Abstract

Tuberculosis (TB) remains an important public health concern in Nigeria and continues to contribute to preventable illness, transmission, and mortality. Early identification of tuberculosis cases through appropriate screening and diagnostic evaluation is essential for initiating timely treatment, reducing transmission, preventing complications, and improving treatment outcomes. Tuberculosis screening uptake refers to the extent to which individuals who are exposed to or at risk of TB participate in recommended screening or diagnostic services. Health promotion campaigns are organized public health communication and education activities designed to increase awareness, improve knowledge, encourage healthy behaviours, and promote utilization of preventive and diagnostic health services. Such campaigns may use radio, television, social media, community outreach, health education sessions, posters, interpersonal communication, and other communication channels to provide information about TB symptoms, risk factors, transmission, prevention, screening, and treatment. In Nigeria, low awareness, misconceptions about TB, stigma, fear of diagnosis, financial constraints, limited access to health facilities, transportation difficulties, and inadequate information about available screening services may contribute to delayed screening and diagnosis. Health promotion campaigns may address some of these barriers by increasing awareness of TB symptoms, correcting misconceptions, reducing stigma, and encouraging individuals to seek screening when appropriate. Against this background, this study investigates the effect of health promotion campaigns on tuberculosis screening uptake in Nigeria. The study is anchored on the Health Belief Model (HBM), Theory of Planned Behavior (TPB), and Social Ecological Model. The Health Belief Model explains participation in preventive health services through perceived susceptibility to disease, perceived severity, perceived benefits of preventive action, perceived barriers, and cues to action. Health promotion campaigns may serve as cues to action by increasing awareness of TB risk and encouraging individuals to seek screening. The Theory of Planned Behavior proposes that attitudes, subjective norms, and perceived behavioral control influence intentions and health-related behaviours, including the decision to participate in TB screening. The Social Ecological Model recognizes that health service utilization is influenced by interacting individual, interpersonal, community, organizational, and policy-level factors. Collectively, these theoretical perspectives provide a comprehensive framework for explaining how health promotion campaigns may influence tuberculosis screening uptake in Nigeria. The study adopts a quantitative cross-sectional research design. Primary data will be collected from adults in selected communities and healthcare facilities in Nigeria using a structured interviewer-administered questionnaire. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, and eligible respondents. Health promotion campaigns will be measured using respondents' exposure to TB-related messages, frequency of exposure, communication channels used, understanding of campaign messages, perceived relevance of the messages, and exposure to community-based TB education and outreach activities. Tuberculosis screening uptake will be measured using participation in TB screening, history of symptom screening, attendance at TB screening or diagnostic facilities, willingness to undergo screening when recommended, and completion of recommended screening or diagnostic procedures. Descriptive statistics will be used to summarize respondents' sociodemographic characteristics, exposure to health promotion campaigns, TB knowledge, and screening behaviour. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple logistic regression analysis, will be employed to determine the effect of health promotion campaigns on tuberculosis screening uptake. Appropriate diagnostic tests will also be conducted to assess multicollinearity, model specification, goodness of fit, and the robustness of the estimated relationships. The study anticipates that exposure to effective health promotion campaigns will have a significant positive effect on tuberculosis screening uptake in Nigeria. Individuals who receive accurate and understandable TB information are expected to demonstrate greater knowledge of TB symptoms, modes of transmission, risk factors, prevention, and the importance of early screening. Increased awareness may encourage individuals with symptoms or relevant risk factors to seek screening and may reduce misconceptions and stigma associated with TB. Campaigns delivered through trusted communication channels, community health workers, healthcare facilities, radio, television, and digital platforms may increase the reach of TB information and encourage timely utilization of screening services. However, health promotion campaigns alone may not guarantee screening uptake because individuals may continue to face barriers such as distance to healthcare facilities, transportation costs, service availability, waiting time, stigma, fear of a positive diagnosis, and financial constraints. Consequently, the effectiveness of TB health promotion campaigns is expected to be enhanced when communication activities are combined with accessible, affordable, confidential, and reliable screening and diagnostic services. This study is expected to make significant contributions to the literature on tuberculosis prevention, health promotion, health communication, disease screening, and public health in Nigeria by providing empirical evidence on the relationship between health promotion campaigns and TB screening uptake. The findings will provide useful information for the Federal Ministry of Health and Social Welfare, National Tuberculosis and Leprosy Control Programme (NTBLCP), Nigeria Centre for Disease Control and Prevention (NCDC), state ministries of health, local government health authorities, healthcare facilities, community health workers, media organizations, development partners, and policymakers regarding strategies for improving TB screening. The study will also provide evidence-based recommendations for strengthening TB health promotion campaigns, improving community-based outreach, addressing stigma and misinformation, expanding the use of trusted communication channels, increasing awareness of available screening services, and linking health promotion activities with accessible TB screening and diagnostic services to promote earlier detection and reduce tuberculosis transmission in Nigeria.

Keywords: Health promotion campaigns, tuberculosis, TB screening, screening uptake, health communication, tuberculosis awareness, disease prevention, community health, public health, Nigeria.