Date of Award

1-1-2019

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

John L. Davis

Abstract

TB education and counseling (TEC) is universally recommended for individuals initiating treatment for active TB in Uganda. The effectiveness of routine TEC in Kampala and the association between specific knowledge domains and treatment outcomes is unknown. We sought to (1) to evaluate the effectiveness of routine TEC in helping individuals to increase and retain TB-specific knowledge and (2) to examine the association between TB knowledge and treatment outcomes among individuals diagnosed with TB. We enrolled adults (age ≥18) initiating treatment for active TB at Kisenyi Health Centre in Kampala, Uganda into a prospective, observational cohort study. We administered a verbal survey before and after TEC and at three refill appointments. We analyzed change in knowledge at three hierarchically-organized levels. We used Poisson and logistic regression models to describe associations with nonadherence and final treatment outcome, respectively. Eighty patients were enrolled. After TEC, TB disease-specific and treatment-specific knowledge increased significantly overall and across each of the eight sub-domains. Nine of 17 disease-specific questions and 11 of 13 treatment-specific questions changed significantly after TEC. For disease-specific knowledge, scores did not change significantly at two of three follow-up interviews; for treatment-specific knowledge, scores did not change significantly at any of the follow-up interviews. Disease- and treatment-specific scores were significantly associated with nonadherence at two weeks and two months. At least two of the eight sub-domains were significantly associated with nonadherence at each time point. Routine TEC was effective at increasing knowledge, and this knowledge was generally retained. Individual question scores were heterogeneous and show where TEC can be improved. Further, domains associated with nonadherence provide insight into areas where TB knowledge may be most important and where TEC should be targeted in future interventions.

Comments

This is an Open Access Thesis.

Download
Open Access

This Article is Open Access

Share

COinS