Understanding of hospital outpatients towards tuberculosis: a cross-sectional study in herat, Afghanistan

Tuberculosis (TB) remains a major public health challenge in Afghanistan, requiring enhanced community engagement for effective control. This study assessed the knowledge, attitudes, and practices (KAP) related to TB among outpatients in Herat to inform targeted interventions. A convenience-based, face-to-face cross-sectional study was conducted from January 15 to December 27, 2024 on 434 hospital outpatients in Herat using a structured questionnaire developed from peer-reviewed English articles translated into Persian and back-translated for accuracy and validated by ten research experts. A pilot study with 30 participants confirmed reliability (Cronbach’s alpha = 0.798). Descriptive statistics, chi-square test, and Multivariable Logistic Regression Analysis were performed using SPSS version 27, with statistical significance set at p < 0.05. Of the 434 participants, with a mean age of 24.97 ± 9.64 years, 61.8%, 50.2%, and 51.2% reported good knowledge, attitude, and practices, respectively. Female had significantly higher odds of demonstrating good knowledge, and practice compared to males [odds ratio (OR) = 1.8; 95% Confidence Interval (CI): 1.02–3.12; p = 0.045], (OR = 6.5; 95% CI 3.6–11.7; p < 0.001), respectfully. University-level education was more likely to have good knowledge, attitude, and practice compared to having no formal education (OR = 2.9; 95% CI 1.54–5.43; p = 0.001), (OR = 1.9; 95% CI 1.05–3.37; p = 0.034), (OR = 2.5; 95% CI 1.31–4.56; p = 0.005). respectfully. Participants whose homes had windows had significantly higher odds of demonstrating good attitude compared to no window (OR = 6.3; 95% CI 1.73–22.99; p = 0.005), (OR = 4.61; 95% CI 1.30–16.39; p = 0.018), respectfully. Additionally, unskilled workers had significantly greater odds of good attitude compared to others (OR = 1.8; 95% CI 1.04–2.88; p = 0.038). Participants with high economic status also had significantly increased odds of good attitude (OR = 2.3; 95% CI 1.01–4.99; p = 0.049). The study revealed moderate levels of tuberculosis-related knowledge, attitude, and practice among participants, with better outcomes significantly associated with female gender, higher education, and adequate housing conditions. Targeted interventions focusing on socio-demographic disparities may enhance TB control efforts in Herat.