Knowledge, attitudes, and perceived barriers to tuberculosis care among patients and household contacts in Wolisso District, Oromia Region, Ethiopia

Background: Tuberculosis (TB) remains a major global health challenge, particularly in low-income settings where structural inequities hinder early diagnosis and care. Ethiopia, one of the 30 high TB-burden countries, continues to experience marked geographic disparities. Understanding knowledge, attitudes, and practices (KAP) among affected populations is essential to inform context-specific interventions supporting the End TB Strategy. Methods: A cross-sectional KAP survey was conducted in Woliso District (Oromia Region, Ethiopia) between April 2023 and December 2024, including 152 TB index cases and 326 household contacts. A structured, interviewer-administered questionnaire assessed knowledge of TB symptoms, transmission, diagnosis, and perceived barriers to care. Categorical variables were compared using Chi-square or Fisher's exact test, and continuous variables with Mann-Whitney test. Conclusions: While TB knowledge and attitudes were generally high, misconceptions about transmission and persistent structural barriers hinder access to timely diagnosis and care. Expanding community-based diagnostic capacity, improving rural infrastructure, and integrating social protection strategies are key to advancing Ethiopia's progress toward End TB targets.