Attitude and Determinant of Lumbar Puncture Acceptability Among Caregivesr at Three Hospitals In Zambia

Abstract

Lumbar puncture (LP) acceptability is a problem at Arthur Davison Hospital, Ndola Central and Kitwe Central Hospitals, evident by a growing trend of lumbar puncture refusals over a four year period (2003-2006). Obtaining Cerebral Spinal Fluid by LP for microscopic examination is essential in the diagnosis of Central Nervous System infections and inflammatory conditions such as meningitis. The study aimed at determining attitudes and determinants of LP acceptability among caregivers at three tertiary hospitals in Zambia. An explorative study design was conducted at three health care facilities; Arthur Davison Children's Hospital, Kitwe and Ndola Central Hospitals from November, 2008 to April 2009. Some of the variables in the study were attitudes towards lumbar puncture, knowledge of lumbar puncture and educational level. A total of 584 caregivers were recruited through purposive sampling. The sample size was calculated using EPI INFO version 6 at 95 percent confidence level. Data was collected using structured interview schedules and analysed using SPSS 11.6 and EPI INFO software packages. The majority, (93.5 %) of the respondents had negative attitudes towards LP. They would not accept LP to be performed on themselves, neither would they recommend a patient to undergo LP for fear that they or their patient would die. There was no significant association between education level and advising a patient to undergo LP, (p = 0.642). 66 % of the respondents revealed that they would not accept LP because the outcome of LP is death. The study also revealed that majority, (56 %) of the respondents lacked knowledge on LP hence this influenced decision making. It is recommended that the Ministry of Health should rigorously disseminate information to members of the public on the importance of this diagnostic procedure through the media in order to strengthen its use in hospitals. Further, the Ministry of Health should bridge the gap between Resident Medical Doctors and consultants, in order to build capacities of the former so that they are able to perform LP. Health care providers at all levels should also endeavour to increase awareness of the role of LP in their institutions. The study must be conducted on a larger scale in order to allow for generalization of results.