dc.contributor.author | Onyango, Sarah A | |
dc.date.accessioned | 2013-06-07T11:57:24Z | |
dc.date.available | 2013-06-07T11:57:24Z | |
dc.date.issued | 1995 | |
dc.identifier.citation | Onyango, S.A(1995). Gender differentials in tuberculosis case detection in a rural district in Kenya | en |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/11295/30035 | |
dc.description | Master of Public Health Thesis | en |
dc.description.abstract | Tuberculosis remains a major health problem and it is estimated that each year, between
50 and 100 million people are infected by the tubercle bacillus and of these, 10 - 20 million
develop overt disease and 3 million die. These figures are expected to increase as a result
of the rising numbers of tuberculosis cases among persons with HIV and AIDS. The
tuberculosis situation in Kenya is further highlighted by lower incidence rates of the disease
among women as compared to the men.
The aim of this study was to determine some of the factors that determine the gender
differences in TB case detection in Kitui District, Kenya.
The study was conducted in Kitui district between 7th June and 5th July, 1993. The study
consisted of interviews, BeG-scar inspection, Mantoux Test and review of TB case notification data from 2 registering health facilities.
A total of 910 respondents were interviewed and 430 of them given a Mantoux Test. The
sex distribution of the respondents was 596 (65.5%) females and 314 (34.5%) males. The
study revealed higher literacy rates and occupation levels among the males than the
females.
TB awareness was generally high. Eight-hundred and four (92.4%) of the respondents
knew the local name for TB and 205 (22.5%) mentioned TB as one of the five most
common diseases in the area. Furthermore, 36% of the respondents felt that TB was a
problem in their area.
Knowledge of several aspects of TB namely: signs, symptoms, cause, mode of
jI transmission and control was significantly higher among the males than the females.
However, the level of knowledge of TB prevention was higher among the females (62.4%)
than the males (60.1 %).
i Attitudes towards TB patients were positive overall, with the males showing more 'liberal'
attitudes towards social interactions with TB patients than the females.
Both males and females preferred to seek treatment for TB, from a health facility (91.8%)
ifthere was need. Most (68.6%) of those interviewed made the decision as to where they
should go for treatment if they were unwell. However, a significantly higher proportion of the males (79.6%) made this decision as compared to the females (62.8%).
BCG-scar inspection revealed that 62.8% of the respondents had a scar. The presence of
a BCG scar was significantly higher (p = 0.0047) among the males (69.0%) than the
females (59.5%).
Only 430 (49.2%) of those offered the Mantoux test accepted the test and 403 (93.7%) of
these were available for the test to be read after 48 - 72 hours. Mantoux sizes ranged from
0- 40 mm, with 42.4% of the respondents being Mantoux positive. There was no difference
in Mantoux positivity between the males and females even after controlling for age and
presence of a BCG-scar. Mantoux positivity was however, significantly higher (p = 0.009)
among those with a BCG-scar (47.9%) as compared to those without (34.8%).
A total of 408 cases were notified in 1992 in 2 major registration facilities in the district. The
data showed a male:female ratio of 1.85 : 1.
From this study, it was found that:
1. The prevalence of tuberculosis infection is the same for both males and females;
2. Women have poorer knowledge about TB than males and their attitudes towards
TB patients are less 'liberal' than those of the males.
3. Women are less likely to decide on where they should go for treatment when unwell
and more likely to seek money for transport to a health facility from their spouses
than the males.
4. TB case detection does not accurately reflect the findings of this study which
showed no difference in Mantoux positivity between males and females.
The study recommends further studies to determine the true prevalence of TB infection,
the differences in exposure to TB infection and the breakdown rates from infection to
disease between males and females. Health education campaigns should be intensified.
Instead of only passive hospital out-patient screening of suspects for TB, active casefinding
methods should be strengthened. Community based TB control programmes should
be in~it,iated. | en |
dc.language.iso | en | en |
dc.subject | Gender differentials | en |
dc.subject | Tuberculosis detection | en |
dc.subject | Rural district | en |
dc.subject | Kenya | en |
dc.title | Gender differentials in tuberculosis case detection in a rural district in Kenya | en |
dc.type | Thesis | en |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
local.publisher | Department of Community Health, University of Nairobi | en |