Tuberculosis Knowledge, Attitudes, and Practice in Middle- and Low-Income Countries: A Systematic Review

Table 2

Summary of the study settings, aims, and outcomes of the included studies for this systematic review (n = 30).

Study ID	Country and setting	Sample size	Survey location	Aim of the study	Outcomes
					Knowledge	Attitudes	Practice
[16]	Sudan, urban-rural	1275	HC^†	Contribute to knowledge about barriers to the success of the TB^§ control program and inform program managers and decision-makers	Symptoms, transmission, prevention, level of knowledge, sources of information about TB and cure		Healthcare seeking and treatment
[17]	Nigeria, rural	1186	Home, community	Determine the level of KAP^‡ of people towards TB in a rural Nigerian community	Cause, symptoms, transmission, prevention, level of knowledge, and treatment	Stigma, beliefs, and screening test	Treatment
[18]	India, rural	128	Hospital	Investigate TB KAP among HIV-infected patients in a high HIV prevalence region of India	Transmission, sources of information about TB and cure
[19]	Nigeria, urban	916	Home	Reduce the burden of TB disease in 18 communities through educational intervention, TB case detection and integration into the State National Tuberculosis and Leprosy Control Program (NTBLCP)	Cause, symptoms, transmission, prevention, and treatment	Stigma and beliefs	Healthcare seeking, treatment, difficulties accessing healthcare and prevention
[20]	Iran, urban	593	Other (street)	Define the KAP of homeless people in Tehran regarding TB and HIV	Transmission, level of knowledge, and cure
[21]	Nigeria, urban	504	Home	Examine the current level of knowledge and attitude with the goal of guiding future interventions	Cause, symptoms, transmission, prevention, level of knowledge, sources of information about TB and treatment	Stigma, reaction to diagnosis, and beliefs	Prevention
[22]	Ethiopia, rural	422	Home	Assess communities’ KAP regarding TB in South Western Ethiopia	Cause, symptoms, transmission, prevention, level of knowledge and sources of information about TB	Stigma and reaction to diagnosis	Treatment
[23]	Colombia, rural	300	Community	Describe the KAP on tuberculosis and its association with some sociodemographic aspects of inhabitants of rural and indigenous areas of Córdoba (Colombia) and evaluate the validity and reliability of the KAP scale	Cause, symptoms, transmission, prevention and sources of information about TB	Stigma, beliefs, and screening test	Healthcare-seeking and nearby cases
[24]	Ethiopia, urban-rural	3503	Home	Better understand TB-related knowledge, attitudes, and practices (KAPs) and generate evidence for policy and decision-making	Cause, symptoms, transmission, level of knowledge, sources of information about TB and cure	Reaction to diagnosis	Healthcare seeking
[25]	Ethiopia, rural	422	Hospital, HC	Evaluate of the knowledge, attitudes and health-seeking behaviors and associated factors of pulmonary tuberculosis patients	Cause, symptoms, prevention, level of knowledge, sources of information about TB and cure	Stigma, secret, and reaction to diagnosis	Healthcare seeking, delay, difficulties accessing healthcare
[26]	Colombia, urban	878	Home	Describe the KAP about TB in the HCs of patients diagnosed with this disease	Symptoms, transmission, prevention, sources of information about TB, cure and treatment	Stigma and reaction to diagnosis	Healthcare seeking
[27]	Tajikistan, rural	509	Home	Elucidating the key factors influencing access to TB diagnosis and treatment among migrants in their labor destination country and home country	Cause, symptoms, level of knowledge, sources of information about TB and cure	Stigma	Healthcare seeking and treatment
[28]	Tanzania, rural	105	Community	Evaluation of the KAP among the masai on TB and gain insight into the role of traditional healers	Cause, symptoms, and cure	Beliefs	Healthcare seeking, treatment, and difficulties accessing healthcare
[29]	Nigeria, urban-rural	3021	Home	Measure knowledge of TB among the general population	Level of knowledge and cure		Healthcare seeking and treatment
[30]	India, rural	1985	Home	Assess the level of awareness, attitude, and treatment-seeking behavior regarding tuberculosis in a rural area of Tamil Nadu	Transmission and sources of information about TB	Secret	Healthcare seeking and difficulties accessing healthcare
[31]	Ethiopia, urban	420	HC^†	Assess knowledge, attitude, and preventive practice towards tuberculosis	Cause, symptoms, transmission, prevention, level of knowledge, and sources of information about TB	Stigma and beliefs	Prevention
[32]	Pakistan, rural	488	Home	Understand and assess the knowledge, awareness, perceptions, and health-seeking behavior of general and TB-affected population	Symptoms, transmission, prevention, sources of information about TB, cure, and treatment	Stigma	Healthcare seeking
[33]	Cameroon, urban-rural	3663	Home	Assess TB-related KAP in Cameroon and identify barriers to seeking care	Symptoms, transmission, and sources of information about TB	Stigma and reaction to diagnosis	1 2 4 healthcare seeking, treatment, and difficulties accessing healthcare
[34]	South Angola, urban-rural	805	Home	Measure health-seeking behavior in Southern Angola and to inform the design of context-specific interventions to improve case detection	Symptoms	Secret	Healthcare seeking and treatment
[35]	Mongolia, urban-rural	10581	Home	Estimate the level of KAP concerning TB among the public and to examine how those are affected by demographic, socioeconomic, and policy factors in inner Mongolia	Symptoms, transmission, level of knowledge, sources of information about TB and cure	Stigma
[36]	Pakistan, urban-rural	1080	Home	Explore KAP regarding TB in the general population of two districts of Punjab province, and the effect of socioeconomic determinants	Symptoms, transmission, prevention, and sources of information about TB	Stigma and reaction to diagnosis	Healthcare seeking and treatment
[37]	Pakistan, urban-rural	1080	Home	Explore inequities in KAP regarding TB among the population	Symptoms, transmission, prevention, level of knowledge, sources of information about TB and treatment	Stigma, reaction to diagnosis, and beliefs	Healthcare seeking and treatment
[38]	Botswana, urban-rural	2032	Home	Assess KAP of communities on TB and identify sources of their information on this disease and HIV	Transmission	Stigma and beliefs
[39]	Madagascar, urban	266	Home	Assess the KAP of the population for the management of the disease and propose recommendations to the authorities based on the study	Symptoms, transmission, prevention, level of knowledge and cure	Stigma and beliefs	Healthcare seeking and treatment
[40]	Madagascar, urban	68	Community	Evaluate KAP to the distribution of TB and to provide information for the improvement of the National Tuberculosis Program	Cause, symptoms, transmission, sources of information about TB and treatment	Beliefs	Treatment and prevention
[41]	India, urban-rural	4562	Home	Describe the prevalence of stigmatizing attitudes towards TB patients among general population and their association with knowledge regarding TB	Transmission and level of knowledge	Stigma
[42]	Ethiopia, urban-rural	585	Home	Assess the pastoralist community KAP towards TB in comparison to the neighboring sedentary communities	Cause, transmission, prevention, level of knowledge, and sources of information about TB	Stigma, secret, reaction to diagnosis and beliefs	Healthcare seeking and treatment
[43]	India, urban-rural	4562	Home	Assess knowledge of TB and its association with respondent’s sociodemographic characteristics	Symptoms, transmission, sources of information about TB and treatment	Screening test	Treatment
[44]	Myanmar, rural	349	Other (workplace)	Evaluate workers’ KAP about TB	Transmission	Stigma	Healthcare seeking, treatment, delay, and difficulties accessing healthcare
[45]	Ethiopia, urban-rural	410	Home	Assess community’s KAP towards TB	Cause, symptoms, transmission, prevention, level of knowledge, and sources of information about TB	Stigma, reaction to diagnosis and beliefs	Healthcare seeking and treatment

^†HC: health center. ^‡KAP: knowledge, attitudes, and practice. ^§TB: tuberculosis.