Pediatric Tuberculosis: Knowledge, Perceptions, and Care-Seeking Practices Among Caregivers and Healthcare Providers in the Kabondo-Dianda Health Zone, Democratic Republic of the Congo.

Background: Pediatric tuberculosis (TB) remains underdiagnosed in high-burden, resource-limited settings. Caregivers' knowledge and perceptions, along with healthcare providers' practices, are crucial for early recognition and timely care-seeking for children with suspected TB. Objective: To assess knowledge, perceptions, and care-seeking practices related to pediatric tuberculosis among caregivers and healthcare providers in the Kabondo-Dianda Health Zone, Democratic Republic of the Congo. Methods: A descriptive cross-sectional study was conducted in 2024 among 163 caregivers and 27 healthcare providers selected through convenience sampling. Data were collected through face-to-face interviews using a structured questionnaire covering sociodemographic characteristics, knowledge of tuberculosis transmission and prevention, perceptions of tuberculosis transmission, and care-seeking practices. Tuberculosis knowledge was assessed using 11 items related to transmission and prevention, and composite knowledge scores were calculated. Perceptions were assessed through structured items exploring biomedical and non-biomedical beliefs, including perceived transmission through coughing, contact, evil spirits, and domestic animals. Care-seeking practices were assessed by documenting the first point of care, timing of consultation, and reasons for choosing specific care options. Data were analyzed descriptively using frequencies, percentages, mean scores, and group-level comparisons. No inferential statistical tests were performed. Results: Caregivers had a low tuberculosis knowledge score, with a mean of 2.7 ± 1.28 out of 11 and a knowledge index of 24.5/100. Healthcare providers had a higher score, with a mean of 8.3 ± 1.36 and a knowledge index of 75.5/100. Among caregivers, misconceptions were common, including perceived transmission by evil spirits and domestic animals. Only 49.1% of caregivers reported seeking care first at a health facility, while 64.5% reported delayed care-seeking and 50.9% reported informal care-seeking. Among healthcare providers, 70.4% reported health facilities as the first point of care, 48.1% reported delayed consultation, and 29.6% reported informal care-seeking. In descriptive comparisons, healthcare providers showed higher tuberculosis knowledge scores and reported more frequent use of formal health services than caregivers. However, no inferential statistical tests were performed; therefore, these observations should not be interpreted as statistically significant associations. Conclusion: This study identified important gaps in pediatric tuberculosis knowledge, perceptions, and care-seeking practices, particularly among caregivers. The findings suggest the need to strengthen community-based tuberculosis education, culturally appropriate risk communication, and continued capacity-building of frontline healthcare providers, while recognizing the descriptive nature of the study. Given the descriptive design and convenience sampling, the findings should be interpreted cautiously and cannot establish statistical associations or causal relationships.