Results

Demographic characteristics of the study participants:

A total of 1155 participants filled out the online questionnaire, and the responses were
saved on Google Drive in a password-protected manner. The baseline demographic
characteristics of the respondents are shown in Table 1. Almost (n = 89; 7.2%) of
students did not agree to participate in the study, either because they did not want to
participate or because they were younger than 18 years old, while (n = 1155; 92.8%)
agreed to participate (Figure 1). As shown, most of the participants were female (n =
788; 68.2%). The ages of participants ranged from 18 to ≥ 25 years. Most participants
(n = 626; 54.2%) were aged 21–24. Also, most of the participants were Saudi citizens
(n = 1119; 96.9%). Most of the students were in the medical colleges (n = 486;
42.1%). The education level with the highest percentage was a fourth year (n = 261;
22.6%), while the lowest was a sixth year (n = 47; 4.1%). The social status of most
participants was unmarried (n = 1091; 94.5%). In addition, more than half of the
participants were nonsmokers (n = 1011; 87.5%). A high percentage of the
participants (n = 1095; 94.8%) did not know people who have/had tuberculosis.
Among all participants, only 849 heard about TB and completed the questionnaire.
Participants who had never heard about TB (n = 306; 26.4%) were excluded from the
study and submitted the questionnaire without filling out the knowledge, attitudes,
and practices sections. Also, students at other universities were excluded from the
study. The highest number of participants (n = 230; 27%) answered that they heard
about TB from newspapers, radio, TV shows, or social media, followed by brochures,
posters, lectures, and other printed materials (n = 180; 21.2%).

Students who either heard about TB or not were similar in all characteristics except
for age (p = 0.001), faculty, educational level, and knowing people had TB or not (p
<0.001) (Table 2). According to Table 2, most of the participants aged 21–24 years
(57.6%) heard about TB. High percentage of younger age were not heard about TB.
Participants from the first academic year were less likely to heard about TB. The
highest percentage of the participants (50.5%) who heard about TB were from
medical colleges. Students who did not know people had TB were more likely to hear
about it.
 .Table 1. Baseline demographic characteristics of the 1155 respondents

Frequencies
Demographic characteristics
)%( n

)31.8( 367 Male

Gender
)68.2( 788 Female

)39.7( 458 20 – 18

)54.2( 626 24 – 21 Age (years)

)6.1( 71 25 ≥

)96.9( 1119 Saudi

Nationality
)3.1( 36 Non-Saudi

)42.1( 486 #
Medical Colleges

)27.7( 320 #
Science and Engineering Colleges
Faculty
Humanities, Education, Sharia and
)30.2( 349 #
Administrative colleges

)17.2( 199 First year

)21.2( 245 Second year

)18.7( 216 Third year

)22.6( 261 Fourth year Educational level

)9.3( 107 Fifth year

)4.1( 47 Sixth year

)6.9( 80 Internship year

)94.5( 1091 Single

)5.2( 60 Married Social status

)3( 4 Divorced / Widow

)9.5( 110 Yes Smoking

)87.5( 1011 No

)2.9( 34 Ex-smoker
 )5.2( 60 Yes Do you know people who
)94.8( 1095 No ?have/had Tuberculosis (TB)

)73.5( 849 Yes

?Have you heard about TB
)26.5( 306 No

Newspapers, Radio, TV show, or social

)27.1( 230
.media

Newspapers, Radio, TV show, or social

)8.8( 75 media, family, friends, neighbors,
.healthcare workers, or colleagues

Newspapers, Radio, TV show, or social

media, family, friends, neighbors,
)11.8( 100 healthcare workers, or colleagues,
brochures, posters, lectures, and other
.printed materials
From where you have heard
Newspapers, Radio, TV show, or social ?about TB
)11.3( 96 media, brochures, posters, lectures, and
.other printed materials

Family, friends, neighbors, healthcare

)14.5( 123
.workers, or colleagues

Family, friends, neighbors, healthcare

)5.3( 45 workers, or colleagues, brochures, posters,
.lectures, and other printed materials

Brochures, posters, lectures, and other

)21.2( 180
.printed materials

Medical Colleges include Medicine, Dentistry, Pharmacy, and Applied Medical #

Sciences. Science and Engineering Colleges include Science, Engineering, Computer
Science and Information Technology, Design and Applied Arts. Humanities,
Education, Sharia and Administrative colleges include Sharia and regulations,
.Business Administration, Literature, Education, and Applied college
.Figure 1. Response rate for the study online survey
Table 2. Comparing sociodemographic characteristics of the participants according if
.they heard about TB or not

)%( Have you heard about Tuberculosis (TB)? N

No Yes Characteristic
p
n=306 (26.5%) n=849 (73.5%)

,Gender

0.912 )32%( 98 )31.7%( 269 Male

)68%( 208 )68.3%( 580 Female

,Age (years)

)48%( 147 )36.6%( 311 18-20

0.001
)44.8%( 137 )57.6%( 489 21-24

)7.2%( 22 )5.8%( 49 25 ≥

Nationality

0.345 )96.1%( 294 )97.2%( 825 Saudi

)3.9%( 12 )2.8%( 24 Non-Saudi

Faculty

)18.6%( 57 )50.5%( 429 Medical Colleges

#

)35%( 107 )25.1%( 213 Science and Engineering Colleges

#

0.001<
)46.4%( 142 )24.4%( 207 #
Humanities and Education

0.001< ,Educational level

)25.2%( 77 )14.4%( 122 First year

)23.5%( 72 )20.4%( 173 Second year

)15%( 46 )20%( 170 Third year

)20.6%( 63 )23.3%( 198 Fourth year

)5.2%( 16 )10.7%( 91 Fifth year

 )5.6%( 17 )3.5%( 30 Sixth year

)4.9%( 15 )7.7%( 65 Internship year

,Social status

)93.8%( 287 )94.7%( 804 Single

0.319
)6.2%( 19 )4.8%( 41 Married

)0%( 0 )0.5%( 4 Divorced/Widow

,Smoking

)11.4%( 35 )8.8%( 75 Yes

0.319
)86.3%( 264 )88% 747 No

)2.3%( 7 )3.2%( 27 Ex-smoker

Do you know people who

?have/had TB
0.001<
)0.3%( 1 )6.9%( 59 Yes

)99.7%( 305 )93.1%( 790 No

#
Medical Colleges include Medicine, Dentistry, Pharmacy, and Applied Medical
Sciences. Science and Engineering Colleges include Science, Engineering, Computer
Science and Information Technology, Design and Applied Arts. Humanities,
Education, Sharia and Administrative colleges include Sharia and regulations,
Business Administration, Literature, Education, and Applied college.

Assessment of the knowledge of the study participants about TB:

The knowledge questions were scored as one point for the correct answer and a zero
for the incorrect answer, with the percentage of each answer shown in Table 3. Most
respondents had a high level of knowledge toward the cause of TB representing
(44.3%) of the total participants, and (76.3%) of them correctly answered regarding
the organ most affected by TB. Moreover, (57%) of the participants knew that there is
a vaccine against TB, and less than half of them (33.1%) did not know. Also, most
participants (70.6%) answered yes to "TB can be cured", while only (20.7%)
answered no. In addition, (74.8%) knew that TB can be transmitted by the air when a
person with TB coughs or sneezes, and only (21.4%) chosen consuming uncooked
milk. Most participants don’t know the correct duration of treatment. According to
table 6, most participants have fair and similar knowledge score toward TB among all
characteristics. A good knowledge score is shown in the age of 21-24 (n=165) with a
significant p value (<0.001). Participants from medical colleges have the higher
percentage of a good knowledge toward TB. Participants from the first academic year
were less likely to have good knowledge where's 3rd and 4th have the highest.

Assessment of the attitude of the study participants towards TB:

Table 4 shows the respondents’ attitude towards TB. Among the 849 participants,
most respondents had a high level of awareness toward TB. About (85.7%) strongly
agreed that “if they develop tuberculosis, they must immediately notify their family
and/or Physician”. Also (80.8%) of the participants strongly agreed that they would
encourage those around them who have tuberculosis to seek treatment. (79.6%)
strongly agreed that “If they had TB, they would take anti-TB medications on regular
bases, as prescribed by their doctor”. Results in the attitude sections reflect a proper
attitude among students with an attitude score of (54.1%).

According to table 7, most participants have good attitude score toward TB among all
characteristics. A good attitude score is shown with females (n=310) also with the age
21-24 (n=273), third & fourth year (n=202) and non-smoker (n=411). Participants
from medical colleges have the higher percentage of a good attitude toward TB. With
p-value <0.001. Participants who don't know people with TB is higher (n=421).

Assessment of the practice of the study participants towards TB:

There were 8 questions to assess the practice related to TB infection among the
participants which is shown in Table 5. Among the 849 participants, the participants
have a good TB-related practice level. About 79.2% answered that they always cover
their mouths when they sneeze or cough for fear of spreading infections. Also, 71.6%
of the participants answered that they always open the window to let fresh air enter to
avoid infections. 68.2% answered that they always wash their hands or use a hand
sanitizer after going to the hospital. Most of the participant answered that they always
followed the healthiest practices, such as wearing a face mask in infective
environments, maintaining a healthy diet, and doing regular exercise and the total
Practice score was (61.2%) calculated from the average answers.

.Table 3. Knowledge of study participants (n = 849) who have heard about TB

)%( N Questions

TB is caused by:

)44.3( 376 - Bacterium

)1.4( 12 - Parasite

)0.4( 3 - Fungus

)29.6( 251 - Virus

)24.4 207 - I don’t know

The organ most affected by TB is:

)6( 5 - Skin

)1.2( 10 - GIT

)76.3( 648 - Lung

)0.7( 6 - Heart

)6.4( 54 - Liver

)1.8( 15 - Kidney

)13.1( 111 - I don’t know

I don’t )%( No n )%( Yes n Questions

)%( know n

)33.1( 281 )9.9( 84 )57( 484 - Is there vaccine for TB?

)20.7( 176 )7.8( 74 )70.6( 599 - TB can be cured?

- Drug resistance develops in the patient on

)42.2( 358 )9.9( 84 )47.9( 407
discontinuation of treatment

- If a person has a TB patient among his family

)20.4( 173 )9.1( 77 )70.6( 599
or friends, he should be tested for the disease

)28.9( 245 )22.1( 188 )49( 416 - The TB microorganism circulates in the air
 - A single dose of the BCG vaccine can provide
)55.6( 472 )21.4( 182 )23( 195 lifetime protection against tuberculosis
infection

)20.4( 173 )12.8( 109 )66.8( 567 - Is TB a contagious disease?

)51.6( 438 )7.8( 66 )40.6( 345 - TB vaccination is taken at the age of 6 months

Which of the following are TB symptoms?

)16.7( 142 )3.8( 32 )79.5( 675 - Fever

)52.5(446 )31.8( 270 )15.7( 133 - Constipation

)34.2( 290 )9( 76 )56.9( 483 - Weight loss

)10.4( 88 )1.5( 13 )88.1( 748 - Cough or cough with blood

)35.5( 301 )4.5( 38 )60.1( 510 - Night sweat

)42.3( 359 )9.1( 77 )48.6( 413 - Muscle pain

Risk Factors of TB infection including the following:

)21.4( 182 )5.8(.49 )72.8( 618 - Smocking

)41.8( 355 )20.4( 173 )37.8( 321 - Heart disease

)36.9( 313 )16.7( 142 )46.4( 394 - Malnutrition

)46.5( 395 )24.5( 208 )29( 246 - Physical inactivity

)25.1( 213 )4.7( 40 )70.2( 596 - HIV infection

)49( 416 )18.1( 154 )32.9( 279 - Diabetes mellitus

TB could be transmitted through:

)30.3( 257 )35.5( 301 )34.3( 291 - Handshakes with TB patients

- The air when a person with TB coughs or

)16.6( 141 )8.6( 73 )74.8( 635
sneeze

- Touching items in public places that have

)30.4( 258 )22.1( 188 )47.5( 403
been touched or used by TB patients

)36( 306 )21.2( 180 )42.8( 363 - Sexual transmission of an infection from an
 infected individual to their partner

)53.1( 451 )25.4( 216 )21.4( 182 - Consuming uncooked milk

)29( 246 )9.3( 79 )61.7( 524 - Contaminated blood transfusions

Which of the following treatments is most effective for treating TB?

)36.2( 307 )49.9( 424 )13.9( 118 - Herbal medicine/traditional healers

)14.3( 121 )2.7( 23 )83( 705 - Specific medicine

)20.5( 174 )72.3( 614 )7.2( 61 - Buy OTC drug

The treatment duration of TB is:

)47.6( 404 )43( 365 )9.4( 80 - 1-2 weeks

)47.8( 406 )35.6( 302 )16.6( 141 - 1-2 months

)45.6( 387 )7.5( 64 )46.9( 398 - 6-9 months

Which of the following are TB prevention methods?

)19.3( 164 )12.4( 105 )68.3( 580 - Avoiding TB patients

- By maintaining a healthy diet and engaging in

)23.4( 199 )15.9( 135 )60.7( 515
a lot of physical activity

)32.0( 272 )21.3( 181 )46.6( 396 - Maintaining a normal blood pressure

- By wearing a mask while interacting with

)13.9( 118 )4.4( 37 )81.7( 694
someone who has an Infection

)16.7( 142 )4.8( 41 )78.4( 666 By residing in ventilated homes -

.Table 4. Attitudes of the respondents toward TB

)%( Responses N

Strongly
Strongly Variable
Disagree Neutral agree
disagree Agree (A) (SA)
(D) (N)
(SD)
 If I develop tuberculosis, I must
)1.3( 11 )0.9( 8 )4.6( 39 )7.4( 63 )85.7( 728 immediately notify my family and/or
.Physician

( 230 If I had TB, it might not decrease the

)11.1( 94 )28.4( 241 )17.0( 144 )16.5( 140
)27.1 .quality of my life and daily tasks

Tuberculosis screening is difficult to

( 250
)14.5( 123 )22.1( 188 )16.3( 138 )17.7( 150 access at health facilities such as
)29.4
.community health centers

I would encourage those around me who

)1.2( 10 )2.0( 17 )6.9( 59 )9.1( 77 )80.8( 686
.have tuberculosis to seek treatment

( 160 .TB is regarded as a serious disease

)1.8( 15 )3.1( 26 )26.7( 227 )49.6( 421
)18.8

( 207 Annual medical examinations can't help

)26.9( 228 )29.4( 250 )8.2( 70 )11.1( 94
)24.4 .prevent tuberculosis

( 92 Education regarding TB is desperately

)47.6( 404 )25.7( 218 )5.2( 44 )10.7( 91
)10.8 .needed

( 219 Quarantine of tuberculosis patients may

)2.6( 22 )5.3( 45 )18.5( 157 )47.8( 406
)25.8 .reduce the risk of TB spread

)1.3( 11 )2.0( 17 ( 137 )21.1( 179 )59.5( 505 The public has significant role in
)16.1 .controlling TB

)13.8( 117 )17.2( 146 ( 304 )16.5( 140 )16.7( 142 If I had TB, the inability to leave work
)35.8 or lack of knowledge where to go is the
reason of not visiting a healthcare
.facility

)1.3( 11 )1.3( 11 )8.4( 71 )9.4( 80 )79.6( 676 If I had TB, I would take anti-TB
medications on regular bases, as
.prescribed by my doctor
 .Table 5. Practice of the respondents towards TB

)%( Responses N

Always Variable
Never Rarely Sometime Usually
(N) (R) s (S) (U) )A(

)0.5(4 )0.9(8 )6.6(56 )12.8(109 )79.2(672 I cover my mouth when I sneeze or

cough for fear of spreading
.infections

)0.9(8 )2.6(22 )10.4(88 )14.5(123 )71.6(608 I open the window to let fresh air
.enter to avoid infections

)2(17 )5.8(49 )22.1(188 )17.6(149 )52.5(446 I eat a well-balanced and nutritious

diet to stay healthy to avoid
.infections

( 13 )3.7(31 )11.0(93 )15.7(133 )68.2(579 I wash my hands or use a hand

)1.5 .sanitizer after going to the hospital

)3.9(33 )9(76 )21.9(186 )18.4(156 )46.9(398 I exercise on regular bases to

.maintain my health

)3.2(27 )7.7(65 )17.1(145 )16.1(137 )55.9(475 I wear facemasks when visiting a

.hospital

)1.9(16 )3.3(28 )14.1(120 )17.0(144 )63.7(541 I would visit a health facility, if my

cough persisted for longer than two
.weeks to get examined

)5.7(48 )10.4(88 )19.7(167 )15(127 )49.4(419 I read materials intended to raise

.awareness about TB
 .Table 6. Assessment of the knowledge score of the study participants toward TB

Knowledge score
)%( N
Poor Fair Good Characteristic
p-value n = 298 n = 386 n = 165
(35.1%) (45.5%) (19.4%)
Gender
0.142 )39.4%( 106 )40.9%( 110 )19.7%( 53 Male
)33.1%( 192 )47.6%( 276 )19.3%( 112 Female
Age (years)
)40.5%( 126 )49.2%( 153 )10.3%( 32 18-20
0.001< )31.9%( 156 )42.5%( 208 )25.6%( 125 21-24
)32.7%( 16 )51.0%( 25 )16.3( 8 25 ≥
Nationality
)34.7%( 286 )45.8%( 378 )19.5%( 161 Saudi
0.292
)50.0%( 12 )33.3%( 8 )16.7%( 4 Non-Saudi
,Faculty
#
Medical Colleges
)22.8%( 98 )45.9%( 197 )31.2%( 134
Science and Engineering
)46.5%( 99 )45.5%( 97 )8.0%( 17
0.001< #
Colleges
)48.8%( 101 )44.4%( 92 )6.8%( 14
Humanities, Education, Sharia,
#
and Administrative colleges
Educational level
)42.4%( 125 )47.8%( 141 )9.8%( 29 1st and 2nd
0.001<
)34.8%( 128 )45.7%( 168 )19.6%( 72 3rd and 4th
)34.2%( 45 )41.4%( 77 )34.4%( 64 5th and 6th and above
Social status
0.916 )37.8%( 17 )45.5%( 366 )19.5%( 157 Single
)35.1%( 281 )44.4%( 20 )17.8%( 8 + Married
Smoking
)%.34( 257 )45.4%( 339 )20.2%( 151 Non-smoker
0.245
)40.2%( 41 )46.1%( 47 )13.7%( 14 +Smoker
0.020 Do you know people who
 ?have/ had TB
)62.7%( 13 )62.7%( 37 )15.3%( 9 Yes
)36.1%( 285 )44.2%( 349 )19.7%( 156 No
Medical Colleges include Medicine, Dentistry, Pharmacy, and Applied Medical#
Sciences. Science and Engineering Colleges include Science, Engineering, Computer
Science and Information Technology, Design and Applied Arts. Humanities,
Education, Sharia and Administrative colleges include Sharia and regulations,
.Business Administration, Literature, Education, and Applied college

.Table 7. Assessment of the attitude score of the study participants toward TB

Attitude score
)%( N
Poor Fair Good Characteristic
p-value n = 214 n = 176 n = 459
)% 25.2( )% 20.7( (54.1%)
Gender
0.256 )27.1%( 73 )17.5%( 47 )55.4%( 149 Male
)24.3%( 141 )22.2%( 129 )53.4%( 310 Female
Age (years)
)26.4%( 82 )20.3%( 63 )53.4%( 166 18-20
)23.3%( 114 )20.9%( 102 )55.8%( 273 21-24
0.244
)36.7%( 18 )22.4%( 11 )40.8%( 20 25 ≥
Nationality
)25.5%( 210 )20.7%( 171 )53.8%( 444 Saudi
0.595
)16.7%( 4 )20.8%( 5 )62.5%( 15 Non-Saudi
Faculty
#
Medical Colleges
)19.6%( 84 )18.3%( 78 )62.2%( 267
Science and Engineering
)31.5%( 67 )23.0%( 49 )45.5%( 97 #
Colleges
0.001< )30.4%( 63 )23.7%( 49 )45.9%( 95
Humanities, Education, Sharia,
#
and Administrative colleges
Educational level
)27.5%( 81 )21.7%( 64 )50.8%( 150
1st and 2nd
)24.7%( 91 )20.4%( 75 )54.9%( 202
0.667 3rd and 4th
)22.6%( 42 )19.9%( 37 )57.5%( 107
5th and 6th and above
Social status
)24.5%( 197 )96.0%( 169 )54.5%( 438 Single
0.130
)37.8%( 17 )4.0%( 7 )46.7%( 21 + Married
Smoking
)24.5%( 183 )20.5%( 153 )55.0%( 411 Non-smoker
0.290
)30.4%( 31 )22.5%( 23 )47.1%( 48 +Smoker
 Do you know people who
?have/had TB
)23.7%( 14 )11.9%( 7 )64.4%( 38 Yes
0.156
)25.3%( 200 )21.4%( 169 )53.3%( 421 No
Medical Colleges include Medicine, Dentistry, Pharmacy, and Applied Medical#
Sciences. Science and Engineering Colleges include Science, Engineering, Computer
Science and Information Technology, Design and Applied Arts. Humanities,
Education, Sharia and Administrative colleges include Sharia and regulations,
.Business Administration, Literature, Education, and Applied college

.Table 8. Assessment of the practice score of the study participants toward TB

Practice score
)%( N

Poor Fair Good Characteristic

p-value n = 161 n = 182 n = 506
(19%) (21.4%) (59.6%)

Gender
0.387 )19.7%( 53 )18.6%( 50 )61.7%( 166 Male
)18.6%( 108 )22.8%( 132 )58.6%( 340 Female
Age (years)
)19.3%( 60 )21.9%( 68 )58.8%( 183 18-20
0.725
)19.4%( 95 )20.7%( 101 )59.9%( 293 21-24
)12.2%( 6 )26.5%( 13 )61.2%( 30 25 ≥
Nationality
0.764 )19%( 157 )21.6%( 178 )59.4%( 490 Saudi
)16.7%( 4 )16.7%( 4 )66.7%( 16 Non-Saudi
Faculty
)16.6%( 71 )22.8%( 98 )60.6%( 260 #Medical Colleges
0.363 )20.7%( 44 )18.8%( 40 )60.6%( 129 #Science and Engineering Colleges
)56.5%( 46 )21.3%( 44 )56.5%( 117 Humanities, Education, Sharia, and
#
Administrative colleges
Educational level
)16.9%( 50 )24.1%( 71 )59%( 174 1st and 2nd
0.187
)20.4%( 75 )17.7%( 65 )62%( 228 3rd and 4th
)19.4%( 36 )24.7%( 46 )55.9%( 104 5th, 6th and above
Social status
0.031 )19.7%( 158 )20.8%( 167 )59.6%( 479 Single
)6.7%( 3 )33.3%( 15 )60%( 27 +Married
,Smoking
0.339 )18.6%( 139 )20.9%( 156 )60.5%( 452 Non-smoker
)21.6%( 22 )25.5%( 26 )52.9%( 54 +Smoker
 Do you know people who
?have/had TB
0.016
)5.1%( 3 )22%( 13 )72.9%( 43 Yes
)20%( 158 )21.4%( 169 )58.6%( 463 No
Medical Colleges include Medicine, Dentistry, Pharmacy, and Applied Medical#
Sciences. Science and Engineering Colleges include Science, Engineering, Computer
Science and Information Technology, Design and Applied Arts. Humanities,
Education, Sharia and Administrative colleges include Sharia and regulations,
.Business Administration, Literature, Education, and Applied college