Tuberculosis in Malaysia: A Systematic Review of Knowledge, Attitudes, and Practices Among Different Communities

Abstract

Introduction: Tuberculosis (TB) is a highly endemic infectious disease that poses a serious public health problem in Malaysia. Materials and methods: This study systematically reviews knowledge, attitudes, and practice (KAP) studies on TB in Malaysia. Searches for eligible primary studies were conducted in the EBSCOHost, MEDLINE, CINAHL, ScienceDirect, Scopus, Web of Science, and UKM Journal Article Repository databases with no time limits in September 2021. Grey literature, reference lists of included studies and Google Scholar were also searched for eligible studies. Three independent authors screened search results, selected studies, and extracted data. The Critical Appraisal Skill Program (CASP) was used to assess the risk of bias in the included studies, focusing on validity, results, and societal value. Two reviewers independently evaluated each study, with a third author resolving any disagreements. Results: A total of 16 studies were included, with fifteen, six, and seven articles assessing knowledge, attitudes, and practices regarding TB. Based on CASP, all included studies demonstrated clear aims, findings, and research value. The KAP results vary among the studies; however, KAP on TB was moderate to good in healthcare workers (HCWs), TB patients, and prison workers, while KAP on TB was found to be low to moderate in the community and student populations. Additionally, a high KAP level was attributed to certain socio-demographic factors. Conclusion: The finding brings relevant information on TB-related KAP that is useful in developing continuous education, awareness, and prevention strategies in high-risk groups and communities. Reviews also identify gaps in the literature investigating KAP towards TB in other high-risk groups, such as immigrants, prisoners, sex workers, and states with high TB cases.