Compliance with Tuberculosis Infection, Prevention and Control Guidelines among Healthcare Workers in Kenyatta National Hospital and Mbagathi District Hospital

Janeffer Muthoni Wangari¹, Emmah Mwangi² and Washington Auma Arodi^3,

¹Department of Environmental and Occupational Health, Kenyatta University, P.O Box 74714-00200 Nairobi, Kenya

²Department of Environmental and Occupational Health, Kenyatta University, Nairobi, Kenya

³Department of Medical Laboratory Sciences, Kenyatta University, Nairobi, Kenya

Cite this paper:
Janeffer Muthoni Wangari, Emmah Mwangi and Washington Auma Arodi. Compliance with Tuberculosis Infection, Prevention and Control Guidelines among Healthcare Workers in Kenyatta National Hospital and Mbagathi District Hospital. American Journal of Public Health Research. 2023; 11(3):88-98. doi: 10.12691/ajphr-11-3-2

Abstract

Background: Tuberculosis is a major occupational hazard among healthcare workers, not just in Kenya but globally due to consistent and routine exposure. This is especially true among the nurses and laboratory workers among the profession cadre who are regarded as high-risk groups for both latent Tuberculosis infection (LTBI) as well as active TB, with the lowest risk noted among the administrative staff. The escalated occupational tb cases were associated to poor implementation of full hierarchy of IPCs as outlined by the World Health Organization (WHO) especially the administrative control. This study was cross sectional study which was conducted in Kenyatta National Hospital and Mbagathi District Hospital, Nairobi County. Objective: The study sought to determine the influence of socio-demographic factors on compliance to TB IPC guidelines among HCWs in Kenyatta National Hospital and Mbagathi District Hospital. Materials and methods: The study adopted a descriptive cross-sectional community study design. The study utilized qualitative and quantitative research methods in order to obtain the required information from respondents. Quantitative data collection was done by use of semi-structured, self-administered questionnaires while qualitative data was collected through key informant interview (KII) and standardized observation checklist among Health Care Workers (HCWs), specifically nurses and laboratory staff. Confidentiality of information collected was observed and consent was sought from the respondents before collecting any form of information from them. A total of 38 nurses and 4 laboratory staff from Mbagathi District Hospital and 332 nurses and 32 laboratory staff from Kenyatta National were randomly selected (n=406). The response rate was 98% with 398 participants having completely and accurately filled and returned the questionnaires. The tools that the researcher used included questionnaire, interview schedule, pens and pencils. Descriptive data was analyzed with the aid of the Statistical Package for Social Sciences (SPSS) version 22.0 with the help of Microsoft Excel programme to generate frequency tables, graphs and pie-charts. Inferential statistics was calculated using Chi-Square tests (p=0.005) done at 95% confidence level to determine the linkage between the Variables. Results: There was no statistically significant association between marital status and compliance to TB-IPC guidelines (P=0.067) with the divorced more likely to comply with TB-IPC standards (OR=3.6, CI: 0.504, 25.323). The study findings further revealed that majority 171 (59.6%) of participants had a fair attitude and comply to TB-IPC guidelines (P=0.034). 245(61.6%) have a work experience of less than 2 years, followed by 142(35.7%) having worked three to five years with 11(2.8%) having worked over 5 years. There was a statistical association between the number of years worked and compliance to TB-IPC guidelines. According to the study findings, participants with good attitude levels are more likely to comply with TB-IPC guidelines (OR=1.688, CI: 1.15, 2.555). Conclusion: There is a dire need to develop and implement a robust occupational health management system that takes cognizance of: development and adherence to sensitization framework; accurate and prompt surveillance and reporting of TB; supportive legal framework; committed leadership; financial investment and strict/stringent measures in place to ensure compliance to set guidelines.

Keywords:
health care workers Nosocomial tuberculosis hierarchy of control infection prevention and controls (IPC) compliance

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