UNIVERSITY OF NAIROBI

SCHOOL OF NURSING SCIENCES

RESEARCH TOPIC:

FOCTORS AFFECTING ACCEPTABILITY TO THE CHEMOTHERAPY

TREATMENT OF TUBERCULOSIS IN INMATES AGED BETWEEN 18-55 YEARS

IN LANG'ATA WOMEN'S PRISON

A RESEARCH PROPOSAL PRESENTED IN PARTIAL FULFILMENT FOR THE

AWARD OF A DEGREE IN BACHELOR OF SCIENCE IN NURSING [BScN] OF

UNIVERSITY OF NAIROBI.

BY:

MURANGO E. MIRITI

H3212630103

BSCN. IV.

SUPERVISOR:

MRSCHEGE,

LECTURER, SCHOOL OF NURSING SCIENCES,

COLLEGE OF HEALTH SCIENCES,

UNIVERSITY OF NAIROBI.

DATE: 2/09/2007

TABLE OF CONTENTS:Table of contents. . . ... . .. .. . ... . . . ... .. . .. . . . . ... ... ... ... ... ... ... ... ... ... . . ... II

Acknowledgement--------------------------------------------------------------- III

Dedication------------------------------------------------------------------------ IV

Declaration----------------------------------------------------------------------- V

Certificate of approval---------------------------------------------------------- VI

List of abbreviations------------------------------------------------------------ VII

Operational definitions -------------------------------------------------------- Vlll

Abstract-------------------------------------------------------------------------- IX

CHAPTER ONE:1.0 Introduction----------------------------------------------------------------- 11.1 Problem statement---------------------------------------------------------- 21.2 Justification of the study-------------------------------------------------- 31.3 Research questions-------------------------------------------------------- 41.4 Main study objectives----------------------------------------------------- 41.5 Specific study objectives------------------------------------------------- 41.6 Hypotheses------------------------------------------------------------------ 5CHAPTER TWO:LIT~RATlJ~ ~,,~~: ---------------------------------------------------- 6

CHAPTER THREERESEARCH METHODOLOGY: -------------------------------------------- 82.0 Study design----------------------------------------------------------------- 83.1 Study area-------------------------------------------------------------------- 83.2 Study population------------------------------------------------------------ 93.3 Inclusion criteria------------------------------------------------------------ 93.4 Exclusion criteria----------------------------------------------------------- 93.5 Sampling method----------------------------------------------------------- 93.6 Sample size determination------------------------------------------------ 103.7 Study instruments---------------------------------------------------------- 113.8 Pretesting of study instruments------------------------------------------- 113.9 Data collection-------------------------------------------------------------- 113.10 Data cleaning ------------------------------------------------------------- II3.11 Data analysis-------------------------------------------------------------- 113.12 Data presentation--------------------------------------------------------- 123.13 Ethical considerations---------------------------------------------------- 123.14 Control of biases--------------------------------------------------------- 123.15 Limitation of study------------------------------------------------------- 123.16 Benefits of the study----------------------------------------------------- 13References ---------------------------------------------------------------- 14APPENDIX;3.0 Map of study area ------------------------------------------------------ 15

3.1 Questionnaire--------------------------------------------------- 163.2 Focus group discussion with wardens------------------ 203.3 ~ ork plan-------------------------------------------------------- 213.4 Budget------------------------------------------------------------ 223.5 Map of Lang'ata-------------------------------------------------- 233.6 Research participant consent form---------------------------- 244.6Letter seeking authority to conduct research. ----------------- 26

11

ACKNOLEDGEMENTI acknowledge my supervisor, Mrs. Chege for being so instrumental and

facilitative in the development of this research proposal. I also acknowledge Mr.

Ademba for assistance in getting relevant literature review from the University of

Nairobi Medical School Library. Moreover, classmates and friends for their

continuous psychological support and encouragement during my research work.

III

DEDICATIONI humbly dedicate this research proposal to my beloved family and especially to

my dear parents, Mr. and Mrs. Murango.

IV

DECLARATION

I, Murango E. Miriti hereby declare that the research proposal is my original work

and has not been presented for any award of degree or diploma in any university

before.

Signature ...a:Date.&J!iJ.1!.~~

Murango E. Miriti

H321263 0/03

v

ABREVIATIONS:

AIDS - Acquired Immune Deficiency Syndrome

BScN - Bachelor of Science in Nursing

CDC - Centers for Disease Control

CI Confidence Interval

HIS Health Information System

HIV Human Immunodeficiency Virus

ICRC - International Committee of the Red Cross

Ksh Kenya shilling

MDR - Multiple Drug Resistant

PTB Pulmonary Tuberculosis

S.P.S.S.- Statistical Program for Social Sciences

TB tuberculosis

U.o.N- University of Nairobi

WHO- World Health Organization

Vll

ABSTRACTTuberculosis is the leading infectious cause of morbidity and mortality in adult

worldwide, killing about 2 million people every year (22). About 1.6billion are infected

worldwide. Investigation has revealed that there is multiple drug resistant tuberculosis

(MDR-TB) among inmates in Kenya (16). This has been associated with various factors

including low acceptability to TB chemotherapy. This poses big threat to the society in

general as TB continuous to spread to healthy persons and society in general there is need

to look for lasting solution. Currently there is inadequate data and information of factors

affecting acceptability to TB chemotherapy and emergence ofMDR-TB hence this

research.

This study is a cross sectional study aimed at determining factors affecting

acceptability of chemotherapy treatment of tuberculosis in inmates aged betwwen 18-

55years in Lang'ata women's prison. The available literature shows that TB is an

important health problem in prison setting (1). This has been associated with poor general

health conditions in prisons, congestion, delayed case finding and poor compliance to TB

chemotherapy.

This study will be conducted using structured questionnaire and focused group

discussion. Trained research assistants will be used. Pretesting of tools will be done in

Kamiti maximum prison. Data will be analyzed using statistical programme for social

sciences (S.P.S.S) computer package. Data will be presented in form of frequency tables,

graphs, and percentages. Findings of the study will be used in making health policies in

prison and improving health for all inmates in Kenya.