FACTORS INFLUENCING CLINICAL MANAGEMENT OF CRYPTOCOCCAL MENINGITIS AMONG HEALTH CARE PROVIDERS AT TWO REFERRAL HOSPITALS IN KISUMU COUNTY, KENYA

Abstract

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