extent and risk factors for multiple drug resistance among tuberculosis patients in baringo county, kenya

Description

In Kenya, tuberculosis remains a principal cause of morbidity and mortality. This study sought to determine the extent of and risk factors for multiple drug resistance among tuberculosis patients in Baringo County, Kenya. The study aims were: to identify the prevalence of MDR TB in Baringo County, and to establish the relationship between socio-demographic factors, previous TB treatment, TB treatment related factors, history of imprisonment, history of migration, educationrelated factors, behavioral practices, health system and provider factors and occurrence of MDR TB among tuberculosis patients in Baringo County. The study employed the cross-sectional survey design. Using purposive sampling, proportional to size sampling, and purposive census to recruit the respondents. 263 participants were selected from six sub-county hospitals. Data was collected using structured questionnaires including dichotomous questions (yes and no questions). The experts in the Department of Community Health and Epidemiology improved the validity of the instrument. The tool was pilot-tested to measure its reliability coefficient. The research instrument’s reliability was 0.796, which was within acceptable threshold. Descriptive statistics (frequency distributions, means and standard deviation) and inferential statistics (chi-square) were utilized to explore the collected data using IBM SPSS program version 26. The finding of the study revealed MDR TB prevalence among tuberculosis patients in Baringo County to be 14.9%. The study adopted 0.05 Alpha (α) level. The chi-square results indicate that, highest level of education, incomes of TB patients, TB treatment related factors: history of imprisonment, history of migration, behavioural practices, health system and provider factors have no significant relationship with MDR TB prevalence in Baringo County. The results for the correlation are: Fisher’s Exact Test = 8.230; p = 0.075, χ2 = 0.295; df = 1; p = 0.705, (χ2 = 0.706; df = 1; p = 0.49), (χ2 = 0.053; df = 1; p = 0.853), (χ2 = 0.305; df = 1; p =0.658), Fisher’s Exact Test = 3.311; p = 0.200, respectively. Consequently, the study established strong statistically significant positive relationship (χ2 = 68.371; df = 1; p< 0.001), between previous TB treatment, and prevalence of MDR tuberculosis among the study participants. The qualitative findings shows that long distance, stigma, drug abuse, and mal-absorption syndrome leads to none adherence to ant-TB medication which leads to MDR-TB. The findings may help in informing policymakers to formulate relevant public health strategies to increase adherence and compliance to tuberculosis therapy. Additionally, findings from the study will be used by ministry of health to come up with specific MDR TB preventative strategies. Future research should capture other contributory factors in settings beyond Baringo County, and provide more generalizable findings.