Self reported tuberculosis history among healthcare workers and infection control practices in healthcare settings in Kenya

Objectives: Tuberculosis (TB) remains a significant occupational hazard for healthcare workers (HCWs) in high-burden countries like Kenya. Despite their increased risk of exposure, the burden of TB and associated factors among this workforce remains inadequately documented. This study aimed to assess self-reported TB history among HCWs in Kenya and evaluate the existing TB infection prevention and control (IPC) measures in healthcare settings. Materials and Methods: A cross-sectional survey was conducted from May to July 2024 across 13 counties in Kenya, representing high, medium, and low TB-burden counties, based on case notification rates. Health facilities were sampled across levels two to six of healthcare. HCWs in service delivery were selected using stratified purposive sampling across cadres and facility departments. Data were collected electronically using pre-tested structured questionnaires, and analysis was done using STATA version 18. The study applied descriptive statistics (frequencies, proportions) to summarize participant characteristics, self-reported TB history, exposure patterns, and IPC practices. Results: Out of 640 surveyed HCWs, 19 (3%) reported a history of treatment for TB disease, four of whom were still on treatment. Among the HCWs with TB, 58% (11/19) were female, and 13 (68%) had been in service for ≥6 years. Despite 95% of HCWs reporting direct contact with known TB patients, only 23% had used TB preventive therapy (TPT). IPC practices varied widely, with 62% of facilities having written TB policies/guidelines, while 26% did not train staff on IPC. Conclusion: Self-reported TB history was reported among health care workers. Despite varying IPC practices and occupational exposure to TB in the health facilities, less than one-third of the HCWs had ever received TPT in their lifetime. Effective TB control in Kenya depends on safeguarding healthcare workers through the consistent application of infection prevention measures.