Is the tuberculosis knowledge awareness obstructing tuberculosis infection in rural areas of Anqing, China?

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Yunfei Zou, Zhiping Zhang, Huan Wu, Ximei Wang, Chenxu Wang, Hui Xue, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-22226/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 5 You are reading this latest preprint version Abstract Background Health education on tuberculosis is considered as one of the major measures for prevention of tuberculosis disease epidemic. This study is to assess the effects of tuberculosis awareness on tuberculosis infection in rural areas in China. Methods This study was conducted in rural areas of Anhui province, China. There 1118 newly diagnosed TB patients were selected as case group while 384 participants with no TB disease enrolled in control group. Univariate analysis and Multivariable logistic regression model were carried out to assess the effect of TB awareness on TB infection. Results The univariate analysis showed that four core knowledge items of TB, sex, age, education, domicile, smoking, drinking, income, contacting with TB patients, vaccination of bacillus calmette guerin and living area on TB were significantly different between the case and control groups ( P < 0.05). The multivariate logistic regression analysis revealed that education ( OR = 0.242, P = 0.001), income ( OR = 0.555, P = 0.016) were protective factors and domicile ( OR = 0.073, P = 0.026), contacting with TB patients ( OR = 3.020 , P = 0.017) were risk factors for TB infection. However, the awareness or any item of knowledge of TB were not found to be related to TB infection. Conclusions The awareness of TB is not the main influencing factor for TB infection in rural areas, the contents or forms of health education towards TB maybe modified in rural areas. Health Economics & Outcomes Research Infectious Diseases Health Policy Tuberculosis Awareness Influencing factors Case-control study Rural areas Background Tuberculosis is a serious communicable disease around the world. In 2015, about 10.4 million people developed TB and 1.4 million died from this disease 1 . Current studies revealed that gender and age, degree of education, smoking, contact with TB patients, income level, history of BCG vaccination and infection with HIV were probably associated to TB infection 2 – 8 . In addition to those factors, the lack of awareness about TB was considered to be the most important factor that increased the risk of exposure to TB 9 . Especially, loss of knowledge on the cause, mode of transmission, and symptoms as well as irregular treatment of TB would pose a great challenge to control the disease 10 – 13 . Furthermore, poor awareness of TB was also an influencing factor of MDR-TB 14 . Unfortunately, the awareness of TB was found to be very poor, especially in rural areas 15 , 16 . Study from Sudan manifested that there was no significant difference of awareness about TB between TB cases and controls 17 . As a consequence, in order to provide a scientific basis for TB prevention, we conducted this case-control study to assess the effects of awareness on TB infection and explore influencing factors for TB infection in Anqing area. Methods Study participants and sampling This study was carried out between June 2014 and December 2015 in Anqing area. The study site was located in typical rural area of central China and in the southwest of Anhui province with relatively high prevalence of TB and the majority of the population were from rural areas with much lower economic level. Therefore, this area is well representing TB epidemic in rural areas of China. A total of 1502 participants were selected in the communities from eight counties, newly diagnosed TB patients were enrolled in the case group, and healthy controls was recruited randomly within the neighborhood or the household of the TB case. The diagnosis are strictly based on laboratory inspections such as chest X-ray examination, sputum smear examination and clinical symptoms. All participants were informed about the objectives of the study and provided verbal informed consent before the survey. Newly detected sputum smear positive pulmonary TB patients > 15 years who had presented at local medical institutions were eligible for inclusion. People who refused to participate or worked in other city were excluded. The study population was finally gathered on the basis of 1118 cases and 384 controls. We defined cases as adults (aged 15 years and older) with sputum smear positive pulmonary TB. They were interviewed immediately after diagnosis. Those who did not have a sputum smear confirmed diagnosis were excluded from the study. We selected controls randomly that had a sputum smear negative TB from the database. All cases and the controls came from the same source population in this study. Study Design And Data Collection The data collection tool was a unified self-administered questionnaire which was designed according to the World Health Organization guidelines 18 , and then it was pre-tested among 100 people who did not participate in the study and was modified as necessary. Participants were interviewed face-to-face by investigators who had medical science background from local Centers for Disease Control and Prevention (CDC). All information about cases was inquired before their suffering from TB disease. The questionnaire consists of questions on demographic and socioeconomic characteristics (sex, age, education, domicile, smoking-alcohol abuse, other respiratory system medical history, contact with TB patients, history of BCG vaccination, income and living space) of the study participants and their awareness of TB. The awareness section contained 6 questions (details in Table 1 ). Table 1 Univariate analysis of knowledge awareness of TB infection Question Case ( n = 1118)% Control ( n = 384)% P -Value Do you know relevant information about tuberculosis 0.436 Awareness 612(54.38) 219(56.25) Unawareness 506(45.62) 165(43.75) What is the main pathogen causing tuberculosis 0.001 Awareness 463(41.41) 199(51.82) Unawareness 655(58.59) 185(48.18) What is the cardinal symptom of TB patients 0.044 Awareness 611(54.65) 187(48.70) Unawareness 507(45.35) 197(51.30) Is tuberculosis a contagious disease 0.634 Awareness 881(78.80) 307(79.95) Unawareness 237(21.20) 77(20.05) What is the source of infection of tuberculosis 0.001 Awareness 384(34.35) 98(25.52) Unawareness 734(65.65) 286(74.48) What is the route of transmission of tuberculosis 0.040 Awareness 615(55.01) 188(48.96) Unawareness 503(44.99) 196(51.04) Statistical Analysis After the data was organized and edited to allow computer entry of all responses. Data was entered into database established using EpiData 3.0 with double entry. SPSS 18.0 was used for statistical analysis. Descriptive statistics with table of frequency distribution was used to summarize demographic and socioeconomic characteristics and the level of knowledge towards TB. Pearson chi-square test was conducted to evaluate the statistical significant of sex, age and other demographic and socioeconomic variates with the outcome variables (TB infection) in univariate analysis. In the knowledge section, chi-square test was carried out to evaluate the association of the awareness of TB with the outcome variables. At last, multivariable logistic regression model was used to identify the influencing factors and odds ratio (OR) was used to report strength of association between the final variables and the target outcome variables. P < 0.05 was considered to indicate a statistically significant difference. Results General information A total of 1118 cases averaged 50.98 ± 17.97 years of age, the youngest and the oldest of whom were 15 and 90 years of age respectively. 384 controls averaged 36.52 ± 18.01 years of age, the youngest and the oldest of whom were 8 and 93 years of age respectively. Male: female ratio in case and control groups were 2.58:1 and 1.26:1 respectively. The study participants were classified into four age groups: 60 years of age or older, 40 to 59 years of age, 25 to 39 years of age, 15 to 24 years of age. Significant difference was detected in case and control groups ( P < 0.001) and details have been presented in Table 2 . Table 2 Univariate analysis of influencing factors for TB infection Characteristics Case ( n = 1118)% Control ( n = 384)% P -Value Sex < 0.001 Male 806 (72.09) 214 (55.73) Female 312 (27.91) 170 (44.27) Age group (yr) < 0.001 8–24 146 (13.06) 117 (30.47) 25–39 158 (14.13) 99 (25.78) 40–59 354 (31.66) 123 (32.03) ≥ 60 460 (41.15) 45 (11.72) Education < 0.001 Primary Schooling or below 655 (58.59) 96 (25.00) High school 409 (36.58) 228 (59.38) College degree or above 54 (4.83) 60 (15.62) Domicile < 0.001 Urban dwellers 133 (11.90) 86 (22.40) Rural dwellers 985 (88.10) 298 (77.60) Smoking < 0.001 Yes 262 (23.43) 71 (18.32) Quit 236 (21.11) 26 (6.54) No 620 (55.46) 287 (75.13) Drinking 0.071 Yes 310 (27.73) 88 (22.91) No 808 (72.27) 296 (77.09) Average annual income(RMB) < 0.001 11000 188 (16.82) 131 (34.11) Contact with TB patients 0.004 Yes 151 (13.51) 72 (18.75) No 491 (43.92) 182 (47.40) Have no idea 476 (42.57) 130 (33.85) BCG vaccination < 0.001 Yes 421 (37.66) 275 (71.61) No 697 (62.34) 109 (28.39) Living area (m²) 0.028 60 114 (10.20) 36 (9.37) Univariate Analysis Of Knowledge Awareness On Tb Infection Table 1 showed that questions of “What is the main pathogen causing tuberculosis”, “What is the cardinal symptom of TB patients”, “What is the source of infection of tuberculosis” and “What is the route of transmission of tuberculosis” differed significantly compared with control group ( P < 0.05); While there were no significant differences at the questions of “Do you know relevant information about tuberculosis” and “Is tuberculosis a contagious disease” compared with the control group. Univariate Analysis Of General Influencing Factors Table 2 showed that sex, age group, education, domicile, smoking, drinking, average annual income, contact with TB patients, BCG vaccination and living area differed significantly compared with the control group ( P < 0.05); While there were no significant differences in drinking. Multivariate logistic regression analysis of knowledge awareness for TB infection Table 3 showed the results of the multivariable analysis. Four questions above, sex, age, education, domicile, smoking, average annual income and contact with TB patients were put into multivariate logistic regression model to identify the influencing factors for TB. After adjustment for age, education, domicile, smoking status, income, contact with TB patients, the following variables remained in the final model: education( OR = 0.242, P = 0.001), income( OR = 0.555, P = 0.016), domicile ( OR = 0.073, P = 0.026), contacting with TB patients ( OR = 3.020, P = 0.017). Table 3 Multivariate logistic regression analysis for knowledge awareness Factors B S.E . Waldχ 2 OR 95% CI P Education -1.420 0.330 18.473 0.242 0.126–0.462 0.001 Domicile 0.928 0.417 4.958 0.073 0.006–0.821 0.026 Income -0.589 0.245 5.795 0.555 0.344–0.896 0.016 Contact with TB patients 1.105 0.462 5.737 3.020 1.222–7.463 0.017 Adjustment for age, education, domicile, smoking status, income, contact with TB patients Discussion The results of this study showed that most of the community’s members of rural area have information about TB disease. The finding is similar to the results of studies from Afar Region 19 , South West Ethiopia 20 and North Ethiopia 21 , 22 , Malaysia 23 and rural China 24 . In our study, about 44.07% of the respondents (41.41% for case and 51.82% for control) knew that TB was caused by Mycobacterium tuberculosis, which was higher than 3.3% in Itang special district, South West Ethiopia 25 . More than half of the participants (53.13%) responded correctly to the question that main symptoms of tuberculosis, which was inferior to high-school learners (63.0%) in South African 26 and members (72.4%) in Somali Regional State (SRS) of Ethiopia 27 . A majority of people (79.09%) identified that TB was a communicable disease and 53.46% were aware of its transmission route, which was in accordance with the study in Ethiopia (80.0%) 27 . Univariate analysis showed that the second, third, fifth and the sixth core information differed significantly compared with the control group. In Esmael A and Obuku EA’s research, lack of knowledge and erroneous beliefs about TB are common amongst TB patients 15 , 28 . In view of demographic and socioeconomic factors, our findings showed that males have higher risk of TB than females, which was in line with previous studies of tuberculosis 29 , 30 . The risk of TB increased progressively with age in the case group 31 , probably because of low immune level among aged. We found that the risk of TB in cases with higher education background were much lower than those with less education, in another words, high degree of education was the protective factor of TB 29 , it may be because higher-educated people know how to protect themselves better. Findings from some studies 32 – 34 revealed that smoking was independently associated with TB, which was consistent with our findings. Our results were in line with previous studies 35 in that a higher income was consistently associated with reduced TB risk. It is likely that people with higher income will have higher medical assurance level. Close contact with TB patients was another well described risk factor for TB 36 , 37 . This study showed that BCG vaccination differs significantly from the control group 38 . In Lienhardt C’ research 9 , overcrowding has been previously documented as a strong risk for TB, which was in line with our results. In multivariate analysis, we put demographic and socio-economic factors with significant differences in univariate analysis and four core TB information into logistic regression equation. However, four core TB information was not as significant as other studies on TB infection. It reveals that the awareness of TB don’t play an important role as expected in Anqing, China or probably suggests that health education was not far from enough in the region. In other words, the results at least guide us to change the direction of TB prevention in this area. Limitations In this study, there are several limitations. Firstly, this research was conducted in the specified region of Anqing area, which may not be representative of those at the national level. Secondly, the questionnaire did not contain the information on occupation and HIV status. Conclusions In summary, our study identified some influencing factors associated with TB infection, of which education, average annual income were protective factors for TB infection, while domicile, contact with TB patients were risk factors. However, it turned out that knowledge awareness of TB has little relationship with TB infection. The contents and forms of health education towards TB maybe modified in rural areas. Abbreviations OR:Odds ratio; CI:Confidence interval; MDR-TB:Multi drug resistance TB; TB:Tuberculosis; MDR-TB:Multiple drug resistance TB; BCG:Bacillus Calmette - Guerin; Declarations Ethical considerations The study was carried out in compliance with the Declaration of Helsinki of the World Medical Association, and according to a protocol approved by Medical Ethics Committee of Wannan Medical College. The objectives of the study were explained to the study participants and verbal consent was obtained before interviewing each participant. Conflict of Interest: No conflict of interest was declared by the authors. Funding This work was supported by the Key Research and Development Program of Anhui Province of China (grant number 1704a0802154). Authors’ contributions YFZ analyzed and interpreted the data, drafted and revised the manuscript. YFW conceived and designed the study, participated in data collection and critically reviewed the manuscript. ZPZ, HW, XMW, CXW, and HX participated in data collection and reviewed the manuscript. All authors read and approved the final manuscript version for publication. Acknowledgements: We would like to extend our thanks to the cooperator of Anqing Center for Disease Control and Prevention. We also thank the study respondents and the whole community at large for their wholesome effort and contribution in provision of the information. And at last but not least, we would like to thank the survey supervisor and data collectors for their effort to accomplish data collection. 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Tuberculosis risk factors among tuberculosis patients in Kampala, Uganda: implications for tuberculosis control. BMC Public Health. 2015;15(1):13. Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revise before sending to peer reviewers 04 May, 2020 Editor assigned by journal 03 May, 2020 Submission checks completed at journal 17 Apr, 2020 Editor invited by journal 17 Apr, 2020 First submitted to journal 08 Apr, 2020 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-22226","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":500206,"identity":"4a9def41-6097-4bf0-a588-7298ebd1dd55","order_by":1,"name":"Yunfei Zou","email":"","orcid":"https://orcid.org/0000-0003-2661-9461","institution":"Wannan Medical College","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yunfei","middleName":"","lastName":"Zou","suffix":""},{"id":500207,"identity":"5d2bbe44-3254-40f2-9b75-0b87c5b7b9d0","order_by":2,"name":"Zhiping Zhang","email":"","orcid":"","institution":"Anqing Center for Disease Control and Prevention","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Zhiping","middleName":"","lastName":"Zhang","suffix":""},{"id":500208,"identity":"a6074a16-723e-4389-8658-67a14abc894c","order_by":3,"name":"Huan Wu","email":"","orcid":"","institution":"Wannan Medical College","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Huan","middleName":"","lastName":"Wu","suffix":""},{"id":500209,"identity":"f11b7d40-3f6b-4c9d-bd12-963627d1dbb2","order_by":4,"name":"Ximei Wang","email":"","orcid":"","institution":"Wannan Medical College","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ximei","middleName":"","lastName":"Wang","suffix":""},{"id":500210,"identity":"8cb09e53-609f-402b-997b-25ebefb36b3e","order_by":5,"name":"Chenxu Wang","email":"","orcid":"","institution":"Wannan Medical College","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chenxu","middleName":"","lastName":"Wang","suffix":""},{"id":500211,"identity":"b1cf4ce6-d6a9-4527-ac9c-0111fe6d1d94","order_by":6,"name":"Hui Xue","email":"","orcid":"","institution":"Wannan Medical College","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Hui","middleName":"","lastName":"Xue","suffix":""},{"id":500212,"identity":"f7f713d2-44d5-4e6e-ad9e-bb08f6165b2b","order_by":7,"name":"Yufeng Wen","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAqklEQVRIiWNgGAWjYFACxocPoCwDYrUwG8OUEq/FTII0LQY3ktmqeXdsk2dgb94mwVBzhzgtt3nP3DZs4DlWJsFw7BlhLWY38o/dzm27ncAgkWMmwdhwmBgtyWzFYC3yb0jQwgyxhYdILfZnHjNL/227bdjGk1ZskXCMCC2S7cmMH2e23ZbnZz+88caHGiK0MAgkQGg2EJFAhAYGBv4DRCkbBaNgFIyCkQwAdHs23dTk2moAAAAASUVORK5CYII=","orcid":"","institution":"Wannan Medical College","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Yufeng","middleName":"","lastName":"Wen","suffix":""}],"badges":[],"createdAt":"2020-04-09 11:46:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-22226/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-22226/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":13499405,"identity":"54fb847c-9353-461d-8f94-0d146d1b4a76","added_by":"auto","created_at":"2021-09-16 23:01:57","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":342871,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-22226/v1/036a2303-8246-47df-aa02-9fe91aca7bc2.pdf"}],"financialInterests":"","formattedTitle":"Is the tuberculosis knowledge awareness obstructing tuberculosis infection in rural areas of Anqing, China?","fulltext":[{"header":"Background","content":" \u003cp\u003eTuberculosis is a serious communicable disease around the world. In 2015, about 10.4\u0026nbsp;million people developed TB and 1.4\u0026nbsp;million died from this disease\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Current studies revealed that gender and age, degree of education, smoking, contact with TB patients, income level, history of BCG vaccination and infection with HIV were probably associated to TB infection\u003csup\u003e\u003cspan additionalcitationids=\"CR3 CR4 CR5 CR6 CR7\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. In addition to those factors, the lack of awareness about TB was considered to be the most important factor that increased the risk of exposure to TB\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. Especially, loss of knowledge on the cause, mode of transmission, and symptoms as well as irregular treatment of TB would pose a great challenge to control the disease\u003csup\u003e\u003cspan additionalcitationids=\"CR11 CR12\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. Furthermore, poor awareness of TB was also an influencing factor of MDR-TB\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eUnfortunately, the awareness of TB was found to be very poor, especially in rural areas\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. Study from Sudan manifested that there was no significant difference of awareness about TB between TB cases and controls\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e. As a consequence, in order to provide a scientific basis for TB prevention, we conducted this case-control study to assess the effects of awareness on TB infection and explore influencing factors for TB infection in Anqing area.\u003c/p\u003e "},{"header":"Methods","content":" \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy participants and sampling\u003c/h2\u003e \u003cp\u003eThis study was carried out between June 2014 and December 2015 in Anqing area. The study site was located in typical rural area of central China and in the southwest of Anhui province with relatively high prevalence of TB and the majority of the population were from rural areas with much lower economic level. Therefore, this area is well representing TB epidemic in rural areas of China. A total of 1502 participants were selected in the communities from eight counties, newly diagnosed TB patients were enrolled in the case group, and healthy controls was recruited randomly within the neighborhood or the household of the TB case. The diagnosis are strictly based on laboratory inspections such as chest X-ray examination, sputum smear examination and clinical symptoms. All participants were informed about the objectives of the study and provided verbal informed consent before the survey. Newly detected sputum smear positive pulmonary TB patients\u0026thinsp;\u0026gt;\u0026thinsp;15\u0026nbsp;years who had presented at local medical institutions were eligible for inclusion. People who refused to participate or worked in other city were excluded. The study population was finally gathered on the basis of 1118 cases and 384 controls.\u003c/p\u003e \u003cp\u003eWe defined cases as adults (aged 15\u0026nbsp;years and older) with sputum smear positive pulmonary TB. They were interviewed immediately after diagnosis. Those who did not have a sputum smear confirmed diagnosis were excluded from the study. We selected controls randomly that had a sputum smear negative TB from the database. All cases and the controls came from the same source population in this study.\u003c/p\u003e \u003c/div\u003e \u003ch2\u003eStudy Design And Data Collection\u003c/h2\u003e \u003cp\u003eThe data collection tool was a unified self-administered questionnaire which was designed according to the World Health Organization guidelines\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e, and then it was pre-tested among 100 people who did not participate in the study and was modified as necessary. Participants were interviewed face-to-face by investigators who had medical science background from local Centers for Disease Control and Prevention (CDC). All information about cases was inquired before their suffering from TB disease.\u003c/p\u003e \u003cp\u003eThe questionnaire consists of questions on demographic and socioeconomic characteristics (sex, age, education, domicile, smoking-alcohol abuse, other respiratory system medical history, contact with TB patients, history of BCG vaccination, income and living space) of the study participants and their awareness of TB. The awareness section contained 6 questions (details in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate analysis of knowledge awareness of TB infection\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuestion\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase\u003c/p\u003e \u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1118)%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;384)%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo you know relevant information about tuberculosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.436\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAwareness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e612(54.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e219(56.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnawareness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e506(45.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e165(43.75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhat is the main pathogen causing tuberculosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAwareness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e463(41.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e199(51.82)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnawareness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e655(58.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e185(48.18)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhat is the cardinal symptom of TB patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.044\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAwareness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e611(54.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e187(48.70)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnawareness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e507(45.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e197(51.30)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIs tuberculosis a contagious disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.634\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAwareness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e881(78.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e307(79.95)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnawareness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e237(21.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77(20.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhat is the source of infection of tuberculosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAwareness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e384(34.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e98(25.52)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnawareness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e734(65.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e286(74.48)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhat is the route of transmission of tuberculosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.040\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAwareness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e615(55.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e188(48.96)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnawareness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e503(44.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e196(51.04)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eAfter the data was organized and edited to allow computer entry of all responses. Data was entered into database established using EpiData 3.0 with double entry. SPSS 18.0 was used for statistical analysis. Descriptive statistics with table of frequency distribution was used to summarize demographic and socioeconomic characteristics and the level of knowledge towards TB. Pearson chi-square test was conducted to evaluate the statistical significant of sex, age and other demographic and socioeconomic variates with the outcome variables (TB infection) in univariate analysis. In the knowledge section, chi-square test was carried out to evaluate the association of the awareness of TB with the outcome variables. At last, multivariable logistic regression model was used to identify the influencing factors and odds ratio (OR) was used to report strength of association between the final variables and the target outcome variables. P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered to indicate a statistically significant difference.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":" \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eGeneral information\u003c/h2\u003e \u003cp\u003eA total of 1118 cases averaged 50.98\u0026thinsp;\u0026plusmn;\u0026thinsp;17.97\u0026nbsp;years of age, the youngest and the oldest of whom were 15 and 90\u0026nbsp;years of age respectively. 384 controls averaged 36.52\u0026thinsp;\u0026plusmn;\u0026thinsp;18.01\u0026nbsp;years of age, the youngest and the oldest of whom were 8 and 93\u0026nbsp;years of age respectively. Male: female ratio in case and control groups were 2.58:1 and 1.26:1 respectively.\u003c/p\u003e \u003cp\u003eThe study participants were classified into four age groups: 60\u0026nbsp;years of age or older, 40 to 59\u0026nbsp;years of age, 25 to 39\u0026nbsp;years of age, 15 to 24\u0026nbsp;years of age. Significant difference was detected in case and control groups (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and details have been presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate analysis of influencing factors for TB infection\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1118)%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;384)%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e806 (72.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e214 (55.73)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e312 (27.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e170 (44.27)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge group (yr)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e146 (13.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e117 (30.47)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e158 (14.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e99 (25.78)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e354 (31.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e123 (32.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e460 (41.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45 (11.72)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary Schooling or below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e655 (58.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e96 (25.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e409 (36.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e228 (59.38)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCollege degree or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e54 (4.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60 (15.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDomicile\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban dwellers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e133 (11.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e86 (22.40)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural dwellers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e985 (88.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e298 (77.60)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e262 (23.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e71 (18.32)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e236 (21.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26 (6.54)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e620 (55.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e287 (75.13)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrinking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.071\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e310 (27.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e88 (22.91)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e808 (72.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e296 (77.09)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAverage annual income(RMB)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;4000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e421 (37.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e120 (31.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4000\u0026ndash;11000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e509 (45.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e133 (34.64)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;11000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e188 (16.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e131 (34.11)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eContact with TB patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e151 (13.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e72 (18.75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e491 (43.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e182 (47.40)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHave no idea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e476 (42.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e130 (33.85)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBCG vaccination\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e421 (37.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e275 (71.61)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e697 (62.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e109 (28.39)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLiving area (m\u0026sup2;)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.028\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e391 (34.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e165 (42.97)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e613 (54.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e183 (47.66)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e114 (10.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36 (9.37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003ch2\u003eUnivariate Analysis Of Knowledge Awareness On Tb Infection\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e showed that questions of \u0026ldquo;What is the main pathogen causing tuberculosis\u0026rdquo;, \u0026ldquo;What is the cardinal symptom of TB patients\u0026rdquo;, \u0026ldquo;What is the source of infection of tuberculosis\u0026rdquo; and \u0026ldquo;What is the route of transmission of tuberculosis\u0026rdquo; differed significantly compared with control group (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05); While there were no significant differences at the questions of \u0026ldquo;Do you know relevant information about tuberculosis\u0026rdquo; and \u0026ldquo;Is tuberculosis a contagious disease\u0026rdquo; compared with the control group.\u003c/p\u003e \u003ch2\u003eUnivariate Analysis Of General Influencing Factors\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e showed that sex, age group, education, domicile, smoking, drinking, average annual income, contact with TB patients, BCG vaccination and living area differed significantly compared with the control group (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05); While there were no significant differences in drinking.\u003c/p\u003e \u003ch2\u003eMultivariate logistic regression analysis of knowledge awareness for TB infection\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e showed the results of the multivariable analysis. Four questions above, sex, age, education, domicile, smoking, average annual income and contact with TB patients were put into multivariate logistic regression model to identify the influencing factors for TB. After adjustment for age, education, domicile, smoking status, income, contact with TB patients, the following variables remained in the final model: education(\u003cem\u003eOR\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.242, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001), income(\u003cem\u003eOR\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.555, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.016), domicile (\u003cem\u003eOR\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.073, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.026), contacting with TB patients (\u003cem\u003eOR\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.020, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.017).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariate logistic regression analysis for knowledge awareness\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFactors\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eS.E\u003c/em\u003e.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eWaldχ\u003c/em\u003e\u003csup\u003e\u003cem\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/em\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eOR\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e95%\u003cem\u003eCI\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.420\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.330\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.473\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.242\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.126\u0026ndash;0.462\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDomicile\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.928\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.417\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.958\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.006\u0026ndash;0.821\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.589\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.245\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.795\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.555\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.344\u0026ndash;0.896\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eContact with TB patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.462\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.737\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.222\u0026ndash;7.463\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eAdjustment for age, education, domicile, smoking status, income, contact with TB patients\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e "},{"header":"Discussion","content":" \u003cp\u003eThe results of this study showed that most of the community\u0026rsquo;s members of rural area have information about TB disease. The finding is similar to the results of studies from Afar Region\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e, South West Ethiopia\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e and North Ethiopia\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e, Malaysia\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e and rural China\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. In our study, about 44.07% of the respondents (41.41% for case and 51.82% for control) knew that TB was caused by Mycobacterium tuberculosis, which was higher than 3.3% in Itang special district, South West Ethiopia\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. More than half of the participants (53.13%) responded correctly to the question that main symptoms of tuberculosis, which was inferior to high-school learners (63.0%) in South African\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e and members (72.4%) in Somali Regional State (SRS) of Ethiopia\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e. A majority of people (79.09%) identified that TB was a communicable disease and 53.46% were aware of its transmission route, which was in accordance with the study in Ethiopia (80.0%)\u003csup\u003e27\u003c/sup\u003e. Univariate analysis showed that the second, third, fifth and the sixth core information differed significantly compared with the control group. In Esmael A and Obuku EA\u0026rsquo;s research, lack of knowledge and erroneous beliefs about TB are common amongst TB patients\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. In view of demographic and socioeconomic factors, our findings showed that males have higher risk of TB than females, which was in line with previous studies of tuberculosis\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e,\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e. The risk of TB increased progressively with age in the case group\u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e, probably because of low immune level among aged. We found that the risk of TB in cases with higher education background were much lower than those with less education, in another words, high degree of education was the protective factor of TB\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e, it may be because higher-educated people know how to protect themselves better. Findings from some studies\u003csup\u003e\u003cspan additionalcitationids=\"CR33\" citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003erevealed that smoking was independently associated with TB, which was consistent with our findings. Our results were in line with previous studies\u003csup\u003e\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e in that a higher income was consistently associated with reduced TB risk. It is likely that people with higher income will have higher medical assurance level. Close contact with TB patients was another well described risk factor for TB\u003csup\u003e\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e,\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u003c/sup\u003e. This study showed that BCG vaccination differs significantly from the control group\u003csup\u003e\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e. In Lienhardt C\u0026rsquo; research\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e, overcrowding has been previously documented as a strong risk for TB, which was in line with our results. In multivariate analysis, we put demographic and socio-economic factors with significant differences in univariate analysis and four core TB information into logistic regression equation. However, four core TB information was not as significant as other studies on TB infection. It reveals that the awareness of TB don\u0026rsquo;t play an important role as expected in Anqing, China or probably suggests that health education was not far from enough in the region. In other words, the results at least guide us to change the direction of TB prevention in this area.\u003c/p\u003e "},{"header":"Limitations","content":" \u003cp\u003eIn this study, there are several limitations. Firstly, this research was conducted in the specified region of Anqing area, which may not be representative of those at the national level. Secondly, the questionnaire did not contain the information on occupation and HIV status.\u003c/p\u003e "},{"header":"Conclusions","content":" \u003cp\u003eIn summary, our study identified some influencing factors associated with TB infection, of which education, average annual income were protective factors for TB infection, while domicile, contact with TB patients were risk factors. However, it turned out that knowledge awareness of TB has little relationship with TB infection. The contents and forms of health education towards TB maybe modified in rural areas.\u003c/p\u003e "},{"header":"Abbreviations","content":" \u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eOR:Odds ratio; CI:Confidence interval; MDR-TB:Multi drug resistance TB; TB:Tuberculosis; MDR-TB:Multiple drug resistance TB; BCG:Bacillus Calmette - Guerin;\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e "},{"header":"Declarations","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eEthical considerations\u003c/h2\u003e \u003cp\u003eThe study was carried out in compliance with the Declaration of Helsinki of the World Medical Association, and according to a protocol approved by Medical Ethics Committee of Wannan Medical College. The objectives of the study were explained to the study participants and verbal consent was obtained before interviewing each participant.\u003c/p\u003e \u003c/div\u003e \u003cp\u003e \u003ch2\u003eConflict of Interest:\u003c/h2\u003e \u003cp\u003eNo conflict of interest was declared by the authors.\u003c/p\u003e \u003c/p\u003e \u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThis work was supported by the Key Research and Development Program of Anhui Province of China (grant number 1704a0802154).\u003c/p\u003e \u003ch2\u003eAuthors\u0026rsquo; contributions\u003c/h2\u003e \u003cp\u003eYFZ analyzed and interpreted the data, drafted and revised the manuscript. YFW conceived and designed the study, participated in data collection and critically reviewed the manuscript. ZPZ, HW, XMW, CXW, and HX participated in data collection and reviewed the manuscript. All authors read and approved the final manuscript version for publication.\u003c/p\u003e \u003ch2\u003eAcknowledgements:\u003c/h2\u003e \u003cp\u003eWe would like to extend our thanks to the cooperator of Anqing Center for Disease Control and Prevention. We also thank the study respondents and the whole community at large for their wholesome effort and contribution in provision of the information. And at last but not least, we would like to thank the survey supervisor and data collectors for their effort to accomplish data collection.\u003c/p\u003e "},{"header":"References","content":"\u003col\u003e\u003cli\u003e \u003cspan\u003eWorld Health Organization (WHO). \u003cem\u003eGlobal tuberculosis report\u003c/em\u003e. Geneva. 2016; Available at: .\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eRhines AS. The role of sex differences in the prevalence and transmission of tuberculosis. Tuberculosis. 2013;93(1):104\u0026ndash;7.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eGraciani Rodrigues CC, Esp\u0026iacute;ndola AL, Penna TJP. An agent-based computational model for tuberculosis spreading on age-structured populations. Physica A. 2015;428:52\u0026ndash;9.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eZhu SY, Hou YC, Shu W, Zhang GL, Nie SF, Chen W, et al. Study on the risk factors of tuberculosis in four cities and provinces in China. Zhonghua liu xing bing xue za zhi. 2013;34(2):129\u0026ndash;32.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eYen YF, Yen MY, Lin YS, Lin YP, Shih HC, Li LH, et al. Smoking increases risk of recurrence after successful anti-tuberculosis treatment: a population-based study. 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BMC Public Health. 2015;15(1):13.\u003c/span\u003e \u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Tuberculosis, Awareness, Influencing factors, Case-control study, Rural areas","lastPublishedDoi":"10.21203/rs.3.rs-22226/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-22226/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eHealth education on tuberculosis is considered as one of the major measures for prevention of tuberculosis disease epidemic. This study is to assess the effects of tuberculosis awareness on tuberculosis infection in rural areas in China.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis study was conducted in rural areas of Anhui province, China. There 1118 newly diagnosed TB patients were selected as case group while 384 participants with no TB disease enrolled in control group. Univariate analysis and Multivariable logistic regression model were carried out to assess the effect of TB awareness on TB infection.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe univariate analysis showed that four core knowledge items of TB, sex, age, education, domicile, smoking, drinking, income, contacting with TB patients, vaccination of bacillus calmette guerin and living area on TB were significantly different between the case and control groups (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The multivariate logistic regression analysis revealed that education (\u003cem\u003eOR\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.242, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001), income (\u003cem\u003eOR\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.555, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.016) were protective factors and domicile (\u003cem\u003eOR\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.073, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.026), contacting with TB patients (\u003cem\u003eOR\u0026thinsp;=\u0026thinsp;3.020\u003c/em\u003e, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.017) were risk factors for TB infection. However, the awareness or any item of knowledge of TB were not found to be related to TB infection.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe awareness of TB is not the main influencing factor for TB infection in rural areas, the contents or forms of health education towards TB maybe modified in rural areas.\u003c/p\u003e","manuscriptTitle":"Is the tuberculosis knowledge awareness obstructing tuberculosis infection in rural areas of Anqing, China?","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-04-22 13:37:43","doi":"10.21203/rs.3.rs-22226/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revise before sending to peer reviewers","date":"2020-05-04T12:00:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2020-05-03T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2020-04-17T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2020-04-17T12:00:00+00:00","index":"","fulltext":""},{"type":"submitted","content":"","date":"2020-04-08T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e8fb3a1e-92c8-43b7-8e89-b6439d522253","owner":[],"postedDate":"April 22nd, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[{"id":87040,"name":"Health Economics \u0026 Outcomes Research"},{"id":87041,"name":"Infectious Diseases"},{"id":87042,"name":"Health Policy"}],"tags":[],"updatedAt":"2020-05-04T17:04:41+00:00","versionOfRecord":[],"versionCreatedAt":"2020-04-22 13:37:43","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-22226","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-22226","identity":"rs-22226","version":["v1"]},"buildId":"WrCJVZZCHTDjtuVLN7oU0","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}