Hospital waiting area- a platform for Information, education and communication display for Tuberculosis infection control: an exploratory study from Solan, India, 2024

Abstract

Background: Waiting areas of hospitals provide opportunity to interact with patients. Lack of knowledge and misconceptions about tuberculosis (TB) disease transmission in health care facility attendees may prove as hindrance in disease control activities. Evaluating these in waiting areas can assist in formulating appropriate information; education and communication (IEC) material for greater community reach which can be then displayed in these areas.

Methods: A cross sectional study on 302 patients from the waiting areas of a secondary care hospital (taking the probability of knowledge deficit about TB as 26.8% from nationwide longitudinal study) was conducted in January-February, 2024. Objectives of the study were to assess the waiting areas of the hospital, to assess the knowledge about tuberculosis (TB) and to evaluate the misconceptions about the disease. Correct knowledge (without misconceptions) was used as a dependant variable. Explanatory variables tested by univariate and bivariate analysis were: age, gender, education, occupation, residence settings, patient’s isolation from family, disease curability, media exposure and TB considered as a public health problem by Government. Informed written consent was secured from the study participants and Ethics permission was secured from the institutional review board.

Results: Six waiting areas were assessed and poor crowd management was observed here. The average waiting time was seven minutes. There was no IEC display in these areas. 269 respondents completed the study. 150 females and 119 males (55.80 and 44.20 % respectively) with mean age of 32 years (Mean = 32.74, Standard Deviation = 10.97) years participated. 98.14 % respondents had heard about “an illness called tuberculosis”. Of these only 39.03 % knew about correct mode of disease transmission i.e. “through air while sneezing or coughing”. Common misconceptions observed were the transmission by sharing food, sharing of utensils and touching a TB patient (59.85, 63.57 and 44.98 % respectively). Only 15.98 % (43 patients) had correct knowledge (without misconceptions) of disease transmission although 33.08 % had exposure to media for information. Age (Odd Ratio i.e. OR 1.02, 95% Confidence interval i.e. CI 1.00, 1.05), TB can be cured (OR 0.15, 95 % CI 0.03, 0.65), TB- a public health problem (OR 0.42, 95 % CI 0.20, 0.87) and patient’s non isolation from family (OR 2.27, 95 % CI 1.08, 4.77) were associated with correct knowledge without misconceptions.

Conclusion: Waiting areas of the hospital were poorly managed and lacked IEC material. Poor knowledge and large number of misconceptions about disease transmission exist among patients visiting hospitals. The Government authorities have been recommended that gaps in knowledge of TB among patients can be overcome by displaying appropriate IEC material in the waiting area so as to judiciously utilize the waiting time of the patients.