Nationwide surveys of awareness of tuberculosis in India uncover a gender gap in tuberculosis awareness

Abstract

Tuberculosis remains a major challenge in India, with an estimated 2.69 million cases each year. Although men are more affected than women, gender differences and related factors affect awareness of tuberculosis and thus impact tuberculosis diagnosis and access to treatment. Understanding the gender-specific needs and complexities when diagnosing and treating tuberculosis is essential to manage cases in India. We undertook a comparative study using data from three National Family and Health Surveys (NFHS), specifically NFHS-3, NFHS-4 and NFHS-5. We investigated the prevalence and gender disparity in awareness about tuberculosis, and associated factors, using regression analysis. Most men and women surveyed are between the ages of 15 and 19. Across the surveys, the proportion of men and women who are unaware of spreading of tuberculosis decreases from 44.9% during NFHS 3 to 29.6% during NFHS 5. However, the prevalence ratio of men to women with no knowledge about modes of transmission of Tuberculosis increases from 0.92 during NFHS 3 to 0.98 during NFHS 5. Higher odds with younger age (NFHS 5, aOR: 1.07 (1.01–1.13)) and rural residency (NFHS 5, aOR: 1.12 (1.06–1.18)), and lower odds with unmarried marital status (NFHS 5, aOR: 0.92 (0.86–0.98)) are noteworthy associations. Women and men have differences in knowledge. Gender disparity associated with awareness about tuberculosis in India is observed across all three nationwide surveys. Being aged fifteen to nineteen years and residing in rural area are risk factors. Being unmarried is a protective factor for women, but not for men. Lack of awareness of the spread of tuberculosis may be an important factor contributing to the current burden of disease. We used datasets from three rounds of the National Family Health Survey conducted in India to determine the proportion of men and women who knew how tuberculosis spreads. Using a predictive model, we showed that misconceptions are more common among both men and women. For women, younger age and living in rural areas were risk factors for lack of awareness, which was not the case for men. Such differences may represent a barrier to reducing the burden of disease. These findings can be used to develop gender-specific, comprehensive people awareness programs to raise awareness about tuberculosis. Sobagaiah et al. investigate the gender gap in awareness about how tuberculosis is transmitted 2 across three national family health surveys in India. Regression modelling shows variation in 3 awareness between men and women at a national level.