FACTORS INFLUENCING LOW CASE DETECTION RATE OF PULMONARY TUBERCULOSIS IN KYEGEGWA SUB-COUNTY, KYEGEGWA DISTRICT WESTERN UGANDA.

TABLE OF CONTENTS

DECLARATION .................................................................................................................................... ii

APPROVAL .......................................................................................................................................... iii

ACKNOWLEDGMENT ........................................................................................................................ iv

DEDICATION........................................................................................................................................ v

ABBREVIATIONS................................................................................................................................ vi

LIST OF TABLES .................................................................................................................................... x

TABLE OF FIGURES............................................................................................................................... x

ABSTRACT........................................................................................................................................... xi

CHAPTER ONE: INTRODUCTION ......................................................................................................1

1.0 Introduction.......................................................................................................................................1

1.1 Background .......................................................................................................................................1

1.2. Problem Statement............................................................................................................................2

1.3 Conceptual Frame Work ....................................................................................................................4

1.4 STUDY OBJECTIVES......................................................................................................................5

1.4.1 Main Objective ...............................................................................................................................5

1.4.2 Specific Objectives.........................................................................................................................5

1.5 Study justification..............................................................................................................................5

1.6 Scope of the study .............................................................................................................................5

CHAPTER TWO: LITERATURE REVIEW ...........................................................................................6

2.0 Introduction. ......................................................................................................................................6

2.1. Mycobacterium Tuberculosis Epidemiology. ....................................................................................6

2.2. Knowledge of Health Workers. .........................................................................................................6

2.3. Laboratory Personnel Involved in Tuberculosis.................................................................................7

2.4 Equipment and Materials for Diagnosing Pulmonary Tuberculosis.....................................................8

2.5 Accessibility of pulmonary TB health services to the people. .............................................................8

CHAPTER THREE: METHODOLOGY ............................................................................................... 10

3.0 Introduction..................................................................................................................................... 10

3.1 Study Area....................................................................................................................................... 10

3.1.2 Location ....................................................................................................................................... 10

3.1.3 Population .................................................................................................................................... 10

3.1.4 Health Infrastructure ..................................................................................................................... 10

3.2. Study population............................................................................................................................. 10

3.3. Study design ................................................................................................................................... 11

3.4. Sample size determination .............................................................................................................. 11

3.5 Sampling method............................................................................................................................. 12

3.6.1 Inclusion criteria ........................................................................................................................... 12

3.6.2 Exclusion criteria .......................................................................................................................... 12

3.7 Study variables................................................................................................................................ 12

3.7.1 Dependent variable. ...................................................................................................................... 12

3.7.2 Independent variable..................................................................................................................... 12

3.8 Data collection method .................................................................................................................... 12

3.9 Data analysis method....................................................................................................................... 12

3.10. Data presentation method.............................................................................................................. 13

3.11. Ethical Consideration.................................................................................................................... 13

CHAPTER FOUR: RESEARCH RESULTS.......................................................................................... 14

4.0 RESEARCH FINDINGS: .......................................................................................................... 14

Signs and symptoms of pulmonary Tuberculosis.................................................................................... 16

Risk Groups to Acquiring Pulmonary Tuberculosis Infection mentioned by the Respondents. ................ 18

Laboratory staff..................................................................................................................................... 19

PART TWO: PTB CLIENTS ................................................................................................................ 20

4.2 Social demographic characteristics for PTB clients .......................................................................... 20

Distance Covered By Patients While Coming To Hospital ..................................................................... 21

Table 2: A table showing the distance covered by patients while coming to Hospital.............................. 21

Transport Means Used By Patients While Coming To Hospital.............................................................. 21

Table 3: A table showing the transport means used by patients while coming to Hospital. ...................... 21

CHAPTER FIVE: DISCUSSION .......................................................................................................... 24

5.0. Introduction.................................................................................................................................... 24

5.1 Knowledge of health workers about pulmonary tuberculosis diagnosis............................................. 24

5.2 Materials and equipments for pulmonary tuberculosis diagnosed...................................................... 24

Recommendations................................................................................................................................. 25

Conclusion. ........................................................................................................................................... 25

APPENDIX I: QUESTIONAIRE .......................................................................................................... 28

CONSENT FORM AND INTRODUCTION ......................................................................................... 28

APPENDIX II: WORK PLAN............................................................................................................... 33

APPENDIX III...................................................................................................................................... 34

MAP OF KYEGEGWA SUB-COUNTY............................................................................................... 34

APPENDIX IV...................................................................................................................................... 35

MAP OF KYEGEGWA DISTRICT ...................................................................................................... 35

APPENDIX V....................................................................................................................................... 36

MAP OF UGANDA SHOWING KYEGEGWA DISTRICT.................................................................. 36

ABSTRACT

Introduction: The aim of the study was to assess the factors influencing the low case detection rate of pulmonary tuberculosis in Kyegegwa Sub-county Kyegegwa district in western Uganda.

Specific Objectives: The study aimed at assessing the knowledge of the Health workers about the diagnosis of pulmonary Tuberculosis, whether Kyegegwa has enough materials and equipment for diagnosing PTB, and patients' accessibility to PTB health services.

Methods: A descriptive cross-sectional study design was used and 50 health workers were assessed and 100 PTB clients used a structured questionnaire to collect the data.

Results: The findings of this study revealed that general awareness about pulmonary tuberculosis was high among the respondents as 74% were able to give the correct definition of pulmonary tuberculosis and 96% knew that pulmonary tuberculosis is diagnosed by performing two sputum smears for AFBS supported by the clinical history of the patient, 98% of respondents were able to explain the right procedure. The study also revealed that shortage of equipment and materials for pulmonary tuberculosis diagnosis was implicated as the cause of the low case detection rate of pulmonary tuberculosis in Kyegegwa Sub-county as 71.4% said that they do not have enough equipment and materials while 28.6% said that they do have.

Conclusion: From the study, it was concluded that the low case detection rate of pulmonary tuberculosis was due to lack of materials and enough equipment for diagnosing pulmonary tuberculosis and also some delay in the patients receiving their services as this promotes a rapid spread even to the non-infected.

Recommendations: The researcher, therefore, recommends that the ministry of health and other stakeholders should ensure that equipment and materials for pulmonary tuberculosis diagnosis are available at all times. Continuous Professional Development (CPDs) should be emphasized to all health workers. 20% of the clients reported that they had been delayed for a longer time, the researcher, therefore, recommends that health workers' salaries are increased and there be the identification of better performing health workers in all aspects including time keeping and be rewarded at the end of every month as a way of motivation and improve workers competence at work. In addition, more health workers should be recruited so as to reduce on the Doctor-patient ratio.