An evaluation of knowledge, perceptions and socio-economic aspects of Q-fever infection in a pastoralist system of Kajiado County, in Kenya.
Abstract
Q fever is a zoonotic disease caused by Coxiella burnetii which poses a substantial public
health concern. The disease has potential to cause detrimental effect on human health and
results to substantial economic losses in affected households. Livestock is the main source of
infection to humans. The overall objective of this study was to assess the knowledge and
perception of pastoralists on Q-fever infection and to estimate its economic impact at the
household level to inform decision on whether there is a need for surveillance of this infection
within pastoral systems by the relevant health delivery systems in Kenya. The study was
undertaken between 2015-2017 with field data collection conducted in the month of August
2015 in Namanga, Mashuru and Ngong sub counties of Kajiado County. However, additional
data were obtained through document review of the available literature, based on relevant
studies undertaken after August 2015 to obtain the status of the disease within the affected
systems.
To assess the Knowledge and perception of Q fever in the study area, seven focus group
discussions were conducted with pastoralists and nine key informant interviews were held at
the local health facilities with the health workers in-charge by use of interview guides.
Additionally, data were collected from secondary sources on pastoralist‟s knowledge and
perceptions of Q fever in Kajiado County, prevalence of Q fever in Kenya and Kajiado county
in particular; household monthly incomes; estimated outcomes of primary Q fever infections
in humans.
Based on the data collected, pairwise ranking and scoring methods were used to determine the
most common diseases affecting the community. Further statistical analysis was done using
Kruskal-Wallis one-way analysis of variance to determine if there was a significant difference
in the mean ranks of diseases across the focus group discussions held with pastoralists/farmers and Key informant interviews held with health workers. The economic cost of Q fever
infection in humans was estimated using a deterministic model which was developed in
Microsoft Excel spreadsheet. The estimation of economic cost was based on the reported
prevalence of Q fever infection among pastoralist households, average monthly incomes,
average treatment costs and the number of days‟ people stayed away from work due to illness
with Q fever.
From the focus group discussions with pastoralists, common cold and malaria were ranked
highest as the most prevalent diseases, while pneumonia, malaria, upper respiratory tract
infections and typhoid fever were ranked highly by health workers as the most common
diseases. Even though the presence of Q fever has been established in Kajiado County as
revealed through document reviews, this study reveals inadequate awareness and knowledge
among the pastoralists and heath personnel. Due to inadequacy of awareness, Q fever is most
likely being diagnosed as other febrile illnesses with similar clinical symptoms such as flu,
pneumonia and malaria. Based on previously estimated human prevalence of 26.7% of Q
fever in Kajiado County from documented literature, the economic impact of Q fever
infection in a typical pastoralist‟s household was estimated to be Ksh 4,600 per month. This a
heavy economic burden on a typical pastoralist‟s household. The direct costs attributed to the
number of working days lost were greater than the indirect costs such as treatment and
transport. The results from this study and Q fever document reviews show that there is need
for creating awareness for Q fever among health workers, veterinary practitioners and
pastoralists. Since the presence of Coxiella burnetii has been established in previous studies
conducted in Kajiado County and Kenya at large, and since it is of economic significance,
there is need for surveillance of Q fever infection by the relevant health delivery systems in
Kenya
Publisher
University of Nairobi
Description
Master of Veterinary Epidemiology and Economics (MVEE)
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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