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Factors affecting tuberculosis health message recall 2 years after active case finding in Blantyre, Malawi.

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Monk, E J M, Kumwenda, M, Nliwasa, M, Mpunga, J and Corbett, E (2018) 'Factors affecting tuberculosis health message recall 2 years after active case finding in Blantyre, Malawi.'. International Journal of Tuberculosis and Lung Disease, Vol 22, Issue 9, pp. 1007-1015.

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Abstract

SETTING
Urban slums, Blantyre, Malawi.

OBJECTIVE
To explore tuberculosis (TB) community-wide active case finding (cwACF) recall and accompanying messaging 2 years after the intervention.

DESIGN
This mixed-methods study used population-weighted random cluster sampling to select three cwACF-receiving and three non-cwACF-receiving neighbourhoods in Blantyre. Qualitative data were collected using 12 focus group discussions (community peer-group members) and five in-depth interviews (TB officers) with script guides based on the concepts of the Health Belief Model (HBM). Thematic analysis was used to explore transcripts employing deductive coding. Questionnaires completed by focus group participants were used to collect quantitative data, providing a 'knowledge score' evaluated through univariate/multivariate analysis, analysis of variance and multiple linear regression.

RESULTS
Community peer-group participants (n = 118) retained high awareness and positive opinions of cwACF and recognised the relationship between early diagnosis and reduced transmission, considering cwACF to have prompted subsequent health-seeking behaviour. TB-affected individuals (personal/family: 47.5%) had significantly higher knowledge scores than unaffected individuals (P = 0.039), but only if resident in cwACF-receiving neighbourhoods (P = 0.005 vs. P = 0.582), implying effect modification between exposures, albeit statistically under-powered (P = 0.229).

CONCLUSION
Consistent with epidemiological evidence and HBM theory, cwACF may have a permanent impact on knowledge and behaviour, particularly in communities with a high prevalence of TB-affected individuals. Behaviour change strategies should be explicitly included in cwACF planning and evaluation.

Item Type: Article
Subjects: W General Medicine. Health Professions > W 26.5 Informatics. Health informatics
WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Administration and Organization > WA 590 Health education, Health communication
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
Faculty: Department: Clinical Sciences & International Health > Malawi-Liverpool-Wellcome Programme (MLW)
Digital Object Identifer (DOI): https://doi.org/10.5588/ijtld.18.0006
Depositing User: Stacy Murtagh
Date Deposited: 14 Aug 2018 10:39
Last Modified: 14 Aug 2018 10:39
URI: https://archive.lstmed.ac.uk/id/eprint/9091

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