Factors associated with the willingness to accept tuberculosis preventive treatment among close contacts in Yantai, China: a cross-sectional study

Tuberculosis (TB) remains a major global health threat. Understanding the determinants of willingness to accept TB preventive treatment (TPT) among close contacts is essential for improving prevention coverage and achieving the “End TB Strategy” targets. A cross-sectional survey using a consecutive sampling strategy was conducted in 2024 among close contacts of TB patients across four districts/cities in Yantai (Mouping, Penglai, Haiyang, and Longkou). The questionnaire collected data on sociodemographic, exposure history, lifestyle habits, health status, and TB-related knowledge. Multivariate logistic regression analysis was used to identify factors associated with willingness to accept TPT. A total of 565 close contacts were surveyed. The overall willingness to receive TPT was high at 86.40% (n = 488), though the core TB knowledge awareness rate was 62.30%. Multivariate analysis revealed that willingness was significantly higher among those in the 25–44 age group (OR = 11.641; 95% CI: 2.1–64.541; P = 0.005) and the 45–64 age group (OR = 7.258; 95% CI: 1.379–38.214; P = 0.019). Significant positive associations were found with the frequency of fruit intake (e.g., daily consumption: OR = 17.708; 95% CI: 3.871–81.014; P < 0.001) and, most strongly, with better knowledge of latent TB infection and TPT (all correct answers: OR = 30.159; 95% CI: 11.24–80.919; P < 0.001). Conversely, various occupational groups (e.g., farmers, self-employed, retired individuals) and certain residential relationships (different rooms in the same dwelling) were negatively associated with willingness. Close contacts demonstrated generally high acceptance of TPT. Age, occupation, living arrangements, lifestyle behaviors, and TB-related knowledge were identified as significant factors associated with willingness to accept treatment. Strengthening targeted education and improving awareness of latent TB infection may enhance uptake of TPT and support TB control strategies.