This study demonstrated that the overall knowledge rate was 83.6% in 2020, which was higher than 2013 and 2015. The knowledge rate was also higher than some areas in china10–13 and similar to BeiJing14. Through the "four networks" publicity network based on the Internet, news and broadcasting network, telecommunication network and interpersonal communication network, health education on tuberculosis was carried out to maintain the knowledge rate at a high level. However, further exploration is needed to increase the knowledge rate.
The knowledge of the core information of residents was different. The knowledge rate of questions 2 and 4 was low, indicating that public awareness of the suspected symptoms of tuberculosis and the national reduction policies for screening and treatment was lacking, which should be strengthened in the future.
In the past year, promotional materials on tuberculosis prevention that have been provided to participants mainly consisted of leaflets, brochures, posters and pamphlets, while magnetic tapes, compact discs and videotapes had been gradually replaced. Most of those who were given these promotional materials had read them. It suggested that, with the increasingly developed new media, it may be a trend conformed to the development to make good use of new media publicity, such as TikTok and official accounts of WeChat for science promotion15–17. Doctors were the main deliverers of tuberculosis knowledge or policies, while the proportion of knowledge acquired by the participants from teachers and classmates was relatively low, Kandasamy’s article[18] also reveal the healthcare students’ knowledge is better than non-healthcare counterparts. Therefore, more teachers and classmates need to be trained as volunteers to participate in TB prevention and control to contribute to end TB strategy. The survey found that only about 5% of the participants indicated that they were unwilling to participate in the tuberculosis publicity activities organized by the work unit or community, There seems to be enthusiasm among participants for TB publicity. Thus we need to hold more diverse forms activities to attract the public engagement. The knowledge rate of medical staff was high, but low among workers and farmers19. Income also influenced the knowledge rate, with higher income groups likely to have a higher demand for health-related knowledge than lower income groups20.
After adjusting for possible confounding factors, multivariate analysis showed that occupation and income were associated with participants' awareness of tuberculosis. Improving the cultural literacy of the whole people is the cornerstone of improving health. Cultural was related to the occupation, especially the low knowledge rate of workers and farmers. Therefore, it is necessary to expand the popularization of TB knowledge to the masses. Low-income people with low knowledge rate are at high risk of TB, so targeted health education activities should be carried out for them21–23.
We believe that our study has some limitations. First, as it was a cross-sectional study, it is not possible to determine the cause and effect relationships of the associations. Second, with the prevalence of new media, platforms including TikTok and official accounts of WeChat are important means for residents to obtain information. However, there were limitations in the design of relevant questions in this study, resulting in the validity of this approach not being verified, which can be further improved and adjusted in the following research.
In conclusion, the knowledge rate of TB prevention and control information of residents has been improved compared with that before. Therefore, targeted publicity activities focused on the suspected symptoms of tuberculosis and the national policies should be further conducted out. The combination of traditional media and new media makes the publicity more diversified. Strengthening health education for workers, farmers and low-income groups to make health education more precise and further improve the awareness level of tuberculosis.