Knowledge, attitude and preventive practices regarding tuberculosis and its predictors among HIV patients in General Hospital, Minna, North-Central, Nigeria

Introduction: Tuberculosis is the commonest cause of death among HIV patients in Nigeria. Though tuberculosis is common among HIV patients, their knowledge about transmission and prevention is poor. Objective: To determine knowledge, attitude and preventive practices regarding tuberculosis and its predictors among HIV patients receiving treatment. Methods: A cross sectional study was carried out involving 226 randomly selected HIV patients receiving care at General Hospital, Minna. Study duration was from June 2015 to July 2017. Data on socio-demographic characteristics, psychosocial factors, knowledge, attitude and preventive practices regarding tuberculosis was collected using a self-administered, WHO modified, pretested and validated questionnaires. Data collected was analysed using SPSS version 22. Results: Out of 226 respondents, 60(26.5%) had poor knowledge, 123(54.4%) had negative attitude and 48(21.2%) had poor preventive practices regarding tuberculosis. The predictors of knowledge were age (B=0.087, 95%CI=0.031, 0.143, p=0.002), depression (B=-0.444, 95%CI=-0.673,-0.214, p<0.001) monthly income (B=-0.058, 95%CI=-0.095, -0.021, p=0.002) and marital status (B=-1.276, 95%CI=-2.525,-0.025, P=0.046). The predictors of attitude were anxiety (B=-0.395, 95%CI=-0.584, -0.206, p<0.001), cigarette smoking (B=4.473, 95%CI=0.992, 7.954, p=0.012) and duration of HIV infection (B=0.371, 95%CI=0.110, 0.631, p=0.005). The predictors of practice were depression (B=-0.176, 95%CI=-0.276, -0.076, p=0.001), cigarette smoking (B=2.200, 95%CI=0.926, 3.474, p=0.001) and duration of HIV infection (B=0.098, 95%CI=0.003, 0.194, p=0.043). Conclusion: Overall, knowledge and practices regarding tuberculosis prevention were good, but attitude was poor. The predictors of knowledge, attitude and preventive practices were age, depression, anxiety, cigarette smoking, monthly income, marital status and duration of HIV infection

Information, motivation and behavior-based intervention in improving knowledge, attitude and preventive practices related to tuberculosis among HIV patients in Nigeria

The rising incidence of tuberculosis (TB) among HIV patients poses a great threat to TB control in Nigeria. The risk of development of active TB in HIV-infected individuals is up to 20-37 times higher than those that are HIV negative. Out of 87,211 TB cases (including HIV-positive TB) in Nigeria in 2015, 14,846 TB patients were HIV-positive were registered for treatment and care. Poor knowledge of TB amongst people living with HIV is associated with high transmission and delay in healthseeking behavior. The objective of this study was to develop, implement and evaluate the effectiveness of information, motivation and behavior based intervention program in improving knowledge, attitude and preventive practices related to tuberculosis among HIV patients in General Hospital, Minna, Nigeria. A randomized control trial was conducted to determine the effectiveness of a newly developed information, motivation and behavior based intervention program on TB knowledge, attitude and preventive `practices. Respondents were randomized into intervention and control groups. The intervention group received health education intervention regarding tuberculosis using the manual developed. The control group received the normal services provided for the HIV patients by Ministry of Health. Both programs were delivered by trained experienced facilitators. Baseline, immediate post-intervention, three months, six months and nine months assessment was carried out. Mixed design ANOVA was used to determine the effectiveness of the intervention. The study results showed no significant difference in knowledge, attitude and preventive practices regarding tuberculosis between the intervention and control group at baseline (p=0.142, 0.506 and 0.784 respectively). There was a significant change in good knowledge within the intervention group from baseline to immediate postintervention, three, six and nine months follow up (39.8%, p = 0.001, 38.9%, p = 0.001, 40.7%, p = 0.001 and 39.8%, p = 0.001 respectively). There was no significant change in knowledge regarding TB within the control group from baseline to immediate post-intervention, three, six and nine months follow up (-12.4%, p =0.08, 14.1%, p = 0.068, 7.9%, p = 0.298, 6.2%, p = 0.419 respectively). Similarly, there was a significant change in positive attitude and good preventive practices from baseline to immediate post-intervention, three, six and nine months follow up within the intervention group. There was significant main effect for group [F = (1,218) = 665.925, p = 0.001, partial ἠ² = 0.753]; time [F = (3.600, 218) = 52.620, p = 0.001, partial ἠ² = 0.0.194] and the interaction between group and time [F = (3.600, 218) = 34.389, p = 0.001, partial ἠ² = 0.136) for tuberculosis-related knowledge. Likewise, the main effects for group, time and the interaction of group and time for respondent’s attitude and practice regarding tuberculosis were significant. The information, motivation, and behavior based intervention program developed was effective in improving knowledge, attitude and practice regarding tuberculosis among HIV patients. It is highly recommended that a structured information, motivation, and behavior based intervention program regarding tuberculosis targeted at HIV patients be included in the national tuberculosis control guidelines

Effectiveness of health education intervention in improving knowledge, attitude, and practices regarding tuberculosis among HIV patients in General Hospital Minna, Nigeria – a randomized control trial

Introduction: The risk of development of active TB in HIV-infected individuals is 20–37 times higher than those that are HIV negative. Poor knowledge of TB amongst people living with HIV has been associated with high transmission. Objectives: To determine the effectiveness of a new health education intervention module in improving knowledge, attitude, and practice (KAP) regarding tuberculosis among HIV patients in General Hospital Minna, Nigeria. Methods: A randomized control trial was carried out from July 2015 to June 2017. A random number generating program was used to allocate 226 respondents into 2 groups. The intervention group received health education regarding tuberculosis using the developed module. The control group received the normal services provided for HIV patients. Data were collected from December 2015 to September 2016 at baseline, immediate post intervention, three, six and nine months. The outcome measures were knowledge, attitude, and practice. Results: There was no significant difference with respect to socio-demographic characteristics, KAP of the respondents in the intervention and control group at baseline. However, there was significant improvement in knowledge in the intervention group compared to the control group, group main effect (F = (1,218) = 665.889, p = 0.001, partial ἠ2 = 0.753, d = 5.4); time (F = (3.605, 218) = 52.046, p = 0.001, partial ἠ2 = 0.193, d = 1.52) and interaction between group with time (F = (3.605, 218) = 34.028, p = 0.001, partial ἠ2 = 0.135, d = 1.23). Likewise, there was significant improvement in attitude, group main effect (p = 0.001, d = 1.26) and time (p = 0.001, p, d = 0.65). Similarly, there was improvement in practice, group main effect, time, and interaction of group with time (p < 0.05). Conclusion: The health education intervention program was effective in improving KAP regarding tuberculosis among HIV patients

Baseline comparison of psychosocial factors (anxiety and depression) of the study respondents at baseline.

<p>Baseline comparison of psychosocial factors (anxiety and depression) of the study respondents at baseline.</p

Main effect of intervention on mean knowledge, attitude and practice scores regarding tuberculosis at baseline to follow-up.

<p>Main effect of intervention on mean knowledge, attitude and practice scores regarding tuberculosis at baseline to follow-up.</p

Summary of mixed design ANOVA for tuberculosis knowledge, attitude and practice scores (between and within-subject effects) (N = 216).

<p>Summary of mixed design ANOVA for tuberculosis knowledge, attitude and practice scores (between and within-subject effects) (N = 216).</p

Summary of mixed design ANOVA for tuberculosis knowledge, attitude and practice scores (between and within subject effects) (N = 226).

<p>Summary of mixed design ANOVA for tuberculosis knowledge, attitude and practice scores (between and within subject effects) (N = 226).</p

Flow chart of respondents in a randomized control trial conducted among HIV patients in General Hospital, Minna, Nigeria.

<p>Flow chart of respondents in a randomized control trial conducted among HIV patients in General Hospital, Minna, Nigeria.</p