Knowledge, attitude, and practices of households toward tuberculosis transmission and early diagnosis.

Tuberculosis (TB) remains a major public health challenge, particularly in fragile, high-burden settings like Somalia. Household knowledge, attitudes, and practices (KAP) critically influence early diagnosis, treatment adherence, and community transmission. This study assessed KAP toward TB transmission and early diagnosis among households in Mogadishu. A community-based cross-sectional study was conducted from December 2025 to February 2026 among 403 adult household representatives in Mogadishu. Multistage and systematic random sampling were employed. Data were collected using a structured interviewer-administered questionnaire and analysed with Stata 17. Composite scores for knowledge, attitude, and practice were calculated (range 0–5), and associations with sociodemographic factors were examined using t-tests and ANOVA. Most participants were aware of TB (85.4%), recognized airborne transmission (87.1%) and persistent cough as a key symptom (86.4%), and knew it is curable if diagnosed early (83.1%). Only 48.6% correctly identified TB as caused by bacteria. Positive attitudes were common, with 88.6% perceiving TB as serious and 83.1% believing in completing treatment; however, only 50.6% felt comfortable interacting with TB patients. Mean KAP scores were moderate to good: knowledge 3.91 ± 1.23, attitude 3.92 ± 1.28, and practice 3.92 ± 1.15. KAP scores varied significantly by age, sex, marital status, education, and household size. Households in Mogadishu demonstrate general awareness of TB but substantial gaps remain in biomedical knowledge and zoonotic risk understanding, alongside persistent stigma. Culturally tailored, community-based interventions targeting misconceptions, promoting early diagnosis, and strengthening household engagement are critical for effective TB control.