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Toward community-driven tuberculosis education: findings from a knowledge and
engagement pilot survey in the rural community of Eastern Cape, South Africa
#MMPMID41346758
Dlatu N
; Tsuro U
; Faye LM
; Hosu MC
; Ncomeka S
; Apalata T
Front Public Health
2025[]; 13
(?): 1671871
PMID41346758
show ga
BACKGROUND: Tuberculosis (TB) remains a major public health concern in rural
South Africa, with widespread community knowledge gaps and pervasive stigma
significantly impeding early diagnosis and treatment success. This pilot study
evaluated TB knowledge and barriers to testing among community members in
Ntabankulu, Eastern Cape, to inform targeted, community-driven education
strategies. METHODS: A cross-sectional survey utilizing a structured
Knowledge-Attitudes-Practices (KAP-TB) questionnaire was administered to 131
rural community members. TB knowledge was categorized into low, moderate, and
high levels based on scores derived from a Likert-type scale. Statistical
analysis used Fisher's exact and Kruskal-Wallis tests to examine associations
between knowledge levels, sociodemographic variables, barriers, and TB exposure
history. Boxplots provided visual insight into distributions across age and
gender. RESULTS: Among participants, TB knowledge was mostly moderate (64.9%),
with 11.5% reporting low knowledge and 23.7% high knowledge. Knowledge was
significantly associated with education level (p 0.001): 52% of the
high-knowledge group had a tertiary education, compared to none in the
low-knowledge group. Although gender (p =?0.5) and age (p =?0.2) were not
statistically significant overall, boxplot visualization suggested a trend toward
higher knowledge scores among younger, male participants, especially those with a
history of TB exposure. The most frequently cited barriers to testing were fear
of stigma (42%) and lack of knowledge (33%). Low-knowledge participants more
frequently reported structural barriers such as distance (10%) and cost (7%).
Crucially, participants with a personal (p =?0.047) or family (p 0.001) history
of TB experience were significantly more likely to have high knowledge.
CONCLUSION: TB knowledge in this rural setting is primarily shaped by formal
education and direct personal experience, while stigma and misinformation remain
the predominant barriers to timely testing. Future community-driven education
must prioritize leveraging survivor storytelling, peer education, and culturally
tailored messaging to simultaneously boost TB literacy, actively reduce stigma,
and promote prompt care-seeking.
|*Health Education/methods
[MESH]
|*Health Knowledge, Attitudes, Practice
[MESH]
|*Rural Population/statistics & numerical data
[MESH]
|*Tuberculosis/diagnosis/prevention & control
[MESH]