Assessment of knowledge, attitude andbehavioural practices towards TB prevention and control among healthcare workers at the Thika level 5 hospital

Abstract

Background: Tuberculosis (TB) is a major health concern globally. Ranked among the foremost cause of death amongst infectious diseases in the World, TB affects millions of people each year and remains to be a main universal health problem. TB is a curable with a timely diagnosis and correct treatment. To reduce the health problem caused by TB, countries have fully integrated national TB programme in the primary health-care system. In Kenya, the Government has come up with ways of providing care to TB patients through government hospitals (NASCOP, 2013). Healthcare workers are responsible for educating and promoting behavioural practices that can help reduce transmission of TB. Objective: To assess the knowledge, attitudes and behavioural practices towards TB prevention and control among healthcare workers at the Thika Level 5 Hospital. Methods:This was a cross-sectional study carried out at the Thika Level 5 Hospital. The population of health care workers was stratified by cadre. In each stratum (cadre), health care workers were selected conveniently considering their working schedule.A self-administered structured questionnaire was used to collect data from 201 healthcare workers. Descriptive analysis was done to summarize data. Bivariate analysis was done using Chi-square/ Fishers exact test to evaluate the association between the participants’ knowledge, attitude and practices (KAPs) towards TB infection, transmission, prevention and control; and their demographic characteristics, cadre, work experience, history of service and training in TB prevention and control. Multivariate analysis was performed using Poisson regression model to evaluate the factors associated withKAPs of health workers towards prevention and control of TB.

Results: Two hundred and one healthcare workers participated in the study (a response rate of 96.6 %). A majority (69.6%) of the respondents were female and more than half (55.7%) were nurses. Median age of HCWs in the study was 30 years (Inter-quartile range (IQR): 25-40). Less than half (46.8%) had at least one-year experience dealing with TB patients while 12.95% had no experience in TB care. Almost all respondents (99.5%) had good knowledge regarding TB, 58.7% had positive attitude towards TB care and 71.6% had good TB care practices. The median (IQR) score of basic TB knowledge was 83.3% (66.7-83.3), that of attitudes towards TB disease and care was 53.6% (42.1-63.2) and that of TB care practices was 60.0% (40.0-80.0). Those with more than five years in service at the facility were more likely to have positive attitudes compared to those with five or less years in service (Prevalence ratio (PR)=1.57; CI: 1.19-2.07). Those who had served less than tenTB patients in the past six months were more likely to have poor TB care practices compared to those who had served tenor more TB patients (PR=0.82; CI: 0.67-0.99). Conclusion:Health Care Workers at Thika Level 5 Hospital have goodknowledge on TB care. However, this contrasts with the level of attitudes towards the same where a considerable proportion had negative attitude and the level of TB care practices. Notably, over one-tenth of HCWs in TL5H do not know of existence of TB vaccine, despite treating TB patients. Duration of service was significantly associated with HCWs’ attitudes towards TB care.