JMIR Publications

ABSTRACT

Background:

Tuberculosis (TB) remains a leading infectious cause of morbidity and mortality worldwide, with children representing a particularly vulnerable group. In the Democratic Republic of Congo (DRC), pediatric TB continues to be underdiagnosed and underreported, especially in rural settings such as Kabondo Dianda health zone.

Objective:

This study aimed to assess the knowledge, perceptions, and practices of guardians and health care providers regarding pediatric TB, using the Knowledge-Attitudes-Practices (KAP) framework.

Methods:

A descriptive cross-sectional study was conducted in five diagnostic and treatment centers of Kabondo Dianda health zone between November 25 and 30, 2022. Guardians of children diagnosed with TB (n=163) were recruited exhaustively, while providers (n=27) were included through convenience sampling. Data were collected using a validated structured questionnaire (Cronbach α=0.82). Composite scores were calculated for knowledge, perceptions, and practices. Descriptive statistics and chi-square/Fisher’s exact tests were applied, with significance set at P<.05.

Results:

Guardians demonstrated partial biomedical knowledge: cough was widely recognized as a symptom (75.5%), yet misconceptions persisted, with 27.3% attributing TB to supernatural causes. Preventive knowledge was moderate, with only 41.2% mentioning vaccination. Stigma was reported by 36.5% of guardians, and care-seeking was often delayed (54.8%). Providers showed higher knowledge scores but limited diagnostic engagement: GeneXpert use was reported in 48.1% of cases, and HIV screening in 37.0%. Misconceptions were significantly associated with lower knowledge scores among guardians (P=.03).

Conclusions:

Pediatric TB underreporting in Kabondo Dianda reflects both systemic and behavioral determinants. Aligning interventions with the KAP framework may enhance detection by simultaneously improving community awareness, addressing cultural perceptions, and reinforcing provider capacity. Given the exploratory design, findings are not generalizable but provide valuable insights for strengthening pediatric TB control in rural DRC. Future research should expand to larger, representative samples and longitudinal designs.