Abstract:
Tuberculosis is a major public health problem with a rapid increase in incidence and
prevalence. Kenya continues to treat more and more TB patients each year. However,
widespread co-infection with HIV (close to 48 percent of new TB patients) makes TB
treatment difficult. While the number of new cases appears to be declining, the
number of patients requiring re-treatment has increased.
The main objective of this study was to establish the level of knowledge, attitude and
practice (KAP) on TB among outpatients in selected health facilities in rural and
urban Machakos District Kenya, after a health intervention. A cross sectional study
was conducted at out-patient clinics in selected health facilities in rural and urban
Machakos. A questionnaire was used to gather information on knowledge, attitude
and practice on Tuberculosis from the respondents and statistical significance at 0.05
level was used as a standard measure of significance. A total of 211 outpatients were
interviewed, 84 in urban and 127 in rural health facilities. Chest pain, coughs and
weight loss were reported as the common symptoms of TB. Most of the respondents
(90.5%) indicated that TB transmission was airborne while 94.3% stated that TB was
curable and that medicines for treating TB were available locally. Majority of the
respondents (67.3%) indicated that the community had a negative attitude towards TB
patients while 89.6% stated that HIV positive people should be concerned about TB.
The majority of respondents (86.3%) normally went to government clinics or
hospitals for treatment in the event of sickness. Majority of the respondents (45%)
were young adults between 20-29 years. There was significant association between
place of residence and overall score on TB knowledge/awareness (P= 0.012) where
urban residents had a higher knowledge/awareness score compared to their rural
counterparts. For this study whoever scored 0-5 scores was considered to have poor
knowledge, 6-10 had moderate knowledge and whoever scored above 10 had good
knowledge. Similarly, relationship between knowledge on whether TB was infectious
after a few weeks on treatment was statistically significant (p=0.005). The main
question testing attitude was the perception of the respondents towards TB disease
whereby the response was either positive or negative. Patients residing in urban
residence were 2.24 times more likely to have knowledge on whether TB was
infectious after a few weeks of treatment. However, there was no significant
relationship between overall score on good practice and place of residence (P=0.061),
although urban residents scored low compared to their rural counterparts. Scores on
practice were awarded 1 for every variable listed whoever scored 3 and above was
classified as having good practice. The study recommends more campaigns on
Tuberculosis focusing more on rural areas where awareness levels were lower than
the urban areas. The campaigns should also utilize Radio more than other media
because of its effectiveness, there should be monitoring and evaluation of the
campaigns in order to rate the level of success