Assessing the practices, knowledge and perception of patients and health care workers towards prevention of tuberculosis in Dar Es Salaam Tanzania

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Marko, Astrida Niyonizigiye
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University of Zambia
Tuberculosis (TB) remains a major global infectious disease health problem. It causes ill-health among millions of people each year. Tanzania, like other countries in Africa, shares the same TB burden with an estimated prevalence of 337 per 100,000 populations. Many people including Health Care workers (HCWs) have been infected with TB. The objectives of this study were to identify factors influencing TB transmission among HCWs and patients; to describe how the level of knowledge, perception, and attitude of HCWs and patients influence TB preventive practices and to explore the health seeking behavior among patients and HCWs. The study was conducted at Muhimbili National Hospital and Mwananyamala Hospital in Dar es Salaam, Tanzania. The research design was a health facility-based cross-sectional study. Both qualitative and quantitative design approaches were employed. The quantitative approach was health facility-based using self-administered questionnaire for HCWs and patients. While qualitative approach was Focus Group Discussions (FDGs) with HCWs and patients; key informants interviews and observations that involved assessing the knowledge, practices, and perception of HCWs and patients towards prevention of tuberculosis transmission. Questionnaires were administered to 384 respondents identified by simple random selection; 90 participants were selected for the nine FGDs; six for patients and three for HCWs. FGDs were conducted for males and females independent of each other and covered the age groups 15-29, 30-39 and 40-50 years old. Statistical analysis was performed using Stata, version 11 for descriptive and inferential statistics analysis basing on the following age categories; 15- 29, 30-39, and 40-50 years. Data collected through FGDs were analyzed thematically. As would be expected, more HCWs (17.1%) were aware of TB compared to patients (9.4 %,). In terms of duration before treatment, patients delayed by at least 2 months more compared to (HCWs). HCWs who stopped anti-TB drugs were significantly fewer than patients (5.2 % versus 7.7%, P= < 0.0001). In terms of patients and HCWs knowledge in relation to TB, there was no significant difference between the two groups. Generally, participants were knowledgeable about modes of TB infection. Despite this, there were many other factors that prevented their health seeking behaviors. These included preference to going to pharmacies; using local medicine; fear of TB/HIV association and HIV testing; belief in traditional medicine; self-medication; fear of stigmatization and discrimination; fear of losing employment; high cost of accessing medical services; delay in diagnosis; frequent misdiagnosis; and, taking more than one month (and up to six months) before seeking appropriate medical treatments. Even after getting treatments some patients preferred to stop medication in order to seek alternative health care; avoid severe side effects. The knowledge of patients and HCWs on prevention of TB is not practiced. It is concluded that knowledge of HCWs and patients by itself is not sufficient to reduce the TB burden and transmission in Tanzania. There is need to change or improve people‟s perceptions and misconceptions, practices and beliefs. Further, there is need to improve testing equipment and availability of competent laboratory technicians at all levels of HCFs (from the level of dispensary to referral hospitals), availability and accessibility of PPEs. Effective TB infection prevention and control strategies should be in place for sensitizing the community and HCWs on TB prevention transmission.
Thesis(MSc)-University of Zambia,2015
Tuberculosis-Prevention-Tanzania , Health surveys-Tanzania