Published: 2022-04-27

Effect of training on frontline health workers’ knowledge and attitude towards tuberculosis screening and case finding in Oyo state, Nigeria

Dora O. Akinbiye, Titilayo Olaoye, Adeniyi A. Adeniran


Background: Nigeria accounts for 11% of all undetected, ‘missing’ Tuberculosis cases. TB control is better achieved by improving the knowledge and attitude of frontline health workers (FLHWs) and this study aims to examine the effect of training on the level of knowledge and attitudinal disposition of FLHWs towards TB screening in Oyo State, Nigeria.

Methods: Fifty-one (51) FLHWs enrolled on both intervention and control arms were trained on TB and Hypertension respectively. Outcomes were scores from each construct of the questionnaire administered at baseline and 8 weeks post intervention. The study was approved by Babcock University and Oyo State Ministry of Health.

Results: Results showed that about 88% were females, CHOs were the most prominent cadre- 64%. At baseline, mean knowledge score at the intervention arm was 10.80 (control 10.61), range was 8-13 (control 7-13) and 61% had good knowledge (control 27%); this difference was however not statistically significant, p=0.55. Post intervention, all participants (100%) on the intervention arm had a good knowledge (control 73%), 47% of participants had good attitude score (control 12%). Mean knowledge score was 15.73 (control 11.92) and mean attitudinal score was 11.06 (control 8.86). Knowledge and attitude scores were statistically significantly higher in the intervention group <0.001.

Conclusions: The study provides valuable information on the existing training gap at the lower levels of care towards TB control. Further study would be required to determine the effect of a change in knowledge and attitude on TB case finding.  


Tuberculosis screening, Training, Knowledge, Attitude, Frontline health workers

Full Text:



World Health Organization. Global Tuberculosis Report, 2019. Available at: Accessed on 09 March 2022.

World Health Organization. Global Tuberculosis Report 2020, 2020. Available at: Accessed on 09 March 2022.

Noé A, Ribeiro RM, Anselmo R, Maixenchs M, Sitole L, Munguambe K, Blanco S et al. Knowledge, attitudes and practices regarding tuberculosis care among health workers in Southern Mozambique. BMC Pulmonary Medicine. 2017;17(1):1-8.

Mangvee IL, Suleima HI, Nguku P, Waziri NE, Akhimien MO et al. Health care workers’ knowledge and attitude towards TB patients under Direct Observation of Treatment in Plateau state Nigeria, 2011. The Pan African Medical Journal. 2014;18(1):8.

Shrestha A, Bhattarai D, Thapa B, Basel P, Wagle R. Health care workers’ knowledge, attitudes and practices on tuberculosis infection control, Nepal. BMC Infectious Diseases. 2017;17.

NTBLCP. Module for Training of General Health care Workers on Tuberculosis Control. National Tuberculosis and Leprosy Control Programme, Federal Ministry of Health; 2016.

Nigeria Center for Disease Control and Prevention. Infection Prevention and Control Recommendations during health care when COVID-19 is suspected. 2020;0-10.

Centre for Disease Control and Prevention. National Centre for Chronic Disease Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention. Available at: globalhealth/healthprotection/ncd/training/hypertension-management-training.html. Accessed on 20 June 2021.

Federal Ministry of Health. National Tuberculosis, Leprosy and Buruli Ulcer Management and Control Guidelines. Department of Public Health, 2019. Available at: Accessed on 09 March 2022.

Global Fund. Using Quality Improvement Approaches to increase TB case detection. The Global Fund to Fight AIDS, Tuberculosis and Malaria. 2018;1-12.

Bolarinwa OA. Sample Size Estimation for Health and Social Science Researchers: The Principles and Considerations for Different Study Designs. An Official Publication of The National Postgraduate Medical College of Nigeria. 2020;19-26.

WHO. Advocacy, communication and social mobilization for TB control: a guide to developing knowledge, attitude and practice surveys, 2008. Available at: Accessed on 09 March 2022.

Atulomah NO. Effects of two health education interventions on adherence to antihypertensive medication and on blood pressure in selected tertiary health facilities in Southwestern Nigeria. University of Ibadan. 2014.

Berg-Johnsen A, Hådem SO, Tamrakar D, Harstad I. A questionnaire of knowledge, attitude and practices on tuberculosis among medical interns in Nepal. Journal of Clinical Tuberculosis and Other Mycobacterial Diseases. 2020;20(100173).

Sima BT, Belachew T, Abebe F. Health care providers knowledge, attitude and perceived stigma regarding tuberculosis in a pastoralist community in Ethiopia. BMC Health Services Research. 2019;19(1):1-11.

Olarewaju SO Adebimpe WO, Olarewaju AO Knowledge and use of Tuberculosis Treatment Guidelines in endemic settings: a cross-sectional study among primary health care workers in Ogbomoso, Oyo State, Nigeria. Nigerian Journal of Medicine. 2018;7(1):3-10.

Buregyeya E, Kasasa S, Mitchell EHH. Tuberculosis infection control knowledge and attitudes among health workers in Uganda: A cross-sectional study. BMC Infectious Diseases. 2016;16(1):1-10.