Factors affecting tuberculosis (TB) prevention behaviors among household contacts in Phitsanulok Province, northern Thailand: implications for TB prevention strategy plan

Pulmonary tuberculosis can spread by airborne transmission when an infected person coughs, sneezes and speaks via expectorates. Therefore, household contacts who are close to a tuberculosis patient are at the highest risk of contracting the disease. This analytical cross-sectional study aimed to determine the factors affecting prevention behaviors among household contacts in Phitsanulok Province, northern Thailand.

The study sample included 193 household contacts with pulmonary tuberculosis in Phitsanulok Province. They were randomly selected using a multistage sampling technique. Data were collected by a self-administered questionnaire consisting of 8 parts: (1) sociodemographic characteristics, (2) tuberculosis knowledge, (3) perceived susceptibility of tuberculosis infection, (4) perceived severity of tuberculosis, (5) perceived self-efficacy of tuberculosis prevention, (6) perceived outcome of tuberculosis prevention, (7) social support of tuberculosis prevention, and (8) tuberculosis prevention behaviors. Frequencies, percentages, means, standard deviations, and multiple regression analysis were explored for data analysis.

Most participants (91.2%) had tuberculosis prevention behaviors at a high level (scores of 4.35). Factors that significantly affected tuberculosis prevention behaviors included perceived self-efficacy in tuberculosis prevention (β = 0.474), social support (β = 0.220), current smoker (β = -0.171), driving to the hospital (β = 0.150), unknown history of tuberculosis vaccination (BCG) (β = -0.122), and those who were older siblings, aunts, uncles, younger siblings, or nephews of participants (β = -0.116). These 6 factors explained 38.5% of tuberculosis prevention behaviors.

Household contacts to pulmonary tuberculosis should be educated about the perceived self-efficacy of tuberculosis prevention, and receive more social support to prevent the disease. The focus should be on current smokers, those who drive to the hospital, those who do not know the history of tuberculosis vaccination, and relatives of patients (older sibling, aunt, uncle, younger sibling, nephew) to reduce the risk of pulmonary tuberculosis in the future.