Abstract:

Objective: To assess the status of tuberculosis health education and the factors influencing the comprehension of core tuberculosis prevention and control information among rural residents in China during the ‘13th Five-Year Plan’. The analysis aims to enhance tuberculosis health education based on scientific evidence. Methods: Using the prevalence survey method and referring to multi-stage cluster random sampling method, a total of 26593 permanent rural residents aged 15 and above living in village-level administrative units of 31 provinces (municipalities and autonomous regions) and Xinjiang Production and Construction Corps were selected from the special survey database for the final assessment of the National Tuberculosis Prevention and Control Plan in the ‘13th Five-Year Plan’. We collected 26250 valid responses to questionnaires on tuberculosis health education, yielding an effective response rate of 98.71%. The questionnaire covered general demographic information (gender, age, education level), the core information of tuberculosis prevention and control (Q₁: Tuberculosis is a chronic infectious disease that seriously endangers health for a long time; Q₂: Tuberculosis is mainly transmitted through the respiratory tract, and everyone can be infected; Q₃: Cough and sputum for more than 2 weeks should be suspected of tuberculosis, and seek medical treatment in time; Q₄: Not spitting, covering mouth and nose when coughing or sneezing, and wearing a mask can reduce the spread of tuberculosis; Q₅: Standardized full treatment can cure the vast majority of patients and avoid infecting others), and the current status of health education (methods of receiving health education, preferred methods learning about tuberculosis prevention and control information, methods of accessing online science popularization, preferred types of tuberculosis dissemination and online science popularization materials). Both univariate and multivariate logistic regression analyses were employed to assess the relationship between various demographic characteristics and the level of awareness and understanding of core tuberculosis prevention and control information. Results: The total awareness rate of 26250 rural residents on the core information of tuberculosis prevention and control was 81.77% (107323/131250). The awareness rates of Q₁ to Q₅ core information were 76.97% (20205/26250), 88.14% (23138/26250), 88.70% (23285/26250), 84.00% (22049/26250) and 71.03% (18646/26250), respectively. Among them, the total awareness rate (85.20% (89062/104535)) and the awareness rate of Q₁-Q₅ core information (80.28% (16785/20907), 92.11% (19258/20907), 92.68% (19377/20907), 86.66% (18117/20907), 74.26% (15525/20907)) of tuberculosis prevention and control core information of rural residents who had received tuberculosis health education were significantly higher than those of rural residents who had not received tuberculosis health education (68.35% (18259/26715), 64.01% (3420/5343), 72.62% (3880/5343), 73.14% (3908/5343), 73.55% (3930/5343), 58.41% (3121/5343)), the differences were statistically significant (χ²=4051.600, 635.000, 1545.700, 1619.600, 542.160, 518.430, Ps<0.001). Compared with rural residents aged 15-29, with education levels of primary school or below, employed in government or public institutions and who had not received tuberculosis health education, those aged 45-59, with educational achievements ranging from junior high school to bachelor’s degrees or above, employed in business or services, and who had received tuberculosis health education demonstrated superior awareness of the core information related to tuberculosis prevention and control (OR=1.156, 95%CI: 1.050-1.273; OR=1.667, 95%CI: 1.568-1.773; OR=1.882, 95%CI: 1.716-2.065; OR=1.974, 95%CI: 1.736-2.245; OR=1.693, 95%CI: 1.431-2.005; OR=1.242, 95%CI: 1.035-1.489; OR=2.655, 95%CI: 2.485-2.839). The top three methods for rural residents to receive tuberculosis health education were TV/radio (52.02% (13656/26250)), leaflets/folded pages/posters (31.49% (8265/26250)), and direct doctor communication (26.53% (6963/26250)). The main methods of accessing online health science popularization information were WeChat and Weibo (36.58% (9602/26250)) and search engines (25.28% (6636/26250)). Preferred methods learning about tuberculosis prevention and control information included TV/radio (62.80% (16484/26250)), doctor dissemination (45.95% (12062/26250)), and internet dissemination (36.57% (9599/26250)). Audio-visual (40.98% (10757/26250)) and graphic (36.90% (9685/26250)) materials were the preferred types of tuberculosis dissemination, with video (60.28% (15824/26250)) and graphic (46.82% (12290/26250)) being the most popular types of science popularization. Conclusion: During the assessment of the ‘13th Five-Year Plan’, there was a notable enhancement in the health education status related to tuberculosis prevention and control among rural residents in China. However, the awareness of core tuberculosis information had considerable scope for improvement. On the basis of increasing the publicity of network media and developing the dissemination of publicity materials suitable for network media, targeted publicity and education of tuberculosis prevention and control can be carried out for rural residents with low education level and who have not received tuberculosis health education.

Key words: Tuberculosis, Rural population, Health knowledge,attitudes and practice, Questionnaires, Factor analysis, statistics