Compliance with Tuberculosis Infection, Prevention and Control Guidelines among Healthcare Workers in Kibera, Nairobi City County, Kenya.

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Date
2024-04
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Kenyatta University
Abstract
Tuberculosis is one of the major occupational hazards recorded among healthcare workers, not just in Kenya but globally due to their consistent and routine exposure. This is especially true among the nurses and laboratory workers who are regarded as high-risk groups for both Latent Tuberculosis Infection (LTBI) as well as active TB, among the profession cadre. From the studies done within Kenya and globally, it has been proved that the risk of infection among Health Care Workers (HCWs) compared to the general population is three times more with poor implementation administrative control cited as the major cause according to World Health Organization (WHO). The study was aimed at producing baseline data that would be used to create awareness on existing morbidity within the community hence lead to prevention and control measure being put in place. This too shall contribute significantly to the Sustainable Development Goal (SDG) indicator of ‘End TB 2050’. The study sought to assess the compliance to TB IPC among HCWs in Kenyatta National Hospital and Mbagathi District Hospital. The study sample was 406 participants from KNH and Mbagathi hospitals. Out of the 406 questionnaires distributed, 98.0% (n=398) were completed, accurately filled and returned. A total of 36 nurses, 4 laboratory staff participated from Mbagathi with 328 nurses and 30 laboratory staff from KNH. Statistical Package for Social Sciences version 22.0 was used to analyze the descriptive statistics. Thematic analysis was employed to analyze qualitative data and triangulated with quantitative data either as narrations or direct quotes. The Chi-Square tests were done at 95% confidence interval and results with p-values of less than 0.05 (p<0.05) were considered significant. This helped identify the relationship between various variables. Moreover, Pearson’s correlation too was done to show the strength of the association. The study findings revealed that the socio-demographic factors that significantly influenced respondents’ compliance to the laid down TB IPC guidelines included the number of years worked (P=0.043) and salary received per month (P=0.003). Further, the HCWs generally had a high level of knowledge on TB with low score observed on TB prevention aspect. On compliance, the administrative aspect of control measure was noted as inadequate contrary to what was filled in the questionnaires. The study further revealed that those with a fair attitude were more likely to comply with TB IPC guidelines than their counterparts. Thus, knowledge and attitude levels were significantly associated with compliance to TB IPC guidelines (P=0.000). In conclusion, there is a dire need to offer continuous medical education to HCWs despite their tight schedules with an emphasis on TB prevention. Moreover, the hospitals managements should ensure that appropriate policies such as compensation policy, incentive program, TB screening and HIV/AIDS testing and treatment that is staff-friendly are formulated and implemented to boost the attitude of the HCWs.
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A Thesis Submitted in Partial Fulfillment for the Requirements of the Award of the Degree of Masters of Science (Occupational Health and Safety) in the School of Human Sciences of Kenyatta University April, 2024 Supervisors 1.Emma mwangi 2.Washington Arodi
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