Effect of health education on knowledge and attitude towards early testing of tuberculosis among the nurses of JIPMER, Puducherry, South India: A pre-post interventional study

In India, Tuberculosis(TB) prevalence in 2023 was 312 per lakh. Sputum-positive TB incidence among health workers was 0.37 to 1.57 per 1000, with nurses having the highest rates. Despite bi-annual TB screening recommended in guideline, early testing among nurses is neglected. We aimed to assess, effect of health education on the knowledge and attitude towards early TB testing and to explore TB testing practices and perceptions among nurses. A pre-post intervention study was conducted with 240 staff nurses at JIPMER, Puducherry. The intervention included a PowerPoint presentation, awareness videos, and discussion. Analysis was performed using STATA 16. Baseline and end-line assessments were conducted using an online self-administered questionnaire, with a 4-week interval between the intervention and post-test. Changes in knowledge and attitude towards early TB testing were analyzed with McNemar test. Qualitative data were collected through in-depth interviews, analyzed using thematic analysis. Post intervention, change in knowledge about appropriate mask use (45.4% to 72.1%), patient distancing (47.5% to 64.2%), and attitudes towards annual or bi-annual screening (79.1% to 95.4%) improved ( P < 0.05). About 99.6% agreed on the need for health education for early testing. However, willingness for personal testing if symptomatic showed no significant change. Barriers to early TB testing included fear, stigma, lack of awareness, and denial, while facilitators included early health-seeking behavior and being in the health profession. A targeted health education among nurses in a tertiary care setting improved knowledge and attitudes towards early TB testing but didn't change all aspects of attitude.