Knowledge, Attitudes, and Preventative Behavior Toward Tuberculosis in University Students in Indonesia

Figures & data

Table 1 Student Characteristics

Characteristics		n (%)
Sex	Female	412 (78.63)
	Male	112 (21.37)
Age (Median: 20-years-old)	≥20 years old	364 (69.47)
	<20 years old	160 (30.53)
Faculty	Health faculties	260 (49.62)
	Non-health faculties	264 (50.38)
Academic degree	Postgraduate	45 (8.59)
	Undergraduate	479 (91.41)
Year began university	2016	10 (1.91)
	2017	146 (27.86)
	2018	100 (19.08)
	2019	177 (33.78)
	2020	83 (15.84)
	2021	8 (1.53)
Residence	West Java	393 (75.00)
	Outside West Java	131 (25.00)
Smoker	Yes	44 (8.40)
	No	480 (91.60)
Have obtained information about TB	Yes	438 (83.59)
	No	86 (16.41)
Source of information^#	Social media	322 (27.17)
	Formal education	315 (26.58)
	Internet	351 (29.62)
	TV	110 (9.29)
	Healthcare providers	10 (0.84)
	Relatives	14 (1.18)
	Others	63 (5.32)

Note: ^#Multiple responses.

Abbreviations: n, number of students; %, percentage.

Table 2 Students’ Knowledge About TB

Question		Health Faculties					Non-Health Faculties
		Yes n (%)	No n (%)	Correct Answer (%)	Mean (SD)	Rank	Yes n (%)	No n (%)	Correct Answer (%)	Mean (SD)	Rank
Route of infection	1.Tuberculosis (TB) can occur anywhere in the human body	119 (45.77)	121 (46.54)	45.77	0.46 (0.50)	8	56 (21.21)	144 (54.55)	21.21	0.21 (0.41)	10
	2.TB is inherited from parents, so if parents are infected with TB, then their child will definitely get TB^R	25 (9.62)	209 (80.38)	80	0.80 (0.40)	3	46 (17.42)	161 (60.98)	60.98	0.61 (0.49)	3
	3.TB bacteria are spread in the air	190 (73.08)	50 (19.23)	72.69	0.73 (0.45)	5	168 (63.64)	51 (19.32)	63.64	0.64 (0.49)	2
Symptoms	4.There are no specific symptoms that appear in the early stages of TB infection	103 (39.62)	113 (43.46)	39.62	0.40 (0.49)	10	77 (29.17)	91 (34.47)	29.17	0.29 (0.48)	8
	5.When infected with TB, a person will experience a mild fever in the afternoon	139 (53.46)	28 (10.77)	53.46	0.53 (0.50)	7	105 (39.77)	11 (4.17)	39.77	0.40 (0.49)	7
	6.If mild fever persists and is accompanied by weight loss, it may be TB	172 (66.15)	22 (8.46)	66.15	0.66 (0.47)	6	126 (47.73)	20 (7.58)	47.73	0.48 (0.50)	5
Preventative examinations	7.Chest X-rays are one way to diagnose TB	237 (91.15)	7 (2.69)	91.54	0.92 (0.28)	1	230 (87.12)	2 (0.76)	87.12	0.87 (0.34)	1
	8.A single administration of the Bacillus Calmette–Guérin vaccine can protect against TB infection for a lifetime^R	87 (33.46)	118 (45.38)	45.38	0.45 (0.50)	9	56 (21.21)	64 (24.24)	24.24	0.24 (0.43)	9
Treatment	9.TB can only be treated if there are obvious symptoms^R	91 (35.00)	118 (45.38)	45.38	0.45 (0.50)	9	105 (39.77)	55 (20.83)	20.83	0.21 (0.41)	11
	10.TB is treated by taking medication every day for at least 6 months	203 (78.08)	7 (2.69)	78.08	0.78 (0.41)	4	122 (46.21)	4 (1.52)	46.21	0.46 (0.50)	6
	11.TB treatment is difficult, and if anti-TB drugs are not taken regularly, it can lead to drug resistance	220 (84.62)	0	84.62	0.85 (0.36)	2	150 (56.82)	5 (1.89)	56.82	0.57 (0.50)	4
				Total	7.03 (2.36)				Total	4.98 (2.20)

Note: ^RReverse item.

Abbreviation: SD, standard deviation; n, number of students; %, percentage.

Table 3 Students’ Attitudes Toward TB

Questions		Health Faculties						Non-Health Faculties
		SA n (%)	A n (%)	DA n (%)	SDA n (%)	Mean (SD)	Rank	SA n (%)	A n (%)	DA n (%)	SDA n (%)	Mean (SD)	Rank
Recognition of TB	1.If I got TB, I should immediately inform my family and/or my lecturers	207 (79.62)	51 (19.62)	2 (0.77)	0	3.79 (0.43)	1	194 (73.48)	67 (25.38)	3 (1.14)	0	3.72 (0.47)	1
	2.I think TB can be transmitted without even realizing it	158 (60.77)	92 (35.38)	10 (3.85)	0	3.57 (0.57)	7	118 (44.70)	126 (47.73)	20 (7.58)	0	3.37 (0.63)	8
	3.I may experience obstacles in my family and academic life if I were infected with TB	70 (26.92)	118 (45.38)	70 (26.92)	2 (0.77)	2.98 (0.76)	12	69 (26.14)	117 (44.32)	77 (29.17)	1 (0.38)	2.96 (0.76)	12
	4.I think that TB is a very serious disease	149 (57.31)	109 (41.92)	2 (0.77)	0	3.57 (0.51)	8	138 (52.27)	119 (45.08)	7 (2.65)	0	3.50 (0.55)	5
Preventative examinations	5.I think, regular medical examinations every year can prevent TB	95 (36.54)	141 (54.23)	24 (9.23)	0	3.27 (0.62)	11	106 (40.15)	139 (52.65)	19 (7.20)	0	3.33 (0.61)	9
	6.I think a person should be examined for TB if there is a TB patient among his family or friends	132 (50.77)	119 (45.77)	9 (3.46)	0	3.47 (0.57)	9	99 (37.5)	145 (54.92)	20 (7.58)	0	3.30 (0.60)	10
	7.TB screening can be easily accessed at health facilities, such as community health centers (Puskesmas)	59 (22.69)	124 (47.69)	75 (28.85)	2 (0.77)	2.92 (0.74)	13	41 (15.53)	155 (58.71)	65 (24.62)	3 (1.14)	2.89 (0.66)	13
Treatment	8.If I were diagnosed with TB I would take anti-TB drugs regularly for at least 6 months, as directed by the doctor	203 (78.08)	56 (21.54)	1 (0.38)	0	3.78 (0.43)	2	142 (53.79)	115 (43.56)	7 (2.65)	0	3.51 (0.55)	4
	9.If a friend discontinued taking anti-TB drugs, I would persuade him to continue regular TB treatment	194 (74.62)	64 (24.62)	2 (0.77)	0	3.74 (0.46)	3	132 (50)	125 (47.35)	7 (2.65)	0	3.47 (0.55)	6
	10.I would encourage those with TB around me to obtain treatment	190 (73.08)	70 (26.92)	0	0	3.73 (0.44)	4	138 (52.27)	126 (47.73)	0	0	3.52 (0.50)	3
	11.I think TB can be cured if it is detected and treated early	158 (60.77)	95 (36.54)	7 (2.69)	0	3.58 (0.55)	6	128 (48.48)	130 (49.24)	5 (1.89)	1 (0.38)	3.46 (0.56)	7
Preventative education	12.I am interested in finding out more about TB disease	95 (36.54)	143 (55.00)	21 (8.08)	1 (0.38)	3.28 (0.62)	10	55 (20.83)	184 (69.70)	24 (9.09)	1 (0.38)	3.11 (0.56)	11
	13.I think education about TB is very much needed	189 (72.69)	69 (26.54)	2 (0.77)	0	3.72 (0.47)	5	164 (62.12)	98 (37.12)	1 (0.38)	1 (0.38)	3.61 (0.52)	2
					Total	45.40 (4.17)					Total	43.75 (4.09)

Abbreviations: SA, Strongly agree; A, Agree; DA, Disagree; SDA, Strongly disagree; SD, Standard deviation; n, number of students; %, percentage.

Table 4 Students’ Preventative Behavior Against TB

Questions		Health Faculties						Non-Health Faculties
		SA n (%)	A n (%)	DA n (%)	SDA n (%)	Mean (SD)	Rank	SA n (%)	A n (%)	DA n (%)	SDA n (%)	Mean (SD)	Rank
Route of infection	1.When I sneeze or cough, I cover my mouth	188 (72.31)	68 (26.15)	3 (1.15)	1 (0.38)	3.70 (0.51)	1	197 (74.62)	63 (23.86)	4 (1.52)	0	3.73 (0.48)	1
	2.I often open the window for good air circulation	153 (58.85)	98 (37.69)	9 (3.46)	0	3.55 (0.56)	3	160 (60.61)	99 (37.50)	5 (1.89)	0	3.59 (0.53)	2
	3.I cover my mouth with a handkerchief or tissue when I cough	108 (41.54)	100 (38.46)	49 (18.85)	3 (1.15)	3.20 (0.78)	5	102 (38.64)	106 (40.15)	52 (19.70)	4 (1.51)	3.16 (0.79)	5
Preventative examination	4.I have regular chest X-rays every year	9 (3.46)	37 (14.23)	152 (58.46)	62 (23.85)	1.97 (0.72)	11	13 (4.92)	52 (19.70)	157 (59.47)	42 (15.91)	2.14 (0.73)	11
	5.If I had a cough for more than 2 weeks, I would go to a community health center, medical clinic, or hospital to get myself checked	117 (45.00)	114 (43.85)	26 (10.00)	3 (1.15)	3.33 (0.70)	4	114 (43.18)	120 (45.45)	27 (10.23)	3 (1.14)	3.31 (0.69)	4
Preventative education	6.I often read materials designed to raise awareness about TB	30 (11.54)	100 (38.46)	112 (43.08)	18 (6.92)	2.55 (0.79)	9	16 (6.06)	78 (29.55)	150 (56.82)	20 (7.58)	2.34 (0.71)	9
	7.I actively participate in education about TB	23 (8.85)	80 (30.77)	133 (51.15)	24 (9.23)	2.39 (0.78)	10	14 (5.30)	62 (23.48)	161 (60.98)	27 (10.23)	2.24 (0.71)	10
Healthy lifestyle	8.I usually eat a balanced nutritious meal to maintain health	56 (21.54)	162 (62.31)	39 (15.00)	3 (1.15)	3.04 (0.64)	6	66 (25)	160 (60.61)	37 (14.02)	1 (0.38)	3.10 (0.63)	6
	9.I do not overeat because it can influence my immune system and overall health	41 (15.77)	174 (66.92)	43 (16.54)	2 (0.77)	2.98 (0.60)	7	65 (24.62)	157 (59.47)	40 (15.15)	2 (0.76)	3.08 (0.65)	7
	10.I wash my hands after going out or exercising	168 (64.62)	89 (34.23)	3 (1.15)	0	3.63 (0.51)	2	155 (58.71)	105 (39.77)	4 (1.52)	0	3.57 (0.53)	3
	11.I exercise regularly to maintain good health	38 (14.62)	119 (45.77)	98 (37.69)	5 (1.92)	2.73 (0.73)	8	56 (21.21)	131 (49.62)	72 (27.27)	4 (1.52)	2.91 (0.74)	8
					Total	33.08 (4.49)					Total	33.16 (4.40)

Abbreviations: SA, Strongly agree; A, Agree; DA, Disagree; SDA, Strongly disagree; SD, Standard deviation; n, number of students; %, percentage.

Table 5 Differences in Students’ Knowledge, Attitudes, and Preventative Behaviors Toward TB According to Students’ Characteristics

Variables	Categories	Knowledge		Attitude		Preventative Behavior
		Mean (SD)	t (p)	Mean (SD)	t (p)	Mean (SD)	t (p)
Sex	Female	6.18 (2.46)	3.24 (0.001)*	44.86 (4.15)	3.006 (0.003)*	33.23 (4.44)	1.049 (0.295)
	Male	5.32 (2.54)		43.52 (4.29)		32.73 (4.42)
Faculties	Health faculties	7.03 (2.36)	10.275 (<0.001)*	45.40 (4.17)	4.558 (<0.001)*	33.08 (4.49)	−0.192 (0.848)
	Non-health faculties	4.98 (2.20)		43.75 (4.09)		33.16 (4.40)
Age	<20 years	5.74 (2.28)	−1.560 (0.119)	44.16 (4.21)	−1.495 (0.136)	32.69 (4.70)	−1.489 (0.137)
	≥20 years	6.11 (2.59)		44.75 (4.21)		33.31 (4.31)
Academic degree	Undergraduate	5.72 (2.40)	−8.603 (<0.001)*	44.33 (4.21)	−4.420 (<0.001)*	32.92 (4.43)	−3.09 (0.001)*
	Postgraduate	8.87 (1.66)		47.18 (3.21)		35.13 (3.98)
Residence	West Java	6.05 (2.41)	0.857 (0.392)	44.75 (4.16)	1.698 (0.090)	33.32 (4.41)	1.754 (0.080)
	Outside West Java	5.83 (2.76)		44.03 (4.34)		32.52 (4.48)
Smoking	No	6.15 (2.49)	4.672 (<0.001)*	44.62 (4.27)	0.901 (0.368)	33.19 (4.43)	1.079 (0.281)
	Yes	4.34 (2.03)		44.02 (3.53)		32.43 (4.5)
Have obtained information about TB	No	4.69 (2.61)	−5.450 (<0.001)*	43.28 (4.84)	−3.137 (0.002)*	32.08 (4.99)	−2.390 (0.017)*
	Yes	6.25 (2.4)		44.82 (4.04)		33.33 (4.30)

Notes: All analyses were by t-test; *Significance level was set at p-value < 0.05.

Abbreviation: SD, standard deviation.

Table 6 Variables Affecting Preventative Behavior Against TB

Variables	B^a	SE	β	t	p
(Constant)	10.88	2.056		5.293	<0.001*
Sex^b	−0.12	0.457	−0.001	−0.26	0.979
Age^b	−0.245	0.372	−0.025	−0.659	0.510
Faculty^b	−1.503	0.401	−0.170	−3.749	<0.001*
Academic degree^b	−0.617	0.645	−0.039	−0.958	0.339
Smoking^b	0.863	0.643	0.540	1.342	0.180
Residence^b	0.502	0.379	0.049	1.324	0.186
Obtained information about TB^b	−0.523	0.45	−0.044	−1.163	0.245
Knowledge
Route of infection	−0.054	0.204	−0.011	−0.264	0.792
Symptoms	0.408	0.171	0.096	2.387	0.017*
Preventative examinations	0.732	0.306	0.096	2.396	0.017*
Treatment	0.023	0.206	0.005	0.11	0.913
Attitudes
Recognition of TB	−0.026	0.122	−0.009	−0.211	0.833
Preventative examinations	0.696	0.147	0.21	4.734	<0.001*
Treatment	0.696	0.137	0.138	2.806	0.005*
Preventative education	1.354	0.212	0.287	6.374	<0.001*
R^2 = 0.339; Adjusted R = 0.319; F = 17.342; p < 0.001

Notes: *Significant; ^aUnstandardized coefficient; ^bDummy coding.