Assessment of the knowledge and perceptions about tuberculosis among primary school children in NTCHEU district, Malawi

Abstract

Background: Case finding in Malawi is based on self-referral of symptomatic individuals who are suspected as tuberculosis (TB) cases in health institutions. Knowledge on TB and attitudes/perceptions about the disease can influence care seeking behaviour and adherence to treatment. Like in other countries, studies in Malawi have been conducted to assess knowledge and attitudes regarding TB in adults. Some studies have even assessed the association between knowledge, attitudes and other factors. In Malawi, prevalent health problems are included in the primary school curricula to create awareness and promote desired behaviour towards the diseases among children attending schools. It is, however, not known how much the school children know about TB. It is also not known what their attitudes or perceptions are regarding the disease.Methods: This study was conducted to assess the knowledge and perceptions regarding TB among learners in primary schools in Ntcheu District, Malawi. An analytical cross-sectional design was used to implement the study. A simple random sampling procedure was used to sample four schools from two Traditional Authorities of Makwangwala and Ganya in the targeted district. From each school,boys and girls aged 10-14 years were selected to participate in the study. A closeended questionnaire that was translated into the local language was administered to the learners. Epi info version 3.5.3 was used to capture and analyse the data.Results: The results showed that knowledge of learners regarding the cause of TB,how the disease is spread, factors that influence its spread and preventive measures was generally high. Almost 90% of the learners knew that TB is caused by a germ.However, there were knowledge gaps on specific aspects related to symptoms,cause, cure, as well as attitudes towards the disease. With regard to symptoms,knowledge was low in relation to fever with night sweats (49%) and enlargement of neck glands (40%). The study also revealed knowledge gaps regarding the real cause of the disease and the prescribed duration of anti-TB treatment with 68% of the learners not knowing the correct duration. The study, however, found no association between class (grade) or age of student and knowledge (p>0.05).Conclusion: The findings of this study have implications on the teaching of TB in schools as well as delivery of TB information, education and communication (IEC) messages. The knowledge gaps identified may have origins in the content of the curricula and/or the available IEC messages. Lack of association between knowledge and class could also mean that IEC may have an important role regarding what learners know. The study has also revealed that traditional beliefs are prevalent among the learners and that TB is stigmatising.Being the first study to be conducted on knowledge and perceptions among school children in Malawi, the results will inform the development of relevant IEC materials to enhance information about TB and control measures among school going children in these communities. The study also provides a basis for future studies.