Yinhuan Pi,1,2,* Junyi Tan,3,* Pei Yang,1 Jing Pan,2 Xianghui Yang,2 Mingque Xiang,2 Tianju Li2 

1Business Affairs Section, Chongqing Blood Center, Chongqing, People’s Republic of China; 2Department of Infectious Diseases, The Ninth People’s Hospital of Chongqing, Chongqing, People’s Republic of China; 3Department of Gastroenterology, Chongqing University Three Gorges Hospital, Chongqing, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Tianju Li, Department of Infectious Diseases, The Ninth People’s Hospital of Chongqing, Chongqing, People’s Republic of China, 400700, Email tianjulee@126.com

Objective: To investigate the knowledge, attitudes, and practice (KAP) toward first-line antitubercular agents among patients with pulmonary tuberculosis (TB) in southwestern China, and to examine sociodemographic disparities in KAP.
Methods: A simple sampling survey was conducted among TB patients clinically diagnosed with active pulmonary TB at the Ninth People’s Hospital of Chongqing. The questionnaire was used to collect demographic, knowledge, attitude, and practice data on first-line TB drugs.
Results: A total of 188 respondents were included in the analysis, of whom 129 were males and 59 were females, 44.7% scored below the median knowledge score 7 (4,8). Lower knowledge was seen in those aged ≥ 60 (P=0.001), earning < 1000 yuan/month (P=0.049), with ≤secondary education (P< 0.001), farmers (P=0.015), and single-drug users (P< 0.001). Attitude scores were lower in older (P=0.001), less-educated (P< 0.001), and farming populations (P=0.004). Non-adherent behaviors (18.1%) and missed dose compensation (47.3%) were more common in males (P=0.005), older adults (P=0.026), low-income (P=0.022), less-educated (P< 0.001), farmers (P< 0.001), and single-drug users (P=0.014).
Conclusion: This study reveals significant differences and deficiencies in knowledge, attitude, and practice of first-line antitubercular drugs among patients with active pulmonary TB, with the most pronounced gaps observed among older adults, lower educational attainment, and farmers.
Plain Language Summary: 
What Did We Study?: We wanted to know how well patients with active tuberculosis (TB) in southwest China understand their medications, their attitudes toward treatment, and how they actually take their drugs. TB is a serious infection, and taking medicines correctly is crucial to cure it and prevent drug resistance.
How Did We Study It?: We surveyed 188 TB patients at a hospital in Chongqing. They answered questions about their knowledge of their medications (like doses and side effects), their beliefs about treatment, and their daily habits in taking the drugs. We compared answers across groups—like older vs younger patients, farmers vs other jobs, and those with different income or education levels.
What Did We Find?: TB treatment works best when patients take their drugs correctly. Our study shows that older, low-income farmers in rural areas face the biggest challenges. They need extra support—like easy-to-understand education, community health workers, and better access to all-in-one pills (FDCs). Hospitals and policymakers should focus on these groups to prevent TB from spreading and becoming drug-resistant.
Takeaway Message: Fighting TB isn`t just about medicines—it`s about making sure everyone, especially vulnerable groups, has the knowledge and support to stick to their treatment. Simple fixes, like better patient education and easier-to-use drug packs, could save lives.

Keywords: KAP study, antitubercular drugs, FDC, compliance