Determinants of Insufficient Knowledge About Multidrug-Resistant Tuberculosis Among Tuberculosis Patients in Kinshasa, Democratic Republic of the Congo: A Cross-Sectional Study.

Abstract

Background: Multidrug-resistant tuberculosis (MDR-TB) remains an important public health challenge, particularly in settings with a high tuberculosis burden. This study aimed to identify factors associated with insufficient knowledge about MDR-TB among tuberculosis patients receiving care in Kinshasa, Democratic Republic of the Congo (DRC).  Methods: A quantitative analytical cross-sectional study was conducted among 165 tuberculosis patients aged ≥15 years receiving care at selected tuberculosis diagnosis and treatment facilities in Kinshasa. Data were collected using a structured questionnaire assessing knowledge of MDR-TB, sociodemographic characteristics, access to health information, and selected sociocultural factors. Knowledge was categorized as insufficient when the participant obtained <50% of correct responses and adequate when the score was ≥50%. Associations were assessed using bivariate analysis and multivariable logistic regression. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated.  Results : Among the 165 participants, 106 (64.2%) were men and 59 (35.8%) were women. Most participants were aged 31–40 years (39.4%), and 94 (57.0%) had no formal education or only primary education. Only 44 participants (26.7%) reported having previously received information about MDR-TB. Overall, 100 participants (60.6%) had insufficient knowledge. In multivariable analysis, male sex was associated with lower odds of insufficient knowledge (aOR=0.204; 95% CI: 0.093–0.448; p<0.001), whereas no formal/primary education (aOR=4.393; 95% CI: 1.961–9.840; p<0.001), affiliation with revivalist or Kimbanguist churches (aOR=4.261; 95% CI: 1.698–10.690; p=0.002), and no previous information about MDR-TB (aOR=5.142; 95% CI: 2.188–12.085; p<0.001) were associated with higher odds of insufficient knowledge.  Conclusion : Insufficient knowledge about MDR-TB was common among tuberculosis patients included in this study. Low educational attainment and lack of previous information were particularly strong factors associated with insufficient knowledge. Strengthening patient-centred health education, using communication materials adapted to different literacy levels and involving community stakeholders may improve understanding of MDR-TB in Kinshasa.