‘Fast' Strategy of TB Infection Control: Comparative Knowledge and Attitude of Health-Workers in Tertiary Health Institutions in Abia State, Nigeria

Abstract

Background: Tuberculosis (TB) though a long existent disease still constitutes a major public health problem in Nigeria. TB burden in Nigeria is one of the highest in the world (318 per 100,000) but case detection rate (16 %) is one of the lowest globally. A key strategy for active case finding and TB infection control (TBIC) is the ‘FAST' strategy. FAST stands for Finding (TB cases), Actively, Separating and Treating.

Methods: This was a cross-sectional study of 148 health-workers in the two tertiary health institutions in Abia state (Federal Medical Centre Umuahia (FMCU) and Abia State University teaching Hospital (ABSUTH)) Aba. Seventy-four consenting health workers from each facility were proportionately selected through stratified random sampling. Pretested self-administered questionnaires were administered on them. Knowledge scores were computed using 16 parameters while attitude was computed using 6. Knowledge and attitude were classified as good or poor. Data was analysed using SPSS version 22.

Results:  Among ABSUTH staff, 56(75.7%) had poor knowledge (across cadres of health-workers). Health-workers at FMCU had statistically significant higher knowledge (p= 0.01) than ABSUTH staff though majority; 47(63.5%) also had poor knowledge of the FAST strategy. For attitude towards the strategy, overall, 56(75.7%) of health workers in ABSUTH had good attitude similar to that of FMCU; 57(77.0). Previous attendance at a TB training was found to be a predictor of good knowledge aOR 2.81; 95% CI (1.01-7.99) while age was found to be associated with good attitude aOR 9.68; 95%CI (1.01-92.8).

Conclusion/ Significance: Despite the relevance of the ‘FAST' strategy to TB case detection and TBIC, the study demonstrated poor knowledge among these health workers. The need for health-workers training and re-training on TB is imperative.