A total of 44 student TB patients were found and diagnosed during TB outbreak in a middle school in Jinan, Shandong Province from April 2013 to November 2014. At the same time, TB transmission was ongoing in schools.

In Shaanxi Province of China, from 2011 to 2015, the number of student TB patients was always higher than 1300 annually, accounted for 6.17-6.78% of total TB cases. Globally in 2015, there was an estimated 10.4 million incident cases of TB, of these, China, India and Indonesia alone accounted for 45%. It caused ill-health in millions of people each year and was one of the top 10 causes of death worldwide, ranking above HIV/AIDS as one of the leading causes of death from an infectious disease. Tuberculosis (TB) has existed for millennia and remains a major global health problem. Lower KAP level had been one of the main indicators of poor health, inefficient health care use, the decrease of the disease screening rate, and maladaptive disease preventive behavior. Several studies had shown that, the level of KAP in individuals was linked to efficient management of illness, response to medical treatment, and promotion of one’s own health. Since 1970, Knowledge, attitudes and practices (KAP) research has been the primary educational intervention strategy for tuberculosis (TB) control worldwide. The new tool might help public health researchers evaluate the level of KAP in student TB patients, and it could also be used to examine the effects of TB health education. Psychometric testing indicated that it had adequate validity and reliability for use in KAP researches with student TB patients in China.

ConclusionsĪn instrument, “Knowledge, Attitudes and Practices Questionnaire among Student Tuberculosis Patients (STBP-KAPQ)” was developed. Discriminant validity was supported through a significant difference between student TB patients and healthy students across all domains ( p < 0.05). STBP-KAPQ and PTB-KAPQ had a strong correlation in the knowledge part, and the correlation coefficient was 0.606 ( p < 0.05). Seven common factors were extracted by principal factor analysis and varimax rotation, with a cumulative contribution of 66.253%. Cronbach’s α coefficient and intraclass correlation coefficient (ICC) was 0.817 and 0.765, respectively. The final STBP-KAPQ consisted of three dimensions and 25 items. Content validity was calculated by content validity index (CVI) Construct validity was examined using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) The Public Tuberculosis Knowledge, Attitudes and Practices Questionnaire (PTB-KAPQ) was applied to evaluate criterion validity As concerning discriminant validity, T-test was performed. Reliability was examined with internal consistency reliability and test-retest reliability.

Reliability and validity were assessed using student TB patients ( n = 416) and healthy students ( n = 208). The questionnaire items were evaluated by the Delphi method based on 12 experts. The item pool for the questionnaire was compiled from literature review and early individual interviews. This study was conducted in three stages: item construction, pilot testing in 10 student TB patients and psychometric testing, including reliability and validity. The objective of this study was to develop a Knowledge, Attitudes and Practices Questionnaire among Student Tuberculosis Patients (STBP-KAPQ), and evaluate its psychometric properties. Understanding the knowledge, attitudes and practices among student TB patients in such settings is fundamental when it comes to decreasing future TB cases. TB outbreaking in schools is extremely complex, and presents a major challenge for public health.

Kap survey