Prevalence, Knowledge, Attitude, and Practice on Latent Tuberculosis Infection (LTBI): A Cross-sectional Study Among Medical Students at a Malaysian University

Introduction: Latent TB Infection (LTBI), although asymptomatic, can potentially develop into active TB. This study aimed to assess LTBI prevalence, knowledge, attitude and practices (KAP) among medical students in Negeri Sembilan, Malaysia. Materials and methods: A cross-sectional study was conducted involving 171 clinical-year medical students. A tuberculin skin test (TST) with a 10mm cutoff identified LTBI, confirmed by the QuantiFERON® TB Gold. A questionnaire included sociodemographics, TB exposure, and KAP on LTBI. The Kruskal-Wallis and Spearman correlation coefficients were employed to explore associations among the study variables. Results: LTBI prevalence among medical students was 0.6% (95% CI 0.000, 0.032). The mean of total correct answers for LTBI knowledge was 10.63, SD = 2.064 (range: 5–15), with only 36.8% of the students scoring higher than the median score. The mean total attitude was 36.59, SD = 3.362 (range = 16–40), with 49.1% having a total attitude above the median. The mean total scores for LTBI practice are 22.86, SD = 1.31 (range = 15–24), with 36.3% answering always to all the practice statements. Student's clinical years were associated with knowledge scores (p<0.001). Weak but significant positive correlations existed between knowledge score with age (p<0.001) and practice score (p<0.001). The attitude score was weakly and significantly correlated with practice score (p=0.004). While, the practice score also weakly but significantly correlated with clinical exposure hours (p=0.019). Conclusion: Though promising, the study highlighted knowledge gaps and suboptimal LTBI attitudes and practices among medical students. Comprehensive interventions are crucial to enhance medical students' KAP.