Risk Factors in the Transmission of Tuberculosis in Nairobi: A Descriptive Epidemiological Study


Background: Tuberculosis is an infectious disease with an estimated 1.45 million deaths every year. Many patients get infected as a result of ignorance of the risk factors that contribute to disease transmission. Methodology: A descriptive epidemiological study was conducted on 258 patients presenting with pulmonary tuberculosis. Patients’ sputa were collected for laboratory analysis and patients were required to respond to a structured questionnaire on risk factors for transmission. Data among stratified groups were compared using bivariate analysis. Statistical significance was considered at p < 0.05. Results: There were significantly more males than females associated with pulmonary tuberculosis infection (χ2 = 0.963; df = 1; p < 0.05). Monthly income was significant in disease transmission with 222 (86.0%) of the patients earning less than 100$ and 90 (34.9%) earning less than 50$ per month (p < 0.05, 95% CI). One hundred and seventy three patients (67.1%) were unemployed or running small businesses. Only 85 (32.9%) were in formal employment. Results showed 166 (64.3%) patients were living in single rooms with 110 (42.6%) living with more than two people with a maximum of 10 people in a single room. Only 73 (28.3%) were living alone in a single room and only 7 families (2.7%) were living in houses with five or more rooms. Alcohol consumers and smokers were 102 (39.5%) and 93 (36%) respectively. Half of the patients (137 (53.3%)) had not completed secondary education with only 16 (6.2%) having completed tertiary education. Recurrent cases were 54 (21%) while those exposed to the disease either at home or working place were 75 (29.2%). Out of 171 patients who agreed to test for HIV, 46 (26.9%) were positive. Marital status had no effect on incidence of disease. Conclusion: Emphasis should be given to creating awareness of the risk factors associated with transmission of tuberculosis in order to reduce the rate of infection.

Share and Cite:

P. Ndungu, G. Revathi, S. Kariuki and Z. Ng’ang’a, "Risk Factors in the Transmission of Tuberculosis in Nairobi: A Descriptive Epidemiological Study," Advances in Microbiology, Vol. 3 No. 2, 2013, pp. 160-165. doi: 10.4236/aim.2013.32025.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] CDC, “Core Curriculum on Tuberculosis: What Clinicians Should Know,” 5th Edition, US Department of Health and Human Services, Atlanta, 2000. http://www.cdc.gov/tb/education/corecurr/default.htm
[2] WHO, “Gl Tuberculosis Control Report,” 2010. http://www.who.int/tb/publication/global_report/2010/en/index.html
[3] Ministry of Health, “National Leprosy and Tuberculosis Program (NLTP). Annual Report,” 2007. http://www.nltp.co.ke/docs/Annual_Report_2007.pdf
[4] WHO, “Global Tuberculosis Control Report,” 2009. http://www.who.int/tb/publications/global_report 2009/pdf/full_report.pdf
[5] WHO, “Global Tuberculosis Control,” 2001. http://whqlibdoc.who.int/hq/2001/who_CDS_TB_2001.287.pdf
[6] J. M. Grange, “The Global Burden of Tuberculosis,” In: J. D. Porter and J. M. Grange, Eds., Tuberculosis. An interdisciplinary perspective, Imperial College Press, Singapore, 1999, pp. 3-31. doi:10.1142/9781848160552_0001
[7] E. Nava-Aguilera, N. Anderson, E. Harris, S. Mitchell, C. Hamel, B. Shea, Y. Lopez-Vidal, A. Villegas-Awizon and A. Morales-Perez, “Risk Factors Associated with Recent Transmission of Tuberculosis. Systematic Review and Metaanalysis,” International Journal of Tuberculosis and Lung Disease, Vol. 13, No. 1, 2009, pp. 17-26.
[8] M. Gutierrez, V. Vincent, D. Aubert, J. Bitez, O. Gaillot, L. Lebrun, C. Le Pendeven, M. Le Pennec, D. Mathieu, C. Offrendo, B. Pangon and Pierre-Audigier: “Molecular Fingerprinting of Mycobacterium Tuberculosis. Risk Factors for Tuberculosis Transmission in Paris, France and Surrounding Area,” Journal of Clinical Microbiology, Vol. 36, No. 2, 1998, pp. XGH486-XGH492.
[9] M. F. Fleming, E. Krupitsky, M. Tsoy, E. Zoartau, N. Brazhenko, W. Jakubowiak and M. E. McCaul, “Alcohol and Drug Use Disorders, HIV Status and Drug Resistance in a Sample of Russian Patients,” International Journal of Tuberculosis and Lung Disease, Vol. 10, No. 5, 2006, pp. 65-70.
[10] WHO, “Gender and Health. Gender and Tuberculosis,” 2002. http://whlibdoc.who.int/gender/2002/a85584.pdf
[11] F. Elender, G. Betham and I. Langford, “Tuberculosis Mortality in England and Wales during 1982-1992. Its Association with Poverty, Ethnicity and AIDS,” Social Science and Medicine, Vol. 46, No. 6, 1998, pp. 673-681. doi:10.1016/S0277-9536(97)00178-0
[12] C. Dye, K. Lonnroth, E. Jaramillo, B. G. Williams and M. Raviglione, “Trends in Tuberculosis Incidence and Their Determinants in 134 Countries,” Bulletin of World Health Organization, Vol. 87, No. 9, 2009, pp. 683-691. doi:10.2471/BLT.08.058453
[13] M. F. Cantwell, M. T. McKenna, E. McCray and I. M. Onorato, “Tuberculosis and Race/Ethnicity in the United States: Impact of Socioeconomic Status,” American Journal of Respiratory and Critical Care Medicine, Vol. 157, No. 4, 1998, pp. 1016-1020. doi:10.1164/ajrccm.157.4.9704036
[14] R. Liefooghe, J. B. liddawa, E. M. Kipruto, C. Vermeire and A. O. Munynck, “From Their Perspective. A Kenyan Community’s Perception of Tuberculosis,” Tropical Medicine and International Health, Vol. 2, No. 8, 1997, pp. 809-821. doi:10.1046/j.1365-3156.1997.d01-380.x
[15] C. Auer, J. Sarol Jr., M. Tanner and M. Weiss, “Health Seeking and Perceived Causes of Tuberculosis among Patients in Manilla Phillipines,” Tropical Medicine and International Health, Vol. 5, No. 9, 2000, pp. 648-656.
[16] T. W. Steen and G. N. Mazonde, “Ngaka ya Setswana Ngaka ya Sekgoa or both? Health Seeking Behavior in Botswana with Pulmonary Tuberculosis,” Social Science and Medicine, Vol. 48, No. 2, 1999, pp. 163-172. doi:10.1016/S0277-9536(98)00329-3
[17] K. Lonnroth, B. G. Williams, S. Stadlin, E. Jaramillo and C. Dye, “Alcohol Use as a Risk Factor for Tuberculosis— A Systematic Review,” BMC Public Health, Vol. 8, No. 289, 2008, p. 289. doi:10.1186/1471-2458-8-289
[18] E. Hernandez-Gardano, V. Cook, D. Kunimoto, R. K. Elwood, W. A. Black and J. M. Fitz Gerrald, “Trans-mission of TB from Smear Positive Patients: A Molecular Epidemiology Study,” Thorax, Vol. 59, No. 4, 2004, pp. 286-290. doi:10.1136/thx.2003.011759
[19] M. Singh, M. L. Mynak, L. Kumar, J. L. Matthew and S. K. Jindal, “Prevalence and Risk Factors for Transmission of Infection among Children in Household Contact with Adult Having Pulmonary TB,” Archives of Disease in Childhood, Vol. 90, No. 6, 2005, pp. 624-628. doi:10.1136/adc.2003.044255
[20] K. Toque, M. A. Bellis, N. J. Beeching, Q. Syed, T. Remmington and P. D. O. Davies, “A Case-Control Study of Lifestyle Risk Factors Associated with Tuberculosis in Liverpool, North-West England,” European Respiratory Journal, Vol. 18, No. 6, 2001, pp. 959-964. doi:10.1183/09031936.01.00211701
[21] M. Khurram, H. T. B. Khaar and M. Fahim, “Multi-Drug Resistant Tuberculosis in Rawalpindi, Pakistan,” Journal of Infection in Developing Countries, Vol. 6, No. 1, 2012, pp. 29-32.
[22] A. R. Alvi, S. F. Hussain, M. A. Shah, M. Khalida and M. Shamsudin, “Prevalence of Pulmonary TB on the Roof of the World,” International Journal of Tuberculosis and Lung Disease, Vol. 2, No. 11, 1998, pp. 909-913.
[23] P. C. Hill, D. Jackson-Sillah, S. A. Donkor, J. Out, R. A. Adegbola, C. Lienhardt, “Risk Factors for Pulmonary Tuberculosis: A Clinical Based Case Study in the Gambia,” BMC Public Health, Vol. 6, No. 289, 2006, p. 156. doi:10.1186/1471-2458-6-156
[24] S. Tornee, J. Kaewkungwal, W. Fungladda, U. Silachmroon, P. Akarasewi and P. Sunakorn: “Risk Factors for Tuberculosis Infection among Household Contacts in Bangkok Thailand,” The Southeast Asian Journal of Tropical Medicine and Public Health, Vol. 35, No. 2, 2004, pp. 375-383.
[25] F. Giovanni, “Tuberculosis: Novel Approaches to an Old Disease,” Journal of Infection in Developing Countries, Vol. 6, No. 1, 2012, pp. 4-5.
[26] R. Wood, H. Liang, H. Wu, K. Middlekoop, T. Oni, M. X. Rangaka, R. J. Wilkinson, L. G. Bekker and S. D. Lawn, “Changing Prevalence of Tuberculosis Infection with Increasing Age in High Burden Townships in South Africa,” International Journal of Tuberculosis and Lung Disease, Vol. 14, No. 4, 2010, pp. 406-412.
[27] C. Lienhardt, K. Fielding, J. Sillah, A. Tunkara, S. Donkor, K. Manneh, D. Warndorff, K. P. Mc Adam and S. Bennet “Risk Factors for Tuberculosis Infection in Sub-Sahara Africa. A Contact Study in the Gambia,” American Journal of Respiratory and Critical Care Medicine, Vol. 168, No. 4, 2003, pp. 448-455. doi:10.1164/rccm.200212-1483OC
[28] Akhtar, “Prevalence of and Risk Factors Associated with Mycobacterium Tuberculosis Infection in Prisoners, North West Frontier Province Pakistan,” International Journal of Tuberculosis and Lung Disease, Vol. 32, No. 5, 2003, pp. 794-799.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.