Risk Factors in Transmission of Tuberculosis Infection in Mombasa, Kenya: An Epidemiological Descriptive Study

Abstract

Background: Tuberculosis is an infectious disease with an estimated 2 million deaths every year. In 2013 the estimated global burden of disease was 9 million cases. Many patients get infected as a result of ignorance of the risk factors that contribute to disease transmission. Aim: This study was aimed to determine the risk factors in pulmonary tuberculosis among patients attending various clinics in Mombasa. Study Design: Hospital and laboratory based descriptive cross-sectional study was carried between May 2012 and May 2013 in Coast Provincial General Referral hospital (CPGH), Tudor, Port-Reitz, Mlaleo, Likoni and Mikandani districts and Sub-districts hospitals. Methodology: Tuberculosis was diagnosed following standard clinical bacteriological and radiological procedures. Sputa from 500 tuberculosis suspects underwent mycobacteriologic evaluation using Ziel Nelsen smear microscopy, Lowenstein and Jensen and BACTEC MGIT 960 culturing. Consenting participants were screened for HIV infection by enzyme -linked immunosorbent assay. Patients were required to respond to a structured questionnaire on risk factors for transmission. Data collected from group were compared using univariate and multivariate analysis. The level of significance was set at p<0.05 and for each statistically significant, odds ratios and confidence interval were computed. Results: A Total, 210/500 (42%) of the suspects had mycobacterial disease and 78/210 (37.1%) were HIV co-infected. There were significantly more females than males associated with pulmonary tuberculosis infection (χ 2 =4.26, df=3; p<0.001). Monthly income was significant in disease with 130 (61.9%) of patients earning less than 5000 per month (2.65 (OR=2.65; 95% CI: 1.40-6.23, p<0.041). HIV (OR=2.18; 95% CI: 1.03-4.65, p<0.034), smoking (OR=2.16; 95% CI: 0.13-1.39, p<0.041) and overcrowding (OR=2.71; 95% CI: 1.41-5.62, p<0.051) were also statistically significant risk factors for pulmonary tuberculosis. Conclusion: Among TB patients in Mombasa Kenya, there was high prevalence of the TB risk factors. Effort should be given in creating awareness of the risk factors associated with TB transmission in order to reduce the rate of infection.