UNRAVELLING TUBERCULOSIS PERCEPTIONS: A QUALITATIVE STUDY IN HIGH TUBERCULOSIS ENDEMIC COMMUNITIES IN NORTHERN SABAH Tuberculosis (TB) remains a major public health concern globally. A wider conceptual comprehension of people’s health beliefs and concerns about TB can contribute to achieving the aimed reduction in disease burden, through informed interventions tailored according to the local context. This study explores the notion of TB among community members in high TB endemic localities in Northern Sabah, Malaysia. Grounded-theory study design was utilized to gather data from 42 individuals through in-depth interviews using semi-structured questions, selected purposively by age. Individual interviews were audiotaped, transcribed, and translated into English. The data was analysed using thematic analysis. A majority of the respondents have heard of TB, but do not know what TB is. Most participants agreed that TB is a serious disease that could be fatal, and are worried about getting TB, but showed apprehension about the risk of getting the disease. Their knowledge and risk perception towards TB may affect their response to seeking diagnosis through disease screening. This study revealed persistent misconceptions about TB, which could potentially impact people’s willingness to undergo disease screening and seek appropriate treatment. Promoting health education on TB through a tailored approach according to the local context is crucial.

Introduction: Tuberculosis (TB) is a leading cause of death due to a single infectious agent. The disease is treatable by a minimum of six months of anti-TB drugs. However, prolonged duration of treatment using directly observed therapy (DOT) causes significant inconvenience to patients and is ineffective in improving treatment outcomes. Therefore, incorporating the Health Belief Model into the development of digital technology could help change behaviour and improve adherence. This study aimed to determine the effectiveness of mobile applications in improving TB medication adherence. Methods: This study proposed to conduct a randomized trial among TB patients in the Kota Kinabalu, Penampang, and Putatan districts of Sabah, Malaysia. The eligible sample will be randomly assigned to the mobile application DOT arm and standard DOT arm. The primary outcome is the adherence level calculated by the percentage of medication observed divided by the intended dose taken in two months, with 80% and more successfully observed treatment considered highly adherent. The secondary outcomes are health-related quality of life, satisfaction, and monthly household income. Multiple logistic regression and repeated measures ANCOVA will be used to determine the effectiveness of interventions to achieve primary and secondary outcomes. Discussion: The findings from this study could hopefully provide insight into rethinking TB care delivery to achieve better TB treatment outcomes. Trial Registration: This study protocol has been approved by the Medical Research Ethics Committee (MREC), Ministry of Health Malaysia (NMRR ID-21-01949-73X) and registered with ClinicalTrials. gov (NCT05259254).

Tuberculosis (TB) is a significant public health concern. Globally, TB is among the top 10 and the leading cause of death due to a single infectious agent. Providing standard anti-TB therapy for at least 6 months is recommended as one of the crucial strategies to control the TB epidemic. However, the long duration of TB treatment raised the issue of non-adherence. Non-adherence to TB therapy could negatively affect clinical and public health outcomes. Thus, directly observed therapy (DOT) has been introduced as a standard strategy to improve anti-TB medication adherence. Nonetheless, the DOT approach has been criticized due to inconvenience, stigma, reduced economic productivity, and reduced quality of life, which ultimately could complicate adherence issues. Apart from that, its effectiveness in improving anti-TB adherence is debatable. Therefore, digital technology could be an essential tool to enhance the implementation of DOT. Incorporating the health belief model (HBM) into digital technology can further increase its effectiveness in changing behavior and improving medication adherence. This article aimed to review the latest evidence regarding TB medication non-adherence, its associated factors, DOT’s efficacy and its alternatives, and the use of digital technology and HBM in improving medication adherence. This paper used the narrative review methodology to analyze related articles to address the study objectives. Conventional DOT has several disadvantages in TB management. Integrating HBM in digital technology development is potentially effective in improving medication adherence. Digital technology provides an opportunity to improve medication adherence to overcome various issues related to DOT implementation.