ArticleBMC public health2026
Correct knowledge of tuberculosis as a determinant of risk perception among patients with type 2 diabetes mellitus in rural Karnataka.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe prevalence of type 2 diabetes mellitus (T2DM) varies significantly among Tuberculosis (TB) patients from 25.3 to 44% in India. Correct knowledge regarding TB symptoms is a determinant for health-seeking behaviour among T2DM patients. However, there is limited literature regarding TB knowledge and risk perception among patients with T2DM in rural communities of coastal Karnataka, India.
objectivesTo determine the association of correct knowledge regarding TB among patients with T2DM and their TB risk perception in a rural community in coastal Karnataka. METHODOLOGY: A cross-sectional study was conducted over 18 months in the rural villages under the rural health training centre of a tertiary care private medical college at Dakshina Kannada District, Karnataka, involving 202 T2DM patients. Data were collected via pretested semi-structured questionnaires administered through interviews. Descriptive statistics and chi-square tests were used to analyse demographic variables, TB knowledge and TB risk perception.
resultsAmong the 202 participants, 116 (57.4%) demonstrated overall correct knowledge regarding TB. Participants with high risk perception showed significantly better recognition of specific TB knowledge components, including airborne transmission (p = 0.013), key symptoms such as cough (p = 0.029), fever (p = 0.049), and weight loss (p = 0.019), as well as awareness of asymptomatic disease (p = 0.003) and extrapulmonary involvement (p = 0.046). They were also more likely to correctly reject misconceptions related to TB transmission.However, overall correct TB knowledge was not significantly associated with perceived risk (χ² = 0.008, p = 0.927). High risk perception was significantly associated with being single/widowed (p = 0.003), higher education (p < 0.001), higher socio-economic status (p < 0.001), skilled occupation (p < 0.001), and a family history of DM (p = 0.008). Age, sex, and duration of DM were not significantly associated with risk perception.
conclusionAlthough more than half of the participants demonstrated correct TB knowledge, this did not translate into higher perceived risk, highlighting a critical knowledge-perception gap among patients with T2DM. While specific and clinically relevant knowledge components were associated with higher risk perception, general awareness alone was insufficient to evoke a sense of personal vulnerability. Educational strategies should therefore move beyond general information dissemination and focus on personalised risk communication that explicitly links DM with increased susceptibility to TB. Such interventions should emphasise the possibility of asymptomatic disease and promote timely screening and care-seeking behaviour.
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