Prevalence, knowledge, and occupational risk factors for tuberculosis among health workers in Siaya County Hospitals, Kenya

BACKGROUND TB is a known occupational hazard for healthcare workers (HCWs), especially in countries with high TB burdens. It is estimated that HCWs have a 2- to 3-fold increased risk of developing TB compared with the general population. This study sought to determine the burden of TB among healthcare workers in hospitals in Siaya County and establish their knowledge of TB, and the associated occupational risk factors. METHODOLOGY This analytical cross-sectional study investigated the burden, knowledge and occupational risk factors for TB among HCWs in Siaya County, using a sample of 275 participants. Sputum samples were collected for TB testing using GeneXpert. Selfadministered structured questionnaires and observation checklists were used to collect data from the HCWs. Chi-square test of association and logistic regression were conducted to test for the presence and/or strength of association between participant characteristics, HCW knowledge of TB, and TB prevalence (α =0.05). RESULTS Among the 275 respondents, 18 (6.5%) reported a TB diagnosis within the past five years. Diagnostic tests used included Gene Xpert (69.2%), chest X-ray (19.3%), and smear microscopy (3.8%). Only 68 (24.7%) had received TB training, and 71 (25.8%) strongly disagreed that TB-related manuals were available at their health facilities. Health facilities that provided health talks and prioritized coughers for treatment were significantly associated with lower TB occurrence among health workers (χ2 = 11.125, p = 0.012). However, factors such as consistent N95 mask supply (χ2 = 7.505, p = 0.069), mask usage (χ2 = 6.335, p = 0.135), designated sputum collection areas (χ2 = 6.714, p = 0.116), functional IPC measures (χ2 = 7.796, p = 0.067), scheduled health talks (χ2 = 8.353, p = 0.052), and adequate lighting and ventilation (χ2 = 6.065, p = 0.144) were not significantly associated with TB incidence among health workers. CONCLUSION The unavailability of certain infection prevention and control (IPC) interventions is associated with the occupational risk of TB among healthcare workers. The Ministry of Health should enhance the dissemination of relevant TB manuals to update health care staff on IPC and availing N95 masks to all healthcare workers.