Abstract
BACKGROUND AND AIMS: 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 Balkh to inform targeted interventions. METHODS: A convenience-based, face-to-face cross-sectional study was conducted from June 2024 to April 2025 on 867 hospital outpatients in Balkh using a structured questionnaire developed from peer-reviewed articles. A pilot study with 30 participants showed Cronbach's α = 0.767. Descriptive statistics, χ (2) test, multivariable logistic regression analysis, and Spearman's correlation were performed using SPSS v.27, with statistical significance set at p < 0.05. RESULTS: Of the 867 participants, 63.7%, 52.7%, and 51.4% showed good knowledge, attitude, and practice, respectively. Additionally, good TB-related knowledge was significantly associated with being married (OR = 6.67), university education (OR = 3.31), prior awareness of TB (OR = 2.29), history of TB treatment (OR = 2.79), and TB vaccination (OR = 1.97) (all p < 0.05). Positive attitudes were linked to being married, unskilled employment (OR = 1.83), higher income (OR = 2.50), prior TB awareness (OR = 1.69), and having a window at home (OR = 8.03). Better practice was associated with female gender (OR = 4.20), higher income (OR = 2.02), TB awareness (OR = 1.48), and windowed housing (OR = 6.48), though unvaccinated individuals showed slightly better practice (OR = 1.44). Spearman's correlations showed significant positive associations between KAP scores (all p < 0.001). CONCLUSION: Significant gaps in TB KAP in Balkh reflect socioeconomic and systemic barriers. Targeted education and community-based interventions are essential for effective TB control.