Assessment Knowledge, Attitude, and Practice Toward Tuberculosis Among Syrian People: An online cross-sectional study

Background: TB was reported to have the highest mortality rate among other infectious diseases in 2018 worldwide. Syria and other low-income countries have a higher incidence rate of TB in comparison to high-income countries. Stigma toward TB is extremely high in low-income countries like Syria, and these stigma delays patients from seeking healthcare facilities. Our purpose in this study is to assess the Syrian's knowledge, attitudes, and practices toward TB and understand their Practice related to this disease.  
  
Methods: An online cross-sectional questionnaire was distributed between15 September 7 October 2022, among Syrians to assess their knowledge, attitudes, and practices toward TB. This questionnaire was adapted from a published study, and the inclusion criteria were all male and female Syrian citizens aged 18 or above. The survey was divided into four questions: the first section assessed sociodemographics, and the other sections were about knowledge, attitude, and practices, respectively. Using IBM SPSS V. 28.0, the data were submitted to descriptive and multivariate logistic regression analyses. 
  
Results: About (38.6%) of the 1407 participants in this research were male. The research participants' knowledge scores indicated that 78.1% have excellent knowledge. However, 54.1% of interviewees agreed that shaking someone's hand may transmit tuberculosis. Regarding attitude, more than two-thirds (85.7%) of the participants in the survey had an optimistic outlook. Accordingly, most participants (81.3%) had effective TB preventive and control practices. Participants aged 61 to 70 had more TB knowledge than other age groups (P value<0.05; mean=6.63, SD=1.13). Participants with chronic illness had a more positive attitude toward tuberculosis than those without (P value<0.05) (mean=2.17, SD=0.63). Participants with a university degree demonstrated more TB practice than those with lower levels of education (mean=6.17, SD=0.85). Participants with a university degree were expected to have 4.38 times more TB knowledge than those without formal education (P 0.05). Participants with a university degree were projected to practice tuberculosis 10.63 times more often than those without education (P 0.001). 
  
Conclusion: Our results indicate that there is poor knowledge regarding the route of transmission of TB; therefore, more efforts should be made to raise awareness about TB transmission, as understanding these facts is a crucial aspect in mitigating the incidence of TB. Consequently, individuals reported poor practices toward TB; for that reason, educating individuals about good practices toward TB should take priority in Syria as war has destroyed the understructure of the healthcare system.