Health Care Workers Knowledge, Attitudes, and Practice Towards Childhood Tuberculosis in Primary Health Facilities in Lusaka, Zambia

BACKGROUND Zambia is among the countries with high tuberculosis (TB) and Tuberculosis/Human Immunodeficiency Virus (TB/HIV) burdens, with a significant number of cases affecting children. However, a considerable portion of TB cases, especially in children, remains undiagnosed. This study aimed to assess and understand the factors influencing the knowledge, attitudes, and practices of health care workers (HCWs) regarding childhood TB in Zambia. METHOD Using a cross-sectional survey design, a self-administered anonymous questionnaire was employed to evaluate HCWs’ knowledge, attitudes, and practices related to TB. The study was conducted at two primary health facilities in Lusaka, Zambia, between July and August 2020. The questionnaire data collected was later transcribed to an electronic system called DHIS 2. RESULTS Out of 238 participants, the majority (72.3%) were female HCWs. Most staff members across various departments demonstrated awareness of the primary TB symptom, which is coughing. However, approximately half of the participants had limited knowledge regarding the transmission of TB through oral activities such as singing and laughing. Furthermore, the study found that 21.4% of HCWs reported regular interaction with children in their daily work, while 17.2% did not. Among the HCWs, 73.1% referred children to the TB clinic to submit a sputum sample, 55.5% requested a sample from the patient, 55.9% expedited the process for children, 58.4% provided education on cough etiquette, and 42.4% recorded the child in the presumptive TB register. Only a negligible 0.8% of HCWs did not take any action for children exhibiting TB symptoms. CONCLUSION The study highlighted variations in knowledge levels based on gender, department, and training history among the HCWs. Those working in the TB department generally exhibited better knowledge and attitudes regarding TB, with a 50/50% variation. Therefore, it is crucial to enhance the TB knowledge, attitudes, and practices of female HCWs, who constitute most staff involved in TB diagnosis and treatment. This study emphasizes the importance of improving the understanding of childhood TB among HCWs, particularly among female staff. Enhancing their knowledge and attitudes towards TB will contribute to early diagnosis and improved management of TB cases, ultimately reducing the burden of childhood TB in Zambia.