Non-adherence to tuberculosis contact screening and its associated factors in Kuching, Sarawak: A cross-sectional study

TL;DR

This study explores why people in Kuching, Sarawak, miss follow-up TB screenings and finds that forgetfulness and lack of awareness are major factors.

Contribution

The study identifies non-adherence factors in TB contact screening in Malaysia, emphasizing the need for better reminders and health education.

Findings

19.1% of TB contacts did not adhere to follow-up screening.

Forgetfulness was the main reason for non-adherence.

Only 39.1% of contacts were aware of their risk for active TB.

Abstract

Tuberculosis (TB) contacts in Malaysia undergo follow-up screening to reduce their risk of active or latent TB. However, adherence to this screening is low. Limited studies have explored the factors contributing to non-adherence to follow-up screening. This study aimed to determine the non-adherence rate and reasons in a government health clinic.

Participants were TB contacts due for their 2nd contact screening (including those who attended their first contact screening at Petra Jaya Health Clinic from November 2018 to March 2019), were aged at least 18 years and were able to understand English or Malay. Data were collected during the second contact screening from August 2019 to January 2020.

A total of 383 TB contacts were included. Of them, 56.6% (n=217) were aged 20–39 years, and the sex distribution was equal (men: 44.1%, n=169). The majority were non-household contacts (82.2%, n=315). The rate of non-adherence to follow-up screening was 19.1% (n=73). Approximately 52.1% (n=36) reported forgetting their scheduled appointment date as the primary reason for non-adherence. The influencing factors included employment and ethnicity. Only 39.1% (n=27) were aware of their risk for active TB, while 49.5% (n=189) were unsure whether TB can be cured with proper treatment.

The findings highlight the need to improve the reminder system for TB contacts. Although direct association between knowledge and adherence could not be established, the low percentage of correct answers to most basic knowledge questions associated with TB indicates a need to improve health education for TB contacts.

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