Abstract:

Objective To assess the awareness rate of tuberculosis（TB） prevention and control knowledge，the acceptance of health education，and the current status of TB-related beliefs and behaviors among residents aged 15 and above in pilot communities for Zero Tuberculosis Community in Wuxi City，and provide references for further optimizing grassroots TB prevention and control strategies. Methods From March to May 2024，a questionnaire survey was conducted among residents aged 15 and above in pilot area of Zero Tuberculosis Community in Wuxi City using a multistage random sampling method. The questionnaire covered sociodemographic characteristics，chronic disease prevalence，core knowledge of tuberculosis prevention and control，and health education participation. Single factor analysis was conducted on the awareness rate using a chi square test，multivariate Logistic regression models and decision tree models were employed to analyze factors influencing the awareness rate. Results The overall awareness rate of tuberculosis prevention and control information was 55.97%. Awareness of TB transmission routes（80.38%），TB suspicious symptoms（88.30%） and designated TB medical institutions（81.85%） showed relatively higher single-item awareness rates， while awareness of TB transmission prevention methods was only 7.07%. The univariate analysis revealed that gender，age，educational level，annual household income，occupation，history of chronic diseases，and health education were all associated with residents' health knowledge awareness rate（χ²=45.997，14.832，128.799，80.229，183.812，9.020，295.942，all P<0.05）. Multivariate Logistic regression analysis showed that female gender，age ≥35 years，educational attainment at primary school level or above，annual household income ≥60 000 yuan，healthcare，education，government employees or retirees，presence of chronic diseases，and received health education were protective factors for awareness（all P<0.05）. Decision tree models showed that health education was the most significant factor affecting awareness，in addition to age，education level，occupation，income，and chronic diseases，which were also related factors affecting awareness. 59.18% of respondents had received health education，mainly through television（62.10%），and print media（52.30%），and radio（47.05%）. Preferred health education channels included radio/television/movies/audiovisual materials（56.75%），websites/WeChat/Weibo/short video apps（41.87%），and posters/bulletin boards/blackboard newspapers/display boards/wall slogans（41.03%）. The overall correct rate of belief and behavior regarding TB prevention and control among residents in Wuxi City was 75.94%，with the lowest being "TB is not frightening"（35.39%），and the highest being "standardized treatment compliance after diagnosis"（87.40%）. Conclusion The overall awareness rate of TB prevention and control information among residents aged 15 and above in pilot communities for Zero Tuberculosis Community in Wuxi City has not yet met the targets for establishing Zero Tuberculosis Community. Targeted health education interventions should be intensified for populations with younger age，lower income，limited education，and occupational groups including workers/service sector employees/agricultural workers. It is recommended to expand coverage through both traditional and new media platforms，while simultaneously addressing disease-related stigma to accelerate the construction of Zero Tuberculosis Community.

Key words: Zero tuberculosis community, Tuberculosis, Awareness rate, Decision tree models, Health education, Beliefs and behaviors