sectional survey was done in multiple workplaces like garment factories, jute mills, bidi/tobacco factories, flour mills, and steel mills using a multi-stage sampling procedure. Data on workers’ KAP related to pulmonary TB were collected from 4800 workers in face-to-face interview.ResultsThe workers were quite knowledgeable about symptoms of pulmonary TB (72 %) and free- of-cost sputum test (86 %) and drug treatment (88 %), but possessed superficial knowledge regarding causation (4 %) and mode of transmission (48 %). Only 11 % knew about preventive measures e.g., taking BCG vaccine and/or refraining from spitting here and there. Knowledge about treatment duration (43 %) and consequences of incomplete treatment (11 %) was poor. Thirty-one percent were afraid of the disease, 21 % would feel embarrassed (and less dignified) if they would have TB, and 50 % were afraid of isolation if neighbours would come to know about it. Workers with formal education (AOR 1.92; 95 % CI 1.61, 2.29) and exposure to community health workers (CHW) (AOR 31.60; 95 % CI 18.75, 53.35) were more likely to have TB knowledge score ≥ mean. Workers with knowledge score ≥ mean (AOR = 1.91; 95 % CI:1.44, 2.53) and exposure to CHWs either alone (AOR = 42.4; 95 % CI: 9.94, 180.5) or in combination with print media (AOR = 37.35; 95 % CI: 9.1, 180.5) were more likely to go to DOTS centre for treatment . Only around 43 % had sputum examination despite having chronic cough of ≥ 3 weeks duration.ConclusionThe workers had inadequate knowledge regarding its causation, transmission and prevention which may interfere with appropriate treatment-seeking for chronic cough including sputum test. NTP needs to be cognizant of these factors while designing a workplace TB prevention and control programme for Bangladesh.

Cancer related knowledge, attitude, and practice among community health care providers and health assistants in rural Bangladesh

“…A national strategy on cancer is necessary to establish a proper referral chain between rural and urban components of the healthcare system [ 18 ]. Previous studies have highlighted the importance of integrating cancer prevention strategies at all levels of the healthcare delivery system [ 19 ].…”

“…Lack of knowledge can affect cancer related practices and attitudes among CHCPs and HAs. Currently there is a dearth of information regarding CHWs' KAP levels, which is essential for designing a comprehensive cancer prevention and control strategy [ 19 ]. The aim of this study is to assess cancer related KAP among CHCPs and HAs; to understand the factors associated with each domain; to identify gaps; and provide appropriate policy suggestions.…”

Cancer Related Knowledge, Attitude, and Practice Among Community Health Care Providers and Health Assistants in Rural Bangladesh

“…After extensive literature review, the questionnaire was initially prepared in English and then translated to Bengali for easy administration [16]. The Bengali version of the questionnaire was pre-tested [14] among a small group (n=10) of CHCPs and HAs at a UHC located in Gopalganj, Dhaka; after which minor edits were made based on feedback.…”

“…Lack of knowledge can affect cancer related practices and attitudes among CHCPs and HAs. Currently there is a dearth of information regarding CHWs KAP levels, which is essential for designing a comprehensive cancer prevention and control strategy [14]. The aim of this study is to assess cancer related KAP among CHCPs and HAs; to understand the factors associated with each domain; to identify gaps; and provide appropriate policy suggestions.…”

“…A national strategy on cancer is necessary to establish a proper referral chain between rural and urban components of the healthcare system [13]. Previous studies have highlighted the importance of integrating cancer prevention strategies at all levels of the healthcare delivery system [14].…”