Factors associated with knowledge about tuberculosis and attitudes of
               relatives of patients with the disease in Ribeirão Preto, São Paulo,
               Brazil

Freitas, Isabela Moreira de; Popolin, Marcela Paschoal; Touso, Michelle Mosna; Yamamura, Mellina; Rodrigues, Ludmila Barbosa Bandeira; Santos Neto, Marcelino; Crispim, Juliane de Almeida; Arcêncio, Ricardo Alexandre

doi:10.1590/1980-5497201500020004

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Revista Brasileira de Epidemiologia

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Original Articles • Rev. bras. epidemiol. 18 (2) • Apr-Jun 2015 • https://doi.org/10.1590/1980-5497201500020004 copy

Factors associated with knowledge about tuberculosis and attitudes of relatives of patients with the disease in Ribeirão Preto, São Paulo, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

To investigate the knowledge regarding tuberculosis among relatives of patients with tuberculosis and the possible factors associated with this event and also to conduct comparative analyses between groups of relatives with or with few knowledge regarding tuberculosis, considering their attitudes in both groups.

METHODS:

Cross-sectional study in which the sample was obtained through simple and randomized method. The data were collected by trained interviewers and validated tool. Logistic regression analyses were done using statistical software SPSS, version 22.0.

RESULTS:

Among the 110 subjects recruited for the study, 85 (87.5%) were women, and the mean age was 49 years. Regarding common symptoms of tuberculosis, 102 relatives (90.9%) pointed the chronic cough; regarding the knowledge about tuberculosis transmission modes, 100 (90.9%) of them pointed symptomatic respiratory as the probable infection source. The relatives also reported other tuberculosis transmission models: sharing of clothes (n = 87; 79.1%) and household utensils (n = 66; 60%); sexual relations (n = 50; 50%). Illiterate relatives (adjusted OR = 4.39; 95%CI 1.11 - 17.36), those who do not watch or watch little television (adjusted OR = 3.99; 95%CI 1.2 - 13.26), and also those who do not have the Internet access (adjusted OR = 5.01; 95%CI 1.29 - 19.38) were more likely to have low knowledge regarding tuberculosis. Regardless the group, with or without tuberculosis knowledge, the attitudes of both were satisfactory.

CONCLUSION:

There are evidences that social inequity is associated to the tuberculosis knowledge of patient relatives.

Knowledge; Tuberculosis; Attitude; Health Education; Health Services Accessibility; Social Participation

Variables	n	%
Age (years)
18 – 29	18	16.3
30 – 59	63	57.2
≥60	29	26.5
Sex
Male	25	22.5
Female	85	87.5
Occupation
Retired	24	21.8
Unemployed	13	11.8
Housework	24	21.8
Others	49	44.5
Income
≤ 1 minimum wage^*	26	23.6
1 – 4.9 minimum wage	64	58.1
≥5 minimum wage	20	18.1
Schooling
No schooling	12	10.9
Elementary school	59	53.6
High school	33	30.0
Superior school	06	5.4
Family association
Grandparents	5	4.5
Husband/wife	26	23.6
Son/daughter	12	10.9
Sister/brother	18	16.3
Parents	32	29.0
Uncle/aunt	04	3.6
Others	13	11.8

Variables	n	%
Tuberculosis germ
Virus	36	32.7
Bacteria	35	31.8
Does not know	32	29.2
Others	7	6.3
Factors that favor disease development
Alcoholism	43	39.1
Others	28	25.5
HIV	25	22.7
Does not know	10	9.1
History in the family	03	2.7
Diabetes	01	0.9
Modes of transmission seen by the families*
When the person coughs and if he/she is in the same place	100	90.9
Using the same cloth	87	79.1
Common use of plates, flatware, and glasses	66	60.0
Contaminated water	61	55.5
Sexual intercourse	50	50.0
Seen signals and symptoms*
Cough	102	92.7
Pain in the chest and back	100	90.9
Weight loss	96	87.3
Appetite loss	86	78.2
Cephalea	65	59.1
Night sweating	45	40.9
Leg swallow	17	15.5
Stains in the body	10	9.1
Transmissibility period after beginning of treatment
Others	53	48.2
Does not know	37	33.6
2 weeks (correct)	20	18.2
Duration of treatment
6 months (correct)	71	64.5
Others	26	23.6
Does not know	13	11.8
Has read or heard information about tuberculosis
Yes	101	91.8
No	09	8.2

Variables	Knowledge		Little knowledge		Bivariate analysis		p-value
Variables	n	%	n	%	Crude OR	95%CI	p-value
Age (years)
≤ 51	46	55.4	8	29.6	1	–
> 51	37	44.6	19	70.4	2.95	1.16 – 7.50	0.02^*
Schooling
Yes	78	94	20	74.1	1	–	–
No	5	6	7	25.9	5.46	1.56 – 19.02	0.009^*
Job situation
Employed	72	86.7	25	92.6	1	–
Unemployed	11	13.3	2	7.4	0.52	0.10 – 2.52	0.51
Income (MW)
> 1.8	40	48.2	12	44.4	1	–
≤ 1.8	43	51.8	15	55.6	1.16	0.48 – 2.78	0.73
Reading newspapers
Yes	53	63.9	9	33.3	1	–
No	30	36.1	18	66.7	3.53	1.41 – 8.83	0.005^*
Watching television
A lot	73	88	19	70.4	1	–
Never or hardly ever	10	12.0	08	29.6	3.07	1.06 – 8.85	0.041^*
Internet access
Yes	34	41	03	11.1	1	–
No	49	59	24	88.9	5.55	1.54 – 19.91	0.04^*
Directly observed treatment
Yes	70	84.3	24	88.9	1	–
No	14	15.7	3	11.1	0.67	0.17 – 2.56	0.757
In latent TB treatment
Yes	15	18.1	5	18.5	1	–
No	68	81.9	22	81.5	0.97	0.31 – 2.97	1.000

Variables	Adjusted OR*	95%CI	p-value
Age above 51 years old	1.07	0.330 – 3.45	1.068
No schooling	4.39	1.11 – 17.36	0.035^**
Not watching or watching less television	3.99	1.20 – 13.26	0.024^**
Not reading newspaper	2.22	0.75 – 6.52	0.156
Not accessing the Internet	5.01	1.29 – 19.38	0.019^**

Attitudes	Knowledge about tuberculosis		p-value
Attitudes	Mean ± SD (n = 27)	Mean ± SD (n = 83)	p-value
Embarrassment toward the relative disease	4.53 ± 1.14	4.71 ± 0.95	0.43
Hides from relatives, friends, and neighbors that the relative has tuberculosis	4.07 ± 1.46	4.23 ± 1.43	0.61
Avoids talking about tuberculosis in the presence of other relatives and friends	3.18 ± 1.85	3.77 ± 1.58	0.10
Reported embarrassment of going out with the patient with tuberculosis	4.78 ± 0.98	4.89 ± 0.50	0.14
Reported fear of being identified in the institution where the relative is being treated	4.75 ± 0.84	4.72 ± 0.85	0.87

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[1] Corresponding author: Ricardo Alexandre Arcêncio. Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo. Avenida dos Bandeirantes, 3900, CEP: 14040-902, Ribeirão Preto, SP, Brazil. E-mail: ricardo@eerp.usp.br