FACTORS INFLUENCING CLINICAL MANAGEMENT OF CRYPTOCOCCAL MENINGITIS AMONG HEALTH CARE PROVIDERS AT TWO REFERRAL HOSPITALS IN KISUMU COUNTY, KENYA
DOI:
https://doi.org/10.47604/jhmn.1352Keywords:
Cryptococcal meningitis, influencing, health care providers, Clinical, Kisumu KenyaAbstract
Purpose: Cryptococcal meningitis is one of the most common and lethal opportunistic infections among human immune virus infected clients/patients before initiation of antiretroviral therapy. It is majorly associated to morbidity and early mortality among human immunodeficiency virus infected patients in resource limited countries. The main objective of this study was to investigate the factors influencing clinical management of cryptococcal meningitis in adults among health care providers at two referral hospitals in Kisumu County, Kenya.
Methodology: A cross-sectional study using quantitative approach was used targeting 119 health care providers. Collection of data was through pretested self- administered questionnaires to examine factors influencing clinical management of cryptococcal meningitis. Data obtained was analyzed using the statistical package for social science version 25. Descriptive analysis was done using frequencies, percentages and means. Inferential analysis was conducted using bivariate logistic regression to determine relationships among the variables, p-values of at or below 0.05 were considered statistically significant.
Results: The major factor associated positively with clinical management of cryptococcal meningitis was the acknowledgement by the health care providers that the world health organization guidelines lead to a better patient outcome (97%, n=113) and inadequate supplies and resources to facilitate management (78%, n=90) was the major factor associated negatively. Health care providers with an experience of five years or less were 40% more likely to agree that the factors were influencing clinical management of cryptococcal meningitis in contrast to those with an experience of six years or more (OR: 0.6; 95%CI: 0.1 – 0.74; p=0.04).
Unique contribution to theory, practice and policy: The clinical management of cryptococcal meningitis in adults in the study area is majorly negatively influenced by inadequate supplies and resources to facilitate the process of management. The study recommends that the policy makers in the County government of Kisumu and the two hospital management teams need to scale up a timely and constant provision of adequate resources, facilities and supplies, which will promote effective clinical management of cryptococcal meningitis in the study area
Downloads
References
Babbie, E. (2004). The practice of social research (10th Ed); Thomson Belmont CA: Wadsworth Publishing Company.
Carthey, J., Walker, S., Deelchand, V., Vincent, C., & Griffiths, W.H. (2011). Breaking the rules: understanding non-compliance with policies and guidelines. Br Med J; 343: d5283.
Castro-Sanchez, E., Charani, E., Drumright, L.N., Sevdalis, N., Shah, N., &Holmes A.H. (2014). Fragmentation of care threatens patient safety in peripheral vascular catheter management in acute care – a qualitative study. PLoS One 2014; 9:e86167.
Ganiem, A.R., Indrati, A.R., Wisaksana, R., Meijerink, H., &Van der Ven A. (2014). Asymptomatic cryptococcal antigenemia is associated with mortality among HIV-positive patients in Indonesia. J Int AIDS Soc 17: 18821.
Govender, N.P, Meintjes, G., Bicanic, T., Dawood, H., Harrison, T.S., Jarvis, J.N. (2013). Guideline for the prevention, diagnosis and management of cryptococcal meningitis among HIV-infected persons: 2013 update by the Southern African HIV Clinicians Society. S Afr J HIV Med.; 14(2):76±86.
Guidelines for the diagnosis, prevention, and management of cryptococcal disease in HIV- infected adults, adolescents and children, March 2018. Geneva: World Health Organization. License: CC BY-NC-SA 3.0 IGO.
Kothari, C. R. (2007). Research Methodology: Methods and Techniques. New Delhi: New Age International Publishers
Manga, N.M, Cisse-Diallo, V.M.P., Dia-Badiane, N.M. (2016). Prevalence and Factors Associated with Positive Cryptococcal Antigenemia among HIV Infected Adult Hospitalized in Senegal. J HIV Retrovirus; 2:2:
Mdodo, R., Moser, S.A., Jaoko, W., Baddley, J., Pappas, P., Kempf, M.C. (2011). Antifungal susceptibilities of Cryptococcus neoformans cerebrospinal fluid isolates from AIDS patients in Kenya. Mycoses; 54(5): e438–42.
Mugenda & Mugenda (2003), Research Methods: Quantitative and Qualitative Approaches
Tsiga, E., Panagopoulou, E., Sevdalis, N., Montgomery, A., &Benos, A. (2013). The influence of time pressure on adherence to guidelines in primary care: an experimental study. Br Med J Open; 3:e002700.
World Health Organization (2011). Rapid Advice- Diagnosis, Prevention and Management of Cryptococcal Disease in HIV-infected Adults, Adolescents and Children. Geneva: World Health Organization.
Yamane, T. (1967): Statistics: An Introductory Analysis, 2nd Ed., New York: Harper and Row.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Robina Ogendo
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work’s authorship and initial publication in this journal.
