Abstract
Abstract Background Tuberculosis (TB) remains a major public health challenge and one of the leading causes of morbidity and mortality worldwide. Despite ongoing control efforts, delayed diagnosis, poor treatment adherence, inadequate knowledge, and suboptimal preventive practices continue to hinder progress toward ending the TB epidemic, particularly in low- and middle-income countries such as Ghana. Objective This study assessed the self-reported history of TB diagnosis, TB knowledge, preventive practices, and factors associated with TB prevention practices among adults in Ghana. Methods A community-based cross-sectional survey involving 1,669 adults was conducted in four regions of Ghana using multi-stage sampling. Data were collected using a structured questionnaire administered through KoboCollect and analysed with Stata version 17. Descriptive statistics and multivariable logistic regression were conducted to identify factors associated with TB knowledge, and preventive practice of tuberculosis (TB). Results Overall, 24.1% of respondents reported a self-reported lifetime history of tuberculosis (TB), of whom approximately 70% reported laboratory confirmation, 74.9% of respondents classified as having low TB knowledge, while 62.6% of respondents exhibiting low TB prevention practices. Multivariable logistic regression analysis showed that male respondents were 24% less likely to exhibit good TB prevention practices than females (AOR = 0.76, 95% CI 0.61–0.95, p = 0.018). Respondents with high TB knowledge were 2.2 times more likely to exhibit good TB prevention practices than those with low TB knowledge (AOR = 2.20, 95% CI 1.43–3.72, p = 0.001). While those who experienced barriers such as cost, distance, and long waiting times were 88% less likely to report good TB prevention practices (AOR = 0.12, 95% CI 0.06–0.23, p = 0.013). Conclusion This study revealed a high proportion of respondents reporting a previous TB diagnosis, low TB knowledge, and low TB preventive practices among adults in Ghana. Education, sex, occupation, household size, receipt of TB information, access to TB services, stigma, and TB knowledge were significantly associated with TB prevention practices. Social and structural barriers, including limited access to services, cost, distance, long waiting times, and stigma, were associated with poorer preventive behaviours. To achieve SDG 3.3 (end the epidemics of tuberculosis and other communicable diseases by 2030), the Ghana Health Service should increase health education programs, expand access to TB diagnostic and treatment services, improve preventive practices.