India bears the largest global burden of tuberculosis (TB), and tribal populations in remote, hard-to-reach areas face particular barriers to timely diagnosis and treatment. Factors include scattered settlements, low literacy, reliance on traditional healers, and limited access to screening and diagnostic services. The National TB Elimination Programme (NTEP) recognises community-driven approaches and the role of volunteers in improving case detection and treatment support, but effective volunteer engagement requires adequate TB knowledge and appropriate attitudes and practices.
The study reported here assessed whether a focused, culturally appropriate short training delivered to organised student and women volunteers from tribal communities could improve TB-related knowledge, attitude, and practice (KAP) ahead of a larger community-based intervention in Senapati district, Manipur.
Between February 2023 and August 2025, the project trained 708 volunteers drawn from student and women organisations across 189 villages in Senapati district. Training content included identifying TB symptomatics, sputum collection and transportation, patient support and follow-up during treatment, and counselling. The intervention consisted of a two-day, hands-on program tailored to the local cultural context.
Of the 708 volunteers trained, 339 were retained through the full training and assessment and included in the pre–post analysis reported in the paper.
Study data were captured using REDCap software and analysed with Stata. The design was a quasi-experimental pre–post assessment focused on immediate training outcomes. Both descriptive and inferential statistical methods were used to compare pre-training and post-training KAP measures. Statistical significance was set at p < 0.05.
Knowledge was assessed using categorical scoring with multiple knowledge levels; attitude scores were treated as continuous measures with reported means and standard deviations. The authors report specific statistical tests and results for knowledge distribution changes, attitude score differences, and health-seeking intention shifts.
Training produced substantial immediate improvements in TB knowledge among participants. The probability of being in the highest knowledge category increased markedly from 10% before training to 65% after training. Correspondingly, the likelihood of participants being in the lowest two knowledge categories decreased from 61% pre-training to 8% post-training. These changes indicate a strong short-term effect of the two-day training on volunteer knowledge about TB.
The source article provides tables and figures illustrating these category shifts but does not report longer-term knowledge retention results beyond the immediate post-training assessment in the material presented here.
Attitude toward TB showed a modest but statistically significant improvement. The mean attitude score rose from 24.53 (SD = 4.79) before training to 25.40 (SD = 4.83) after training. The 0.87-point increase reached statistical significance (t(353) = −3.58, p = 0.0004), with a 95% confidence interval reported as [−1.35, −0.39].
Reported health-seeking intentions also improved. Volunteers reported an increased likelihood of seeking care for TB symptoms within 1–2 weeks after the training, a change that was statistically significant (p = 0.0009). The study reports these immediate intention changes but does not provide observed behavioural outcomes (for example actual care-seeking measured in the community) in the source text.
The study demonstrates that a short, culturally tailored, hands-on training can produce large immediate gains in TB knowledge among community volunteers in remote tribal areas and modest but significant improvements in attitudes and intended health-seeking behaviour.
Key limitations reported or implied by the source: the reported outcomes reflect immediate pre–post changes; the source did not present longer-term follow-up data on knowledge retention, sustained attitude change, or actual impact on case detection, diagnostic timeliness, or treatment adherence. The retention rate for assessment (339 of 708) is reported; further details on reasons for attrition or characteristics of non-retained participants are not provided in the source material summarized here.
The authors conclude that focused and culturally appropriate short-term training is a feasible strategy for rapidly improving TB KAP among tribal community volunteers and therefore can be considered as part of community engagement strategies in hard-to-reach settings. Funding for the project was provided by the Indian Council of Medical Research (ICMR), and supporting data are available with the published article.