Beyond Biomedical Models: Socio-Cultural Determinants and Gaps in Tuberculosis Awareness and Prevention Practices in Northern Ghana

Background: Tuberculosis (TB) remains a paramount public health challenge, with significant disparities in awareness and prevention practices among vulnerable populations, including immigrants. This study investigates the socio-cultural determinants influencing TB awareness and preventive behaviors in the Kassena-Nankana and Builsa districts of Ghana, a high-incidence region. Methods: A community-based cross-sectional study was conducted among 383 participants, utilizing a structured questionnaire. Data were analyzed using descriptive statistics and multivariate logistic regression to identify key predictors of TB awareness. Results: While overall TB awareness was high (88.51%), critical gaps were identified. Nearly half (42.56%) of participants were unaware of any TB prevention strategies. Awareness significantly increased with age (p=0.015) and was higher among traditionalists. Surprisingly, higher educational attainment (secondary education) was associated with lower awareness compared to no formal education. Clinical symptom recognition was a mixed predictor; unexplained weight loss significantly increased odds of awareness (OR: 2.14, 95% CI: 1.02-4.48, p=0.043), while common symptoms like cough and night sweats did not. Duration of residence, occupation, gender, and marital status showed no significant association with awareness levels. Conclusion: There exists a significant disconnect between general awareness and practical knowledge of TB prevention in these communities. Public health interventions must move beyond generic awareness campaigns to develop culturally resonant, age-specific, and educationally appropriate strategies that address these critical behavioral gaps to align with the WHO End TB Strategy goals.