Evaluating The Knowledge, Attitudes, And Practices Of Lady Health Workers (Lhws) Regarding Tuberculosis Dots In Islamabad

Abstract

Tuberculosis (TB) remains a significant public health issue in Pakistan and the cases are rising in the capital city, Islamabad. This requires effective implementation on the Directly Observed Therapy Short- course (DOTS) strategy. One way to do this is through the Lady Health Workers (LHW) program. LHWs play a significant role in the country’s TB control program, particularly in promoting and ensuring patient adherence to the TB treatment regimens. This study assesses the Knowledge, Attitudes, and Practices (KAP) of LHWs in Islamabad regarding the TB DOTS. A cross-sectional survey was conducted among LHWs working in the outskirts of Islamabad using a structured questionnaire. The survey evaluated their basic knowledge about TB, such as transmission and symptoms, and their concepts of the TB DOTS; attitudes towards their role as TB treatment supporters providing DOTS for TB management; and their practices related to providing DOTS, treatment support, and health education. The data was analyzed using descriptive statistics in the SPSS software version 27 to summarize the KAP levels. The study included 175 LHWs with the highest frequency of age lying in the 50 above range. The results showed that all the LHWs (100%) knew TB is transmissible, nearly all (98.9%) knew it is a curable disease, and 87.4% correctly identified the mode of transmission. However, only 36.6% knew about all the consequences of incomplete TB treatment. Overall, only 22% of LHWs were categorized in the good knowledge category. Attitudes of LHWs towards TB management and DOTS were poorer compared to knowledge, with 87% in the negative attitude category. In practice, 100% LHWs provide health education regarding TB with 38.9% doing it daily, and 22.9% face problems from TB patients not adhering to the treatment. Overall, there were 62% of LHWs in the unfavorable practice category. The LHWs in Islamabad have a strong foundational knowledge regarding TB and its treatment through the application of DOTS. However, there are specific knowledge gaps, negative attitudes toward TB DOTS, and inconsistencies in practices. Enhanced training and support are recommended to address these gaps and to optimize the contribution of LHWs in the TB control program. These interventions are crucial for achieving better treatment outcomes and for advancing towards a TB- free Pakistan.