Assessment of knowledge, attitude and practice on tuberculosis among health care workers in Busia and Teso districts, Kenya

Abstract

Tuberculos(TB) has re-emerged as a serious public health problem worldwide mainly due to the increasing HIV related TB. Despite effort to control this deadly disease the prevalence and mortality rates still rise steadily leaving most people in their economically productive ages vulnerable.Being an infectious disease it is time to improve community awareness about the disease and hence improve the participation of the community members in the control of this disease. A descriptivecross-sectional study on the knowledge, attitude and practice (KAP) about TB among the health care workers (HCWs) was carried out in 45 health facilities of the old Busia District [currently covering two districts namely Busia and Teso] in Kenya. The instruments used to collect data were a questionnaire written in English and a question guide for the FGDs. Four research assistants were recruited and trained to assist in the actual data collection. A total of 307 HCWs consisting of doctors, nurses and clinical officers were interviewed. Three focus group discussions were carried out among the HCWs of Nangina Mission Hospital, Busia District Hospital and Alupe Sub-district Hospital. Participant observation was also carried out to confirm the findings form the above two methods. Knowledge on TB among the HCWs was good with more than 90 percent having adequate knowledge. The majority did not know the National Leprosy and Tuberculosis Program's (NLTP) current recommended regimen and importance of early case finding and prompt treatment in control of TB. Majority expressed their wish to be educated more about TB and especially the recommended regimen. Almost all (95.4 percent) had rational attitude towards TB except for the misconception that one can contract TB from handling the patient's fomites. Among the respondents46.6 percent had positive practice on TB because 90 percent of them refer their patients to the District Tuberculosis and Leprosy Co-ordinators (DTLCs). Lack of facilities (both diagnostic and treatment) and inadequate knowledge on TB among the patients could hamper the HCWs' effort in the struggle to control TB. Of the personal characteristics of the HCWs, level of training (p=0.Ol79) and cadre (p=0.Ol09) of theHCWs were found to be significantly related to their knowledge on TB. Age (p=0.0384) and number of working years (p=0.Ol79) of the HCWs were found to be significantly related to their attitude towards TB while none was found to be related to their practice on TB. There was no significant relationship between the knowledge (p=0.2345) and attitude towards (p=0.5467) IB among the HCWs in private and public health sectors but there was a significant relationship between their practice on TB (p=0. 0113) and the health sector. The HCWs should be informed on the latest information on IB in order to correct their KAP defects on IB and avoid the deterioration of knowledge and attitude towards IB especially among the doctors and older HCWs and the misconception that one can get TB from handling the patient's fomites. The study suggests more involvement of the HCWs in the management of TB patients to anprove the HCWs' KAP on TB. The NLTP should equally run their activities in the private NGO health sectors in order to improve their participation in TB control. The NLTP should equip the health facilities with the necessary diagnostic and treatment facilities to boost the attitude towards TB among the HCWs especially the older HCWs in the peripheral health facilities. Provision of TB isolationwards in the various hospitals of Busia and Teso districts to reduce nosocomial infection. Last but not least the study suggests a study to be carried out on TB patients and the community at large to determine their knowledge, attitude and practice on TB.