Knowledge, attitude and practice on tuberculosis in selected health facilities in rural and urban areas of Machakos district, Kenya

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