Association between South African high-school learners’ knowledge about tuberculosis and their intention to seek healthcare

BACKGROUND: South Africa has one of the highest prevalence of tuberculosis (TB). Addressing awareness among school learners on TB transmission and prevention may assist in reducing the disease burden. OBJECTIVE: We report on factors associated with high-school learners' intentions to seek healthcare for TB. DESIGN: A survey testing TB symptoms, transmission, prevention knowledge, and intention to seek and adhere to treatment was conducted among 1,114 high-school learners in KwaZulu-Natal (KZN), South Africa. Multivariate models correcting for nesting of students within schools tested associations between demographics, TB symptoms, transmission, prevention knowledge, and intention to seek and adhere to treatment. RESULTS: Learners knowing that coughing for more than 3 weeks (OR: 2.33; 95% CI: 1.35-4.00) and night sweats (OR: 3.12; 95% CI: 1.80-5.41) were TB symptoms, TB is transmitted when a person with TB coughs (OR: 1.56; 95% CI: 1.23-1.98), and coughing in a closed room was an incorrect practice for someone with TB (OR: 1.71; 95% CI: 1.05-2.78) were significantly more likely to intend taking family members for treatment. Learners knowing that coughing for more than 3 weeks (OR: 2.69; 95% CI: 1.19-6.09), coughing blood (OR: 2.24; 95% CI: 1.33-3.76), and night sweats (OR: 2.25; 95% CI: 1.09-4.64) were TB symptoms, were significantly more likely to intend encouraging family members to adhere to TB treatment. Learners knowing that coughing for more than 3 weeks (OR: 1.47; 95% CI: 1.05-2.07), coughing blood (OR: 2.08; 95% CI: 1.44-3.01), and weight loss (OR: 1.85; 95% CI: 1.38-2.49) were TB symptoms, were significantly more likely to intend taking TB treatment if symptomatic. Learners knowing that coughing for more than 3 weeks (OR: 2.04; 95% CI: 1.45-2.87), and coughing blood (OR: 1.81; 95% CI: 1.24-2.62), were TB symptoms were significantly more likely to intend adhering to TB treatment. CONCLUSIONS: High-school learners with knowledge about TB symptoms, transmission, and prevention have positive intentions to seek treatment for themselves and family members and adhere to treatment.