Background: Knowledge plays a vital role in influencing the behavior and practices of individuals. Tuberculosis (TB) is a major public health problem. Our objective is to identify the extent of awareness about TB among King Saud University students, and to compare knowledge about tuberculosis amongst different University tracks. Methods: This study was conducted using a cross-sectional approach including 530 students in three different academic tracks: Health, Scientific, and Humanitarian tracks. For data collection, a structured questionnaire was developed through revision of the literature which contained three different parts; demographic data of subjects, knowledge about TB and attitude toward TB. Results: The established scoring system revealed a poor grade of knowledge at 51.4%. Tuberculosis knowledge was significantly higher amongst the track of Health colleges (46.7% compared with 27.2% for the track of Science and 26% for the track of Humanitarian studies). However, some of the issues were answered fittingly in higher magnitude by the two other non-health tracks; there was no significant difference in gender-specific awareness level (48% for both). Conclusion: Although the Health track has better knowledge in general (46.7%), the level of awareness of Tuberculosis is poor among King Saud University students. Moreover, the level of awareness differs among the three tracks, which are health, humanitarian, and science. The health track showed the highest level of awareness.
Tuberculosis (TB) is a major public health concern in Saudi Arabia [
Literature review does not reveal previous studies assessing tuberculosis public awareness conducted in Saudi Arabia. Therefore, the objective of this study is to assess the extent of awareness amongst King Saud University students regarding TB.
This study was conducted using a cross-sectional approach targeting students from King Saud University (KSU) including different academic tracks: Health, Scientific, and Humanitarian tracks. Sample size was determined assuming the prevalence of poor knowledge of TB equals 30% and degree of precision = 0.05. A stratified random sampling technique was used to recruit the respondents. To compensate for non-responders, 32% were added, which yielded a total sample of 530. The stratification was done according to the tracks and colleges. Proportionate allocation method was used to determine the number of participants from each college. Ethical approval of the study protocol was obtained from college of medicine ethical committee (IRB). Letter of study approval from the college of medicine was sent to track administrators
For data collection, a structured self-administered questionnaire was developed through revision of the literature it contained three different parts; demographic data of subjects, e.g. demographic variables; gender, and age; knowledge about TB and attitude toward TB*. The questionnaire was tested for validity and reliability. The participants completed the questionnaires through self-administration. Questionnaires were distributed according to the number of students of the three-abovementioned tracks. The health track included colleges of medicine, dentistry, and pharmacy, College of science, college of business and administration, college of engineering and college of computer and information sciences within the track of science colleges, college of law and political sciences, college of languages, college of education and college of literature within the track of humanitarian colleges. TB-specific variables e.g. etiology, mode of spread, contagiousness, signs and symptoms, etc, known TB patients will be excluded from the study. SPSS software was used in data tabulations and analysis [
Five hundred thirty questionnaires were distributed to King Saud University students; 499 completed the questionnaires (94%), 347 (69.5%) males and 152 (30.5%) females. The sample included the three tracks: Colleges of Health, Colleges of Science, and Humanitarian colleges (21.2%, 24.4%, and 53.7%, respectively.) The mean age of participants was 21.54 ± 2.06 years. Smokers were 14.2%, and the ex-smokers were 3.4% (
Characteristics | Frequency | Percent |
---|---|---|
1-Gender | ||
Male | 347 | 69.5 |
Female | 152 | 30.5 |
Total | 499 | 100% |
2-Age x̄ ± SD | 21.544 ± 1.058 | |
3-Marital status | ||
Single | 461 | 93 |
Married | 34 | 6.8 |
Divorced | 1 | 0.2 |
Total | 496 | 100% |
4-Tracks | ||
Science colleges | 122 | 24.6 |
Health colleges | 106 | 21.4 |
Humanitarian colleges | 268 | 54 |
Total | 496 | 100% |
5-Residence | ||
Riyadh | 487 | 98.5 |
Outside Riyadh | 7 | 1.5 |
Total | 494 | 100% |
6-GPA x̄ ± SD | 3.72 ± 0.75 | |
7-Mothers’ educational level | ||
Less than secondary | 134 | 30.2 |
Secondary | 112 | 25.2 |
University | 181 | 40.8 |
Post-graduate | 17 | 3.8 |
Total | 444 | 100% |
8-Fathers’ educational leved | ||
Less than secondary | 70 | 16 |
Secondary | 97 | 22 |
University | 209 | 47 |
Post-graduate | 68 | 15 |
Total | 444 | 100% |
GPA: Grade Point Average; x̄: Statistical mean; SD: Standard deviation.
Source of knowledge | ||
---|---|---|
Frequency | Percent | |
Television | 185 | 37.1 |
Internet | 147 | 29.5 |
Health brochures | 122 | 24.4 |
Newspaper | 108 | 21.6 |
Family member | 95 | 19.0 |
Friends | 79 | 15.8 |
Others | 5 | 12 |
The proportion of participants who know someone that has been infected with TB was 14.0%. Around 63.0% recorded that tuberculosis was infectious, while only 5.0% thought TB is hereditary. About 68.1% of participants have chosen lungs as the most commonly affected organ by tuberculosis. Other organs that may be infected as liver, kidney, bone, spine, testicles, brain, and ears were 19.2%, 14.4%, 10.8%, 8.8%, 8.2%, 6, 8%, and 2.2%, respectively.
Around half of the participants have picked virus as the cause of tuberculosis (46.3%), however 44.3% of them concomitantly selected bacteria. Reported methods of TB spread were cough-air (57%), unclean food or water (19%), sexual contact with TB patient (18.6%), public areas (11.6%), hereditary (6.6%), whereas (20.6%) did not know. Most participants (69.3%) have selected immuno-compromise as a risk-factor for developing Tuberculosis. Followed by, overcrowding (30.9%), smoking (27.7%), illegal drug use (14.2%), genetic predisposition (11.8%), and alcohol (8.6%) (
A total of 335 participants (67.1%) considered TB is a preventable disease. Regarding method of the prevention, 79.7% of them believe that TB is prevented primarily by vaccination, and 20.3% of the participants reported that TB could be prevented by other methods.
Regarding Symptoms of TB, (47.9%) of the participants considered coughing blood as a symptom of TB, (44.9%) agreed that productive/prolonged cough is a symptom of TB. In addition, other symptoms reported, include constipation (37%), night sweating (22%) and weight loss (3.6%). Symptoms such as chest pain, fever, pallor, appetite loss, diarrhea, itching, and impotence were agreed upon being symptoms of TB by 35.7%, 31.5%, 30.3%, 22%, 16%, 14%, and 5.2%, respectively.
As regards to the duration of treatment of TB, 295 participants (59%) did not know the duration of TB treatment. 90 participants (18%) answered with 6 - 9 months, and 63 (12.6%) chose 1 - 5 months as the duration of treatment.
For side effects of TB treatment, 218 (43.7%) participants do not know side effects of treatment. 123 participants reported jaundice (24.6%) while Dizziness was reported by (23.6%). 71 participants (14.2%) responded that red-orange urine was a possible side effect (
Concerning the complications of TB, 197 (39.5%) reported that death is a complication of TB. 189 (37.9%) chose relapse. Furthermore, 175 participants (35.1%) believed that generalized TB was a complication of TB. Drug resistance, bleeding, and cancer were reported by 16.8%, 22.8%, and 4.2%, respectively.
Grade of knowledge in students of King Saud University, according to the median, 179 (51.4%) participants have poor knowledge and 169 (48.6%) have good knowledge. The maximum score was 19 out of 21, and the minimum was one. The mean was 9.54 ± 3.93 and a median was 9.0.
Risk factor | ||
---|---|---|
Frequency | Percent | |
Smoking | 138 | 27.7 |
Overcrowding | 154 | 30.9 |
Genetic predisposition | 59 | 11.8 |
Immuno-compromised | 346 | 69.3 |
Alcohol | 43 | 8.6 |
Illegal drug use | 71 | 14.2 |
Treatment characteristic | ||
---|---|---|
Frequency | Percent | |
Duration | ||
1 - 5 months | 63 | 12.9 |
6 - 9 months | 90 | 18.4 |
10 - 12 months | 39 | 8.0 |
Don’t know | 295 | 60.5 |
Total | 487 | 100% |
Side effect | ||
Jaundice | 123 | 24.6 |
Dizziness | 118 | 23.6 |
Red-orange urine | 71 | 14.2 |
Vomiting | 89 | 17.8 |
Muscle/joint pain | 62 | 12.4 |
Itching | 40 | 8.0 |
Diarrhea | 41 | 8.2 |
Don’t know | 218 | 43.7 |
(P = 0.062).
Regarding the grade of knowledge in the different colleges of King Saud University, 9.2% of the participants in Health Colleges had a poor knowledge. In contrast, 47.12% and 74.5% of the participants in Scientific Colleges and Humanitarian Colleges, respectively, had a poor knowledge with statistical significance in-between (P < 0.05). Considering the maternal level of education, 8.4% of the participants whom mothers had a post-graduate degree had poor knowledge, while 45.5% with a mother’s education of a graduate degree had a poor knowledge. As regards the father’s education and grade of knowledge, 28% of participants with father’s post-graduate degree had a poor knowledge. 41.5% with father’s pre-high-school degree had a poor knowledge. 50.4% with father’s graduate degree had a poor knowledge. 62.4% of the participants with father’s high school degree had a poor knowledge, which is statistically significant (P < 0.05). As for smokers, 52.9% of the smokers had a poor knowledge. While 51.2% of the non-smokers had a poor knowledge and 44.4% of the ex. Smokers had poor knowledge, this was not statistically significant (P = 0.894).
Tuberculosis remains the second most common cause of death due infectious diseases after HIV/AIDS. It con-
Characteristics | Grade of knowledge | ||||
---|---|---|---|---|---|
Poor n (%) | Good n (%) | Total | P | ||
1-Gender (398) | 0.90 | ||||
Male | 121 (67.5) | 114 (67.4) | 235 | ||
Female | 58 (32.4) | 55 (32.5) | 113 | ||
2-Age x̄ ± SD | 21.56 ± 2.08 | 21.44 ± 1.81 | 21.50 ± 1.95 | 0.28 | |
3-Marital status (346) | |||||
Single | 160 (89.8) | 160 (95.2) | 320 | 0.62 | |
Married | 18 (10.1) | 7 (4.1) | 25 | ||
Divorced | 0 | 1 (0.05) | 1 | ||
4-Tracks (347) | |||||
Science colleges | 41 (23) | 46 (27.2) | 87 | <0.001 | |
Health colleges | 8 (4.4) | 79 (46.7) | 87 | ||
Humanitarian colleges | 129 (72.4) | 44 (26) | 173 | ||
5-GPA x̄ ± SD | 3.61 ± 0.72 | 3.98 ± 0.71 | 3.79 ± 0.74 | 0.108 | |
6-Mothers’ educational level | |||||
Less than secondary | 45 (30.2) | 37 (24.1) | 82 | 0.009 | |
Secondary | 43 (28.8) | 33 (21.5) | 76 | ||
University | 60 (40.2) | 72 (47) | 132 | ||
Post-graduate | 1 (0.6) | 11 (7.1) | 12 | ||
7-Fathers’ educational level | |||||
Less than secondary | 17 (11.5) | 24 (15.1) | 41 | 0.002 | |
Secondary | 43 (29.2) | 26 (16.4) | 69 | ||
University | 73 (49.6) | 72 (45.5) | 145 | ||
Post-graduate | 14 (9.5) | 36 (22.7) | 50 | ||
8-Smoking status (345) | |||||
Yes | 27 (15.2) | 24 (14.2) | 51 | 0.894 | |
No | 146 (82.4) | 139 (82.7) | 285 | ||
Ex. smoker | 4 (2.2) | 5 (2.9) | 9 | ||
stitutes a major burden on health care systems across the globe [
The current study’s respondents with parents having secondary or higher education had significantly higher score on general knowledge on TB. This showed education was an important determinant of general knowledge on TB. The study is supported by other studies namely Westaway M.S [
As predicted, tuberculosis knowledge was significantly higher amongst the Health track colleges compared with the two other tracks. This can be explained by the fact that health colleges most probably have had studied TB at some point in their curriculum. This variability in knowledge about TB should point out the populations in which proper health measures are put into appropriate practice.
The current finding is consistent with other analogous studies worldwide [
Current overseas studies on awareness of people regarding tuberculosis have revealed both similar and contrasting aspects of the awareness level. For example, regarding the nature of tuberculosis, one study in Rajasthan, India has revealed that only six (1.6%) out of 376 participants knew that tuberculosis is caused by a germ, while 206 (54.8%) had the misconception that tuberculosis is a hereditary disease [
Concerning the symptoms of tuberculosis, A study that was conducted in Sabah, Malaysia revealed that 91 (46.2%) and 73 (37.1%) out of 197 knew that tuberculosis is associated with hemoptysis and cough, respectively [
A population wise difference is noted in the three studies of Rajasthan, India and Sabah, Malaysia, and China. The studies included similar age groups as ours, except for the added recruitment of younger (<20) respondents in the China [
While the great majority of the respondents thought that TB is treatable and can be cured by modern medicine, one-fifth of the respondents knew the correct duration for treatment of TB. This misconception about the treatment duration of TB in our study requires appropriate educational approaches.
This study concludes that the level of awareness of Tuberculosis is poor among King Saud University students. It differs in the three university tracks, which are health, humanitarian, and science. Furthermore, according to the used scale, in both male and female sections, the health track has shown the highest level of awareness and the second highest is the science track, and, the humanitarian track has the lowest level of awareness overall.
The authors acknowledge the efforts and work of all who helped throughout the study, especially Ibrahim Ali Alshiddi.