Beyond Biomedical Models: Socio-Cultural Determinants and Gaps in Tuberculosis Awareness and Prevention Practices in Northern Ghana

Abstract Background Tuberculosis (TB) remains a major public health challenge, with persistent disparities in awareness and prevention practices across vulnerable populations. This study examined the socio-cultural determinants shaping TB awareness and preventive behaviors in the Kassena-Nankana and Builsa districts of northern Ghana, a high-incidence region. Methods A community-based cross-sectional survey was conducted among 383 adults using a structured questionnaire. Descriptive statistics and multivariate logistic regression were applied to identify predictors of TB awareness. Results General awareness of TB was high (88.5%), but gaps in practical prevention knowledge were striking, 42.6% of participants could not identify any prevention strategy. Awareness increased significantly with increasing age group (p for trend = 0.015) and was higher among Traditionalists compared to Christians. Unexpectedly, secondary education was associated with lower awareness relative to no formal education. Recognition of unexplained weight loss predicted awareness (OR = 2.14, 95% CI: 1.02–4.48, p = 0.043), while common symptoms such as cough and night sweats were not significant predictors. Other socio-demographic factors, including gender, marital status, occupation, and duration of residence, showed no association with awareness. Conclusion Despite high general awareness, critical gaps remain in prevention knowledge and early symptom recognition. Tailored interventions that are culturally grounded, age-sensitive, and educationally relevant are essential to bridge this “know–do” gap and advance Ghana’s progress toward WHO End TB Strategy targets.