ABSTRACT
BACKGROUND: Tuberculosis (TB) morbidity and mortality has been one of the pressing issues in the health sector of our country. In Mongolia, 2 people out of 1000 people developed tuberculosis annually, which leads to becoming one of the 7 countries with high TB morbidity among 37 countries of the Western Pacifi c Region.OBJECTIVE: The aim of the study is to have the baseline to understand and measure knowledge, attitudes and practices regarding tuberculosis among non-tuberculosis health care workers including family group practitioners, nurses and specialized doctors at the primary, secondary and tertiary health care level of Mongolia.MATERIALS AND METHOD: Cross-sectional descriptive qualitative study. Self-admitted questionnaire were performed for 572 health care workers. Total of 4 aimags/provinces and 3 districts were randomly selected. Selenge, Darkhan-Uul, and Khentii aimags are regions with high tuberculosis burden, Dornogobi and Orkhon aimags are with low Tuberculosis incidence and prevalence in 2008.Altogether 572 doctors and health professionals from selected health facilities were involved in survey questionnaire and 39.9% (228 people) of respondents were working at the primary level, 31.3% (179 people) in secondary level, and 28.8% (165 people) in the tertiary level health facility, respectively. Altogether 23 focus group discussions were organized, involving 130 people.RESULTS: Around 98.6% of respondents answered that TB is spread when infected person coughs and sneezes. However, one of every three respondents answered TB can be transmitted when sharing cups, dishes and other cooking utensils with the infected person, one in every ten people–shaking hands with the infected person, and one in every four people–through mother to child transmission. Such misconception is common among the health professionals, especially among nurses of the secondary and tertiary level health facilities. Around 47.6% or 272 people answered correctly that TB patients have symptoms such as coughing for 2 weeks and longer, develop sputum with blood traces, fever and sweating during night sleep, and loss of weight. However, there is some misunderstanding among the doctors and nurses such as there are skin rashes. When doctors and nurses where asked which form of TB is the infectious one, 86.9% answered correctly that TB with positive smear test is infectious. On assessing the knowledge, attitude and practice on TB treatment, about 93.4% of the respondents answered that treatment shall be done by anti-TB drugs and this result is equally strong among health professionals at all service delivery levels (p=0.075). However, there are some misconceptions among the nurses that TB patients should buy anti-TB drugs from the pharmacies, try traditional medicines and follow religious rituals. This should be paid further attention and issues covering TB should be included in their curriculum. Every second person knows the treatment continuation period of drug susceptible TB patient, which is relatively low knowledge level. According to survey results, every second person knows what DOTS stand for. In other words, 55.4% of the respondents identifi ed correctly what is DOTS, and 13.8% answered that it is a combination of anti-TB drugs, 3 .3% - as TB treatment method, 5.6% - as combination of TB reduction measures, and 2.2% answered that they don’t know.CONCLUSION: Many misunderstandings were found in the fi eld of transmission, BCG vaccination, treatment and anti-TB drugs. There is a need to provide training for non-TB medical doctors and nurses.