Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Pathology and Laboratory Medicine

Supervisor

Olea Popelka, Francisco J.

Abstract

There are key challenges people face due to the burden of tuberculosis (TB), caused by Mycobacterium tuberculosis, and zoonotic tuberculosis (ZTB), caused by Mycobacterium bovis, in Kenyan Maasai rural communities. Thus, the objective of this study was to describe current capacities/infrastructure for diagnosis/treatment of TB/ZTB, and knowledge, attitudes, and practices among healthcare workers in rural Kajiado, Kenya. A questionnaire was delivered by Talaku - a Community Based Organization – with data being received from 25 healthcare facilities (HCFs) and 69/75 healthcare workers during January-February, 2022. The data was descriptively analyzed. It was found that only 12% of HCFs listed bacterial culture as an available diagnostic technique, and among healthcare workers, only 19% correctly identified pyrazinamide as a drug that is inherently resisted by M. bovis. We are confident that the data collected will increase awareness for TB, ZTB and provide information to local stakeholders for further work.

Summary for Lay Audience

Annually, the World Health Organization reports over 10 million cases of TB disease among people, globally. TB is caused by the bacterium Mycobacterium tuberculosis, and approximately 1.4 million deaths are caused by TB every year. An unknown number of TB cases are caused by bacteria (Mycobacterium bovis) transmitted from animals, mostly bovines, to humans, which causes zoonotic TB (ZTB) in humans. Kajiado County is home to a significant population of Maasai who are at higher risk for ZTB due to sociocultural practices that increase direct and indirect contact with infected animals and with food products containing M. bovis. These include consumption of raw milk and milk products. The burden of TB/ZTB are ultimately facilitated by a lack of knowledge and resources surrounding TB/ZTB. Thus, there is substantial need to evaluate the ability of Kajiado County healthcare facilities (HCFs) to diagnose, treat, and understand TB/ZTB. With help from Talaku – A Community Based Organization, a survey was delivered to 69 individuals at 25 local HCFs where we found that many HCFs are lacking in the diagnostic techniques necessary for diagnosis of TB in humans, and many healthcare workers are unaware of key knowledge surrounding M. bovis drug resistance and contact at the human-animal interface. The results of the project will contribute to providing key, new information to local stakeholders, and to create awareness for a neglected disease in rural Kenya.

Available for download on Saturday, July 01, 2023

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