A94-05 Tuberculosis-related Health-seeking Behaviour Among Residents of Two Communities in Ile-Ife, Nigeria With Varying TB Incidents: A Comparative Cross-sectional Study

Abstract Rationale Tuberculosis (TB) remains a major public health concern in Nigeria. This study aimed to assess TB-related health-seeking behaviour (HSB) and its determinants in two socio-demographically similar communities with contrasting TB incidence (9% vs. 2%), to inform targeted public health interventions. Methods A cross-sectional study was conducted among 400 adult residents of two communities in Ile-Ife, Nigeria using a multistage sampling technique. Standardized questionnaire was used to collect information on sociodemographic characteristics, knowledge of TB, and HSB, which was classified as appropriate or inappropriate. The chi-square test and multivariable logistic regression were performed to evaluate factors associated with HSB. Results Of the 400 respondents, 292 (73.0%) were female, 304 (76.0%) were married, and 335 (83.8%) had prior knowledge of TB. Majority (85.3%) of the respondents demonstrated appropriate TB-related (HSB), with no significant difference between the high TB incidence community (50.1%) and the low TB incidence community (49.9%) (χ² = 0.020, p = 0.888). However, behavioral patterns varied, residents of the high-incidence community were more likely to seek care at symptom onset (81.0% vs. 73.0%, p = 0.013), while those in the low-incidence community reported more frequent routine clinic visits (≥2/year: 62.5% vs. 37.0%, p < 0.001). Barriers such as cost (60.2% vs. 46.0%) and transportation (22.9% vs. 9.5%) were more prevalent in the high-incidence community. Inappropriate HSB was linked to lower education, unmarried status, longer travel time, and higher stigma. In the low-incidence area, 40.0% with inappropriate HSB had no formal education vs. 14.7% with appropriate HSB (p = 0.001). Good TB knowledge predicted appropriate HSB in the high-incidence area (p = 0.005), but not in the low-incidence (p = 0.078). Misconceptions were more common with inappropriate HSB, while learning from health workers improved care-seeking (p = 0.007).Employment status (OR = 0.204; 95% CI: 0.071-0.588), perceived stigma (OR = 0.191; 95% CI: 0.079-0.457), negative attitude of medical workers (OR = 0.016; 95% CI: 0.002-0.735), and belief about TB patients (OR = 11.439; 95% CI: 0.985-132.797) predicted appropriate HSB. Barriers included uncertainty about care location (OR = 0.033; 95% CI: 0.003-0.309), cost (OR = 0.090; 95% CI: 0.010-0.798), and transport (OR = 0.028; 95% CI: 0.003-0.269). Conclusion Poor TB knowledge, unemployment and limited access to healthcare services reduced care-seeking, while better TB knowledge and health worker support improved HSB across both communities, despite differing stigma and misconception patterns. This abstract is funded by: Royal Society of Tropical Medicine and Hygiene