Evaluating community knowledge of tuberculosis preventive therapy in rural South Africa

Tuberculosis preventive therapy (TPT) effectively reduces TB incidence among people living with HIV, but implementation remains suboptimal and data on community knowledge of TPT is needed. We sought to understand community members' knowledge of TB and TPT to facilitate implementation of TPT.

In rural Msinga, KwaZulu Natal, South Africa, a cross-sectional study was conducted at community events during an HIV and TB testing initiative. Participants ≥ 18 years old who were residents of Msinga were anonymously surveyed. We evaluated Knowledge of TB and TPT, generating separate scores for each domain. Descriptive statistics, chi-square testing, Kruskal-Wallis, linear regression, and exploratory factor analysis (EFA) were performed.

Among 104 respondents, median age was 32.5 years, 65% were female, and 23% completed secondary school. EFA identified two factors for TB knowledge: cultural beliefs of TB's origin and transmission and understanding TB as a disease. Overall, TB knowledge was poor (median 10, IQR 8-12.5). Over one-third (N = 39, 37.5%) were unaware of TPT. Those who had heard of TPT had good knowledge of TPT, with a median score of 4 (IQR 4-4) out of 4. Factors associated with higher TPT knowledge on multivariate linear regression included being motivated to stay healthy to care for one's family and knowing that TB can be avoided.

Rural South African community members demonstrated poor TB knowledge. Community members with good knowledge of TB were also aware of TPT. Greater community-level public health education and individual-level counseling efforts are needed to facilitate TPT expansion and implementation.