Gender differences in the knowledge of tuberculosis and health care seeking behaviors: A cross sectional study among the students in the islamic boarding school (pesantren) in Garut, West Java, Indonesia

Indonesia ranks second in the list of TB high-burden countries (HBC). One segment of the Indonesian population that is vulnerable to TB exposure is the students in Islamic Boarding Schools (pesantren), which may be the result of poor access to health care services and the student's own attitudes when it comes to seeking health care. This research is a cross-sectional study conducted in six Islamic Boarding Schools in Garut, West Java, Indonesia. By applying two stages of cluster sampling, a total of 422 samples were selected and interviewed using pretested questionnaires. The findings reveal that 34.4% of the students (40.2% of the male vs 28.6% of the female) do not know that coughing blood is one of TB symptoms. On the contrary, only some of the female students (8.9%) know about the free TB care policy as opposed to 17.7% of the male students. Following the onset of TB symptoms, 78.2% of female students are more likely to seek health care than their male counterparts (64.9%). However, a large percentage of the female students prefer to visit lower level non-hospital health facilities first, such as the public health centers and private general practitioners. There is a difference with regard to the level of knowledge about TB between male and female students in Islamic Boarding Schools. Issues related to gender should be taken into account to lower the delay in TB diagnostic and improving access to qualified health facilities for TB care for both male and female students.