Extent and Risk Factors for Multiple Drug Resistance among Tuberculosis Patients in Baringo County, Kenya
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Date
2021
Authors
Kapterit, Doreen Jepchumba
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
In Kenya, tuberculosis remains a principal cause of morbidity and mortality. This
study sought to determine the extent of and risk factors for multiple drug resistance
among tuberculosis patients in Baringo County, Kenya. The study aims were: to
identify the prevalence of MDR TB in Baringo County, and to establish the
relationship between socio-demographic factors, previous TB treatment, TB
treatment related factors, history of imprisonment, history of migration, educationrelated
factors, behavioral practices, health system and provider factors and
occurrence of MDR TB among tuberculosis patients in Baringo County. The study
employed the cross-sectional survey design. Using purposive sampling, proportional
to size sampling, and purposive census to recruit the respondents. 263 participants
were selected from six sub-county hospitals. Data was collected using structured
questionnaires including dichotomous questions (yes and no questions). The experts
in the Department of Community Health and Epidemiology improved the validity of
the instrument. The tool was pilot-tested to measure its reliability coefficient. The
research instrument’s reliability was 0.796, which was within acceptable threshold.
Descriptive statistics (frequency distributions, means and standard deviation) and
inferential statistics (chi-square) were utilized to explore the collected data using IBM
SPSS program version 26. The finding of the study revealed MDR TB prevalence
among tuberculosis patients in Baringo County to be 14.9%. The study adopted 0.05
Alpha (α) level. The chi-square results indicate that, highest level of education,
incomes of TB patients, TB treatment related factors: history of imprisonment,
history of migration, behavioural practices, health system and provider factors have
no significant relationship with MDR TB prevalence in Baringo County. The results
for the correlation are: Fisher’s Exact Test = 8.230; p = 0.075, χ2 = 0.295; df = 1; p =
0.705, (χ2 = 0.706; df = 1; p = 0.49), (χ2 = 0.053; df = 1; p = 0.853), (χ2 = 0.305; df =
1; p =0.658), Fisher’s Exact Test = 3.311; p = 0.200, respectively. Consequently, the
study established strong statistically significant positive relationship (χ2 = 68.371; df
= 1; p< 0.001), between previous TB treatment, and prevalence of MDR tuberculosis
among the study participants. The qualitative findings shows that long distance,
stigma, drug abuse, and mal-absorption syndrome leads to none adherence to ant-TB
medication which leads to MDR-TB. The findings may help in informing
policymakers to formulate relevant public health strategies to increase adherence and
compliance to tuberculosis therapy. Additionally, findings from the study will be used
by ministry of health to come up with specific MDR TB preventative strategies.
Future research should capture other contributory factors in settings beyond Baringo
County, and provide more generalizable findings.
Description
A Research Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Public Health (Epidemiology & Disease Control) in the School of Public Health and Applied Human Sciences of Kenyatta University, November, 2021
Keywords
Extent, Risk Factors, Multiple Drug Resistance, Tuberculosis Patients, Baringo County, Kenya