Abstract: Objective: To understand the core knowledge, attitudes, and practices related to tuberculosis (TB) prevention and control among college students in China, and to provide evidence for scientific and effective health education strategies in colleges. Methods: From April to July 2022, stratified cluster sampling method and self-designed network questionnaire were used to investigate freshmen and sophomores from 80 colleges in Zhejiang, Sichuan, Hubei, and Gansu Provinces. A total of 18438 questionnaires were collected, of which 17491 were valid, and the efficiency was 94.86%. Chi-square test was used to analyze differences in total awareness rates. Results: The total awareness rate of core knowledge of TB among college students was 82.20% (115019/139928). In the single awareness rates, that of “If suspected of having TB, individuals need to contact a local TB medical institution for care” was highest (97.14% (16991/17491)) and that of “TB is a chronic infectious disease” was lowest (53.68% (9390/17491)). Higher total awareness rates were observed among female students (83.80% (65333/77960), χ²=309.733, P<0.001), medical students (84.79% (27701/32672), χ²=194.870, P<0.001), students who came from undergraduate colleges (83.25% (66017/79296), χ²=139.249, P<0.001), students who infected TB previously (84.82% (760/896), χ²=4.239, P=0.040), and students who ever received health education (83.62% (97111/116128), χ²=948.032, P<0.001). There were 96.23% (16831/17491) agreed that it was important for colleges to conduct TB health education, 92.37% (16156/17491) were willing to participate in these activities, and 94.66% (16557/17491) were willing to share the knowledge they learned with others among college students surveyed. Supposing they infected TB, 10.99% (1923/17491) responded with indifference/depression/despair/helplessness. If familiar people were suffering from TB, 11.49% (2009/17491) chose to alienate/refuse to communicate with them. There were 12.00% (2099/17491) college students were a current or ever smoker, 66.47% (11627/17491) used to stay up late, 55.33% (9677/17491) experienced insufficient sleep, 30.88% (5401/17491) observed classmates spitting and 37.57% (6572/17491) could not cover their mouth and nose when coughing or sneezing. Conclusion: The core knowledge of TB prevention and control in schools has not been fully widespread among college students. TB health education should be further carried out for male, junior college and non-medical students, etc. Meanwhile, it is imperative to guide students to establish a belief of caring for TB patients and develop a healthy lifestyle.

Key words: Tuberculosis, College students, Health knowledge, attitudes, practices