Purpose: This study examined community and service factors that contribute to the high prevalence of tuberculosis (TB) among nurses in Lusaka, Zambia. Framework: An epidemiological framework informed this study as the Central Board of Health (CBOH) identified TB as a major illness among nurses. Between 1982 and 1984 only 8 nurses suffered and were successfully treated for TB, but between 1993 and 1995, when the nurse population decreased from 1045 to 849, 64 nurses died from TB. By 1997, 114 nurses died from TB leaving a nurses population of 802. Subjects: One-hundred and forty-four nurses who worked in a large teaching hospital were enlisted as subjects using a systematic random sampling technique. Methods: Data for this cross-sectional study were obtained using a self-administered interview schedule, observation of infection prevention measures in clinical areas, culturing equipment and patients’ immediate environment, and focus group discussions. Results: The prevalence of TB among subjects was 11.11%. Cultures isolated mycobacterium tuberculosis from patients’ immediate environments and nursing care equipment. Numerous other factors e.g. poor ventilation on unit-admission days, night shift assignment, and inadequate knowledge on TB updates were found to be associated with TB among nurses. The study also showed that BCG administration, whether in childhood or before entering nurse-training, did not guarantee protection against TB for nurses. Conclusion: The study demonstrates how numerous factors synergistically contribute to nurses acquiring TB. Primary preventive measures required that nurses be updated on the latest issues on tuberculosis control and that the stigma of TB and its relationship to HIV needed to be addressed. Since the study was completed the Zambia Nurses Association (ZNA) has set-up an in-country HIV-AIDS project encouraging nurses to opt for Voluntary Counselling and Testing (VCT). Nurses who opt for VCT now receive Isoniazid and also anti-retroviral therapies if they are HIV positive.
Session #1186 - Occupational & Community Health
The 29th Annual MNRS Research Conference (April 1-4, 2005)