Knowledge, health-seeking behavior, and predictors of treatment adherence among tuberculosis patients in the North-West Region of Cameroon.

INTRODUCTION: tuberculosis (TB) remains a major public health challenge globally, with sub-Saharan Africa bearing a disproportionate burden, and control efforts in the North-West Region of Cameroon have been severely disrupted by prolonged socio-political instability. The objective of this study aimed to assess tuberculosis knowledge, describe health-seeking behavior, and identify predictors of treatment adherence among tuberculosis patients receiving treatment in the North-West Region of Cameroon. METHODS: a facility-based cross-sectional study was conducted among 274 adult TB patients receiving treatment in eight high-volume diagnostic and treatment centres in the North-West Region between March 2024 and March 2025. Data was collected using a semi-structured questionnaire covering sociodemographic characteristics, tuberculosis knowledge, health-seeking behaviour, treatment adherence, and patient experiences during treatment. Descriptive statistics were used to summarize the data. Associations between variables and treatment adherence were examined using chi-square tests, while multivariable logistic regression was used to identify independent predictors of adherence. RESULTS: overall, 48.4% of respondents demonstrated adequate knowledge of tuberculosis. Male gender (p<0.001) and higher education level (p=0.003) were significantly associated with better TB knowledge. Prior to seeking formal care, 88% of participants reported self-medication. Treatment adherence was reported by 70.1% of participants. Secondary education (AOR = 2.03; 95% CI: 1.08-3.84; p=0.028) and employment status (AOR = 1.78; 95% CI: 1.04-3.03; p=0.035) were identified as independent predictors of adherence. Drug shortages, difficulties accessing treatment centres, and financial constraints were commonly reported barriers to adherence. CONCLUSION: tuberculosis knowledge among patients in the North-West Region of Cameroon remains suboptimal, and treatment adherence is influenced by socioeconomic and health system barriers. Strengthening patient education and ensuring uninterrupted access to treatment are critical for improving TB control in conflict-affected settings.