Lumbar Puncture Knowledge and Attitudes among Patients, Caregivers, and Healthcare Workers in Rural Zambia

Lumbar puncture (LP) is a safe, standard procedure essential in the investigation of a variety of neurological disorders. However, in many regions, LP uptake and performance are low, even when it is strongly indicated. We sought to understand patient, caregiver, and healthcare worker perspectives in rural Zambia. We conducted a cross-sectional survey of adult patients, caregivers of adult and pediatric patients, nurses, doctors, and clinical officers at two rural hospitals in the Southern Province of Zambia. The survey consisted of questions on self-reported LP knowledge, an LP knowledge questionnaire, and open-ended questions about LP perceptions and, for healthcare workers, the LP consent process. Descriptive statistics are reported for quantitative questions, and qualitative responses were thematically coded using an inductive approach. Of 120 total participants, the majority (n = 97; 81%) reported they had previously heard of LPs and indicated having "a little" knowledge (n = 71; 59%), with the most common source of knowledge being friends and family members. Scores on LP knowledge questionnaire were low for patients and caregivers (median three out of seven possible points). Healthcare worker knowledge scores were higher than laypersons (mean = 6) but misperceptions about LPs were still common, with half of healthcare workers reporting LPs cause paralysis. This rural cohort essentially demonstrated the same knowledge gaps and misperceptions previously identified in an urban Zambian cohort, further supporting the need for interventions aimed at the community and healthcare workers regardless of urbanicity.