Challenges Faced by House-Hold Contacts of Pulmonary Tuberculosis Patients In An Urban Setting In Nairobi, Kenya

Abstract

Close contacts of active pulmonary tuberculosis (PTB) patients are at higher risk of infection as the confirmed cases remain highly infectious before and while in the early stages of treatment. This work highlights the encounters and perspectives of household contacts (HHCs) of PTB patients in an urban setting in Kenya, with a focus on accessibility to health services, interactions within the community, and the risk of infection at home. A multimethod study design involving descriptive cross-sectional analysis and informal interviews was used. The study participants were recruited from tuberculosis (TB) isolation wards and outpatient clinics of Mbagathi County Hospital in Nairobi, Kenya. Data was collected using structured questionnaires and informal interviews. Results revealed improved access to treatment by PTB patients. However, the global goal of eliminating TB infections by minimizing latent tuberculosis reactivation remains a challenge in this population primarily because most of the HHCs lacked knowledge on diagnosis and treatment of latent tuberculosis infection (LTBI). Most participants were residents of informal settlements in Nairobi characterized by small and poorly planned housing structures with poor waste management systems. In most houses, the living space doubled as cooking and sleeping area. There was therefore a high exposure of spouses, children and other persons living with the patients. We recommend that further education be provided to HHCs to increase awareness on available testing and preventive treatment for LTBI, and infection prevention practices at the household level. Furthermore, additional resources should be offered to economically disadvantaged patients to support their social and treatment needs.