Knowledge and determinants regarding tuberculosis among medical students in Hunan, China: a cross-sectional study

Background: Tuberculosis (TB) is one of the most common infectious diseases worldwide. Insufficient TB knowledge may increase the risk of contracting the disease among medical students. The purpose of this study was to assess the level of TB knowledge and analyse related determinants among medical students. Methods: A cross-sectional study was performed among final-year medical students from three main undergraduate medical universities in Hunan Province. TB knowledge, attitude and practice were assessed using a questionnaire. A t-test and multiple linear regression analysis were conducted to explore the association between TB knowledge and influencing factors. Results: The total mean percentage of correct answers for TB knowledge was 44.4% (SD 13.5%), including 52.5% (SD 16.8%) for epidemiology and prevention, 35.7% (SD 16.1%) for diagnosis, and 47.5% (SD 22.7%) for treatment. Medical students who reported observing at least one TB case and an X-ray of a TB patient had a higher percentage of correct answers for epidemiology and prevention (54.4% vs 43.9%, p < 0.001; 54.3% vs 42.1%, p < 0.001), diagnosis (37.2% vs 29.0%, p < 0.001; 37.1% vs 27.5%, p < 0.001), treatment (50.0% vs 36.0%, p < 0.001; 49.5% vs 35.7%, p < 0.001) and total score (46.2% vs 36.2, p < 0.001; 46.0% vs 34.7%, p < 0.001). Older medical students (= 23 years) had greater knowledge than younger medical students (< 23 years) regarding diagnosis (37.2% vs 31.7%, p < 0.001). The multivariable linear regression analysis determined an association between observing at least one TB case and an X-ray of a TB patient and greater knowledge of epidemiology and prevention (beta = 5.6, 95% CI: 2.3, 8.9; beta = 8.2, 95% CI: 4.6, 11.8), diagnosis (beta = 3.9, 95% CI: 0.8, 7.1; beta = 5.7, 95% CI: 2.2, 9.2) and treatment (beta = 10.1, 95% CI: 5.6, 14.5; beta = 7.0, 95% CI: 2.2, 11.8) and a higher total score (beta = 5.5, 95% CI: 2.9, 8.1; beta = 6.6, 95% CI: 3.8, 9.5). Moreover, an older age (>= 23 years) was associated with more accurate knowledge of diagnosis (beta = 3.9, 95% CI: 1.8, 6.1) and a higher total score (beta= 2.8, 95% CI: 1.1, 4.6). Conclusion: Poor TB knowledge was observed among medical students, which implied a need to innovate our current infectious disease curriculum to promote TB knowledge and practices among medical students.