Socio-economic determinants of knowledge and attitudes about tuberculosis among the general population of Metro Manila, Philippines.

SETTING: Five urban communities in Metro Manila with different socio-economic status.

OBJECTIVE: To investigate general knowledge about tuberculosis (TB) and intended health-seeking behaviour for TB symptoms among the general population of Metro Manila, and how they are determined by socioeconomic factors.

DESIGN AND METHOD: Subjects aged 18 years and over were interviewed in a cross-sectional survey. Data on TB knowledge and intended health-seeking behaviour were stratified by sex, age, educational background, occupation, average family income and place of residence. A TB knowledge score was constructed based on 10 selected questions. Multivariate analysis with standard logistic regression showed those factors that were independently correlated to understanding of the disease, and to attitudes in case of TB symptoms. The TB knowledge score was also analysed by TB information source.

RESULTS: Completed surveys were obtained from 3970 subjects. They scored low in general knowledge about TB (3.64 +/- 1.67, range 0-10). A higher score was independently associated with college education (OR = 4.35, 95%CI 6.60-2.87, P < 0.0001). There was no significant difference in TB knowledge acquired through several sources. No intention of seeking health care and intention to self-treat in case of TB disease were significantly correlated to low family monthly income (OR = 7.10, 95%CI 8.25-6.11, P < 0.0001 and OR = 1.74, 95%CI 2.06-1.46, P < 0.0001, respectively).

CONCLUSION: Socio-economic factors should be taken into account in the design of TB information campaigns and in prioritising public health interventions about TB.