Determinants of Insufficient Knowledge About Multidrug-Resistant Tuberculosis Among Tuberculosis Patients in Kinshasa, Democratic Republic of the Congo: A Cross-Sectional Study.

Jacques Nkolangi Bakokela; Gérard Eloko Eya Matangelo; Bob Senker Ndimba; Emmanuel Kitete Mulongo; Mbadu Zebe; Jean-Paul Ngbolua Koto-Te-Nyiwa; Jules Kangite Moti

doi:10.51168/20405816

Autori

Jacques Nkolangi Bakokela Higher Institute of Medical Techniques of Kinshasa, Kinshasa, Democratic Republic of the Congo
Gérard Eloko Eya Matangelo Higher Institute of Medical Techniques of Kinshasa, Kinshasa, Democratic Republic of the Congo
Bob Senker Ndimba Senior Lecturer, PhD Candidate in Public Health, University of Ngaoundéré, Cameroon
Emmanuel Kitete Mulongo Faculty of Science and Technology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
Mbadu Zebe Higher Institute of Medical Techniques of Kinshasa, Kinshasa, Democratic Republic of the Congo
Jean-Paul Ngbolua Koto-Te-Nyiwa Faculty of Science and Technology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
Jules Kangite Moti Higher Institute of Medical Techniques of Kinshasa, Kinshasa, Democratic Republic of the Congo

DOI:

https://doi.org/10.51168/20405816

Cuvinte cheie:

multidrug-resistant tuberculosis, knowledge, health information, education, Kinshasa, Democratic Republic of the Congo

Rezumat

Background:

Multidrug-resistant tuberculosis (MDR-TB) remains an important public health challenge, particularly in settings with a high tuberculosis burden. This study aimed to identify factors associated with insufficient knowledge about MDR-TB among tuberculosis patients receiving care in Kinshasa, Democratic Republic of the Congo (DRC).

Methods:

A quantitative analytical cross-sectional study was conducted among 165 tuberculosis patients aged ≥15 years receiving care at selected tuberculosis diagnosis and treatment facilities in Kinshasa. Data were collected using a structured questionnaire assessing knowledge of MDR-TB, sociodemographic characteristics, access to health information, and selected sociocultural factors. Knowledge was categorized as insufficient when the participant obtained <50% of correct responses and adequate when the score was ≥50%. Associations were assessed using bivariate analysis and multivariable logistic regression. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated.

Results :

Among the 165 participants, 106 (64.2%) were men and 59 (35.8%) were women. Most participants were aged 31–40 years (39.4%), and 94 (57.0%) had no formal education or only primary education. Only 44 participants (26.7%) reported having previously received information about MDR-TB. Overall, 100 participants (60.6%) had insufficient knowledge. In multivariable analysis, male sex was associated with lower odds of insufficient knowledge (aOR=0.204; 95% CI: 0.093–0.448; p<0.001), whereas no formal/primary education (aOR=4.393; 95% CI: 1.961–9.840; p<0.001), affiliation with revivalist or Kimbanguist churches (aOR=4.261; 95% CI: 1.698–10.690; p=0.002), and no previous information about MDR-TB (aOR=5.142; 95% CI: 2.188–12.085; p<0.001) were associated with higher odds of insufficient knowledge.

Conclusion :

Insufficient knowledge about MDR-TB was common among tuberculosis patients included in this study. Low educational attainment and lack of previous information were particularly strong factors associated with insufficient knowledge. Strengthening patient-centred health education, using communication materials adapted to different literacy levels and involving community stakeholders may improve understanding of MDR-TB in Kinshasa.

Referințe

1. Hoa, N. P., Chuc, N. T. K., & Thorson, A. (2009). Knowledge, attitudes, and practices about tuberculosis and choice of communication channels in a rural community in Vietnam. Health Policy, 90(1), 8–12. https://doi.org/10.1016/j.healthpol.2008.08.006

2. Jaiswal, A., Singh, V., Ogden, J. A., Porter, J. D. H., Sharma, P. P., Sarin, R., Arora, V. K., & Jain, R. C. (2003). Adherence to tuberculosis treatment: Lessons from the urban setting of Delhi, India. Tropical Medicine & International Health, 8(7), 625–633. https://doi.org/10.1046/j.1365-3156.2003.01061.x

3. Jaiswal, A., Singh, V., Ogden, J. A., et al. (2023). Knowledge on the risk factors of drug-resistant tuberculosis among newly diagnosed patients of tuberculosis with first-line antitubercular treatment regimen. BLDE University Journal of Health Sciences, 8, 238–243. https://doi.org/10.4103/bjhs.bjhs_217_22

4. Misombo-Kalabela, A., Nguefack-Tsague, G., Kalla, G. C. M., et al. (2016). Risk factors for multidrug-resistant tuberculosis in the city of Kinshasa in the Democratic Republic of Congo. Pan African Medical Journal, 23, 157. https://doi.org/10.11604/pamj.2016.23.157.6137

5. Munro, S. A., Lewin, S. A., Smith, H. J., Engel, M. E., Fretheim, A., & Volmink, J. (2007). Patient adherence to tuberculosis treatment: A systematic review of qualitative research. PLoS Medicine, 4(7), e238. https://doi.org/10.1371/journal.pmed.0040238

6. World Health Organization. (2025a). Global tuberculosis report 2025. World Health Organization.

7. World Health Organization. (2025b). WHO consolidated guidelines on tuberculosis: Module 4: Treatment and care. World Health Organization.

8. World Health Organization. (2025c). WHO operational handbook on tuberculosis: Module 4: Treatment and care. World Health Organization.