A STUDY TO DETERMINE THE PREVALENCE OF PEPTIC ULCER DISEASE

AMONG ADULTS BETWEEN 20-60 YEARS AT MARIGAT SUB COUNTY

HOSPITAL

CHESANG TOMNO DAVID

D/CM/18021/2142

A RESEARCH PROJECT SUBMITTED TO THE KENYA MEDICAL TRAINING

COLLEGE NAKURU CAMPUS IN PARTIAL FULLFILMENT TO THE

REQUIREMENT FOR THE AWARD OF DIPLOMA IN CLINICAL MEDICINE

JUNE, 2021
DECLARATION

I declare that this study is my original work and has never been presented for any award in

any other college/university.

STUDENT

Name: ChesangTomno David

Student No: D/CM/18021/2142

Sign: ……………………......... Date: …………………………..

SUPERVISOR

Name: PATRICK MUTETI

Sign: …………………………….. Date: ………………………

i
DEDICATION

I wish to dedicate this document to my guardian for their encouragement and financial

support who helped me to achieve this work.

ii
ACKNOWLEDGEMENT

My humble acknowledges goes to the almighty God, for the endurance, strength and whole

the good health bestowed to me. I also express my sincere and heartfelt gratitude to my

supervisor who gave me a basic guidelines concept, support and guidance

iii
ABSTRACT

Peptic ulcers according to Mayo Clinic definition, are open sores that develops on one’s

stomach along the lining and the upper portion of small intestine. This is brought about by

acid that damages along the lining (www.mayoclinic.org).

The ulcer is commonly caused by an infection with the bacterium helicobacter pylori and

long term use of non-steroidal anti-inflammatory drugs. Most studies has been on the

determinants of the causative agents of Peptic Ulcer Disease but little attention was on the

prevalence of the disease. Thus the reason this research was deal on the Prevalence of the

disease among adults aged 20-60. The study was conducted at Marigat Sub-County

Hospital.The objectives of the study were; to determine the knowledge of the people on

peptic ulcer disease, to determine the attitude of the people on peptic ulcer disease and to

identify social-cultural practices that cause peptic ulcer disease.

The study adopted self-administered questionnaire and Researcher administered

questionnaires, this ensures relevant and reliable information is extracted from the potential

respondents during study.

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 Table of Contents

DECLARATION......................................................................................................................I

DEDICATION.........................................................................................................................II

ACKNOWLEDGEMENT....................................................................................................III

ABSTRACT............................................................................................................................IV

TABLE OF CONTENTS........................................................................................................V

CHAPTER ONE.......................................................................................................................1

BACKGROUND INFORMATION........................................................................................1

1.2 JUSTIFICATION OF THE STUDY:......................................................................................3

1.3 OBJECTIVES.....................................................................................................................4

1.3.1 Broad objectives:.......................................................................................................4

1.3.2 Specific objectives:....................................................................................................4

CHAPTER TWO.....................................................................................................................5

LITERATURE REVIEW........................................................................................................5

2.1 KNOWLEDGE OF PEPTIC ULCER DISEASE.....................................................................5

2.2 ATTITUDE.........................................................................................................................6

2.3 PRACTICES.......................................................................................................................7

CHAPTER THREE...............................................................................................................10

METHODOLOGY.................................................................................................................10

3.1 BACKGROUND OF THE STUDY AREA.............................................................................10

3.1.1 Socio-economic activities.......................................................................................10

3.1.2 Health system..........................................................................................................10

3.2 STUDY DESIGN...............................................................................................................10

3.3 TARGET POPULATION...................................................................................................10

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 3.4 SAMPLING TECHNIQUE..................................................................................................11

3.5 SAMPLE SIZE DETERMINATION.....................................................................................11

3.7 STUDY VARIABLES.........................................................................................................12

3.8 DATA COLLECTION METHOD.......................................................................................13

3.8.1 Data collection procedures.....................................................................................13

3.9 DATA ANALYSIS.............................................................................................................13

CHAPTER FOUR..................................................................................................................14

DATA ANALYSIS, PRESENTATION, INTERPRETATION AND DISCUSSION......14

4.1 INTRODUCTION..............................................................................................................14

4.2 PART A: DEMOGRAPHIC DATA...........................................................................14

4.2.1 Age of Respondents................................................................................................14

4.2.2 Gender.....................................................................................................................15

4.2.3 Religion...................................................................................................................15

PART B: KNOWLEDGE OF PEPTIC ULCER DISEASE..............................................15

4.3.1. AWARENESS OF PEPTIC ULCER DISEASE..................................................................15

Section C. Social Economic data....................................................................................17

4.3.1 Level of Education of the Respondents.................................................................17

4.4.2 FOOD RESTRICTION BY THE CULTURE OF THE RESPONDENTS.............19

SECTION SOCIAL PRACTICES DATA...........................................................................20

4.5.1. HEALTH SERVICE PROVIDERS OF THE RESPONDENTS.............................20

CHAPTER FIVE....................................................................................................................21

SUMMARY OF THE FINDINGS CONCLUSION AND RECOMMENDATION........21

5.1 INTRODUCTION..............................................................................................................21

5.2 SUMMARY OF THE FINDINGS........................................................................................21

5.3 CONCLUSION.................................................................................................................22

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5.4. RECOMMENDATION..................................................................................................22

REFERENCE.........................................................................................................................23

APPENDICES........................................................................................................................25

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CHAPTER ONE: BACKGROUND INFORMATION

1.0 Introduction

Human body are becoming more susceptible to various diseases resulting from infections.

Peptic ulcers recently became a rampant infection which when not taken into consideration

will result to more deaths and leaving behind an ailing society.

Peptic ulcers are corrosions which affects ones stomach lining resulting to open sores that

develop till it eats up the lining. Also, the ulcers affects the upper portion of small intestine.

This is according to Mayo Clinic where they extended the infection to being caused by

bacteria H. Pylori and anti-inflammatory pain relievers which include aspirin.

(www.mayoclinic.org).

Helicobacter pylori (HP) is a gram-negative microaerophilic bacterium that infects the

epithelial lining of the stomach. It is in form of an acid that corrodes the stomach then it

graduates to becoming sores (James K. Y. Hooi et al, 2017).The disease can be acute or

chronic and occurs as a result of weakening the defensive lining of the stomach. This defense

is aggregated by the presence of mucus in the lining and thus when the hydrochloric acid and

pepsin secretion occurs the mucus fails to defend and thus exposing the epithelium to the

acid.

H. Pylori has been a global problem with statistics showing the infection affecting about 50%

of the global population (M. Plummer et al, 2015). According to the study dubbed ‘Global

burden of gastric cancer attributable to Helicobacter pylori’; the diseases begins with

infection occurring during childhood and instills on one’s body for long term till adult hood.

1
In USA, Peptic Ulcer Disease has been mapped as a disease that affect approximately 4.6

Million people annually and having about 10% estimates of evidenced ulcers of duodenal

type within some time (Javid G, Zargar SA et al, 2009).

In Nigeria, the prevalence of H. Pylori has notbeen properly established but with partial

studies, it has been established that the prevalence is high. This is asserted by facts of Bello K

et al (2019) Kano where the prevalence is at 81%, Jos, Also they reported reported at 87%

and south-West Nigeria, Muinah A. Et al (2017) reported 73%..More recent studies begin to

show similar prevalence rates for duodenal and gastric ulcers in both southern and northern

Nigeria was 25%; 11% had duodenal ulcers while 14% had gastric ulcers. Peptic ulcers

disease was higher among staff males and 36-40 years of age (Izuchukwu, 2015).

In Nakuru, between 2011-2013 study based at patterns of incidences of peptic ulcer disease in

hospital-based endoscopic studies of dyspeptic patients conducted World J. Gastroenterol,

(2019). Also, a research at St. Mary’s Hospital outpatient clinics, 1372 males and 1564

females showed 962 patients (33%) having gastritis, 280 patients (9.5%) have duodenal

ulcer and gastric ulcer with 54 patients (7.5%) (MakangaW ,Nyaoncha A, Jul 2014)

2
1.1 Statement of the Problem

More than a half of the world´s population is estimated to be infected with Helicobacter

pylori (Hooi et al. 2017). During the study period of the scholar, they came out with a

projection where they predicted worse state to be experienced if no any intervention was

adopted.

Since inception and discovery of helicobacter pylori (H. pylori), various underlying factors

were blamed for development of Peptic Ulcers. These ranged from behavioral practices and

psychosocial factors that are largely disregarded (John Paul, 2015).

Today, Peptic ulcers are being blamed as silent causes of deaths. Mayo Clinic came up with a

causative agents of peptic ulcers to be the common Helicobacter pylori infection, non-steroid

anti-inflammatory drug use such as aspirin and smoking (www.mayoclinic.org).Thus,

alternative determinants of peptic ulcers have received limited attention in recent studies. A

lot of studies were dwelling on causes of Peptic Ulcers but less studies was on the continued

growth and prevalence of the disease. This prompted the researcher to get an urge to study

Prevalence of Peptic Ulcer Disease especially among adults between 20-60 years; as such

information could be prudent guide for decision making and development of prevention

strategies.

1.2 Justification of the study:

Among other stomach problems, ulcers have been a major problem commonly to the aged

group (over 20 years) that has been a major cause of death.Worldwide it has affected over

50% of global population (M. Plummer et al, 2015) thereby being a great public concern. In

Kenya healthcare has been having a flock recently with patients seeking advice and

medication of the same.

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Therefore, the study will provide a base line information to the stakeholders, government

hospitals, NGOs and other those who will have an interest on furthering studies on

prevalence of Peptic Ulcers.

Therefore, as far as the study is concerned:

1. The knowledge of early existence and causative agents of peptic ulcers will aid in

proper managements, treatment and reduce its mortality rate.

2. The research will be useful in identifying the magnitude of the problem and the

intervention to be put in place by the relevant authorities.

3. The research will be used for future reference by other researchers.

1.3 Objectives

1.3.1 Broad objectives:

To determine the prevalence of peptic ulcer disease among adults between 20-60 years

1.3.2 Specific objectives:

1. To find out the demographic characteristics of adults between 20-60 years

2. To determine the knowledge and attitude of the people on peptic ulcer disease

3. To identify social-economic and socio-cultural factors that cause peptic ulcer disease

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 CHAPTER TWO: LITERATURE REVIEW

2.1 Knowledge of Peptic Ulcer Disease

Knowledge regards soliciting general information the people have about the peptic ulcer

disease. On the course, these involve establishing the cause, risk factors, diagnosis, treatment

and prevention of the disease (James K.Y. Hooi Et al, 2017).

Ulcer tends to affect the entire gastrointestinal tract, starting from the lining of the mouth and

ending with the rectal region. The infection is associated with development that gradually

graduates to chronic gastritis and gastric cancer. Without treatment and better diagnosis, it

would definitely lead to death. Why would somebody die on an ailment that is known?

Becomes a question that answers a better extension of knowledge that should be instilled on

one’s finger tips (M. Plummer, Et al., 2015).

Understanding peptic ulcer disease is at something of crossroads since on cross examination,

it is connected more on psychosocial and behavioural practices (Johnpaul IzuchukwuOffor,

2015).

Through early detections, simple life style modifications and with the help of modern medical

treatment, the problem of peptic ulcer disease can be largely controlled and patients with

peptic ulcers can lead a prolonged and healthy life. Mere change of dietary or smoking habits

can reduce the problem of having peptic ulcers. And simple affordable treatment such as the

antimicrobial therapy for the eradication of helicobacter pylori can drastically reduce the

occurrence and recurrence of peptic ulcer disease(M. Plummer, Et al., 2015).

However, among at risk population, the current level of knowledge and behaviours and risk

perception are unknown. Studies show that knowledge about the helicobacter pylori;

interestingly those who have tested negative have more knowledge about helicobacter pylori

5
than those who have tested positive (Sung jj.2009). From the research conducted between

2005-2010 in USA, Most people think that mode of transmission of helicobacter pylori was

through water. From their sample size, 23% of the people answered helicobacter pylori can

be transmitted by unsafe food preparation and water sources.

In Nigeria, More recent studies begin to show similar prevalence rates for duodenal and

gastric ulcers in both southern and northern Nigeria was 25%; 11% had duodenal ulcers while

14% had gastric ulcers. Peptic ulcers disease was higher among staff males and 36-40 years

of age. (Izuchukwu, 2015)

From the same study conducted in Nigeria, when their respondents were asked about where

they usually sought help when they have suspected Peptic Ulcer Disease, 50% claimed used

traditional healers, these depicted some form of informal setup the area was at.

In Kenya, the prevalence of peptic ulcer disease among Kenyans was ranging high with

regards to the symptoms, on endoscopy test, similar test showed from normal findings that

85% (2,081) patients. Gastritis was reported in 26% (1,560) patients, 10% (594) patients

having Duodenal ulcers and 5% (312) Patients have gastric ulcer. This number Makanga and

Nyaoncha (2014) continued by their research had not known how they acquired the infection.

And thus attestation of lack of knowledge can be attributed to the major cause of the peptic

ulcer was helicobacter pylori which was not known by most of the patients. (Makanga and

Nyaoncha, 2014)

2.2 Attitude

This involves provocative intention and feeling an individual has on or about Peptic Ulcer

Disease (World J. Gastroenterol, 2019).

6
In Bangladesh, studies were done and asked questions regarding attitude related to

helicobacter pylori and peptic ulcer disease. All of the studies assessed perception of self-risk

of either contracting helicobacter pylori or developing peptic ulcer disease. Rafi A (2014)

found out that among patients attending Dhaka Medical College Hospital, most people of

cohort 15-45 years viewed their own risk as same or ‘lower’ when compared with people of

the same age and gender. This study further investigated own risk verses developing peptic

ulcer and from His finding, most people viewed their own risk for developing peptic ulcer as

average or low. Rafi A (2014) identified that 86% of people did not think they are affected

with helicobacter pylori despite that within this population prevalence was 40%.

In Nigeria, a study done on peptic ulcer perforation showed that the diseases perforation has

increased in prevalence. Okonkwo O et al (2018) found that the perforation of the gastric and

duodenum was as a result of peptic ulcer complication.it has been noted that most of the

population in area with peptic ulcers is related to non-steroidal anti-inflammatory drugs and

helicobacter pylori infection.it was found that most of the patient with the disease could

expect the disease to heal expecting that the disease would heal without such a complication

of perforation.

2.3 Practices

These are bound by deeds that forms day to day working of an individual. Internal organs

cannot be touched or felt but it can be impacted by how one behaves.

In Nigeria, Izuchukwu (2015) identified some behavioural practices as among the

contributing factors of contraction of Peptic Ulcer Disease. He noted that Smoking claimed to

be a stronger risk factor for chronic ulcers than for new ulcers and it was reported that the risk

of Peptic Ulcer Disease increased as the amount smoked increased. From his sample, he

identified that among the male Peptic Ulcer patients male, 75% of them had smoked/are

7
smoking. These is substantial evidence that tobacco has causative agents for consideration.

Also, the study showed that NSAIDs are said to contribute to peptic ulcer formation by

undermining a vital part of the mucosal defensive forces. This corrodes and thereafter

exposing the epithelium for damage. Evidence that tobacco use is a risk factor for duodenal

ulcer is not conclusive. Support for a pathogenic role for smoking comes the finding that

smoking may accelerate gastric empting and decreases pancreatic production.

In Kenya a study conducted in Nairobi by MwalesoKhamisi Said (2019) on peptic ulcer

disease showed relationship between prevalence of Peptic Ulcer Disease and Social

Economic Status, it was identified that a lower social economic status is associated with a

higher prevalence of a helicobacter pylori infection. Helicobacter pylori tends to cluster in

families and in people living in crowded condition.

In such environment, hygienic observation and absorption is low owing the lack of

concentration due to pressure by the population. Such a condition impacts the kind of food

for uptake, how these food are handled and even to a greater extend the handlers of such food

(Javid G, Zargar SA et al, 2009).

Aziz Et al (2015) asked her respondents of their level of education as a demographic feature.

The results showed most respondents were of informal education with majority being up to

primary Education (Basic), when mapped on prevalence of Helicobacter pylori, the

researcher identified that there is an inverse relationship between helicobacter pylori

prevalence and the educational level of the population. Such environmental factors such as

general of hygiene, source of water supply and sanitation have been linked by the researcher

to prevalence of helicobacter pylori.

In Nakuru, from a study conducted by MakangaW andNyaoncha (2014) on a selected

sampling it showed that infection was high on female having age more than 21 years,

8
working as manual labourers. This spells the work they are subjected to that are strenuous

and demanding to the extent one may not get time or energy of preparing food to eat. And if

they find, the kind of food consumed may not be up to the standard that is required by the

body.

Also, along the study, the researchers connected large family size as associated with peptic

ulcer disease in adults. Such families are mind bungling which the body secretes hydrochloric

acid and thus impacting the mucosal membrane of the stomach lining thus popping up of

sores. (MakangaW andNyaoncha, 2014)

9
 CHAPTER THREE: METHODOLOGY

3.1 Background of the study area

The study was conducted in Marigat Sub-County Referral hospital, found in Marigat Town of

Marigat Sub-County in Baringo County. Marigat is a small town in Baringo County, Kenya.

Marigat is a fast-growing town located in the lowlands of Baringo County. It lies at 0.470 N,

35.980 E. Marigat Sub-County covers an area of 1,677.5 square kilometers and has a

population of 79,629 and 15,545 households (KNBS, 2019).

3.1.1 Socio-economic activities

The people are mainly pastoralists and subsistence peasant farmers. Also, the plains of the

sub-County favours bee keeping and wildlife keeping mainly the indigenous species.

3.1.2 Health system

In the County, the total number of health facilities is 227 comprising of 167 primary health

facilities. In Marigat Sub-County, Level 4 are 1, level 3 are 3, Level 2 are 18 and Level 1

facilities are 5 in Number. These in total are 27 Health Facilities in the Sub-County. (Baringo

County CIDP 2019-2022)

3.2 Study Design

A descriptive cross sectional study and probability sampling was used in finding answers to

the research questions. This design was adopted since it will ensure the target group are being

reached for study. Also, the design appropriately addresses the study objectives.

Demographic profile, knowledge and attitude and socio-economic and Socio-cultural

practices

3.3 Target Population

All adults aged 20-60 attending Marigat Sub-County Hospital.

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3.4 Sampling technique

Probability sampling method was used to ensure each unit of the sample is chosen so that all

units of study population should have an equal or known chance of being included in the

sample and Simple Random Sample was used to select the respondents.

3.5 Sample size determination

Determination of the sample size was done using the Andrew Fisher method of 1994 for

population less than 10,000

Z 2 PQ
nf =
d2

Where nf = The desired Sample size

N= Estimated population

n = 384 which is a constant

Due to the sample being bigger Mugenda and Mugenda (2003) formula was adopted to

determine a smaller sample size.

Nf=N

1+n/N

Where;

Nf- The sample size where population is less than 10,000

n- The desired samples size where population is less than 10,000

N- Estimated of the population

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Nf- 384

1+384/137

Nf=384

1+2.8

Nf- 101 respondents were used by the researcher.

But due to limited time and financial constraints I was able to reach out to 30 respondents.

3.6 Selection Criteria

Inclusion criteria

All adults aged 20-60 who are willing to participate in the study and are attending Marigat

Sub-County Hospital

Exclusion Criteria

1. Adults aged 20-60 years who will not attend Marigat Sub-county Hospital

2. Adults who will be willing to participate in the study

3. Adults who are new residence in the area

4. Residence who are not of sound mind

3.7 Study variables

Dependent Variable

Prevalence of Peptic Ulcer Disease

Independent Variable

1. Knowledge on Peptic Ulcer Disease

2. Attitude on prevalence of Peptic Ulcer Disease

3. Perceived Practices on prevalence of Peptic Ulcer Disease

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3.8 Data Collection Method

Researcher administered questionnaires to the respondents who were not able to read and

write and Self-administered questionnaires to the one who were able to read and write

3.8.1 Data collection procedures

The questionnaires were distributed in the Sub-County Hospital where the respondents were

able to fill by themselves but those who were not able they were assisted by the researcher.

3.9 Data Analysis

The collected data was analysed using percentages by use of computer Package Excel. Data

was presented inform tables, charts and histograms.

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 CHAPTER FOUR

DATA ANALYSIS, PRESENTATION, INTERPRETATION AND DISCUSSION.

4.1 Introduction

This chapter presents analysis and findings of the study as set in the research methodology.

The study aimed at investigating the factors determining prevalence of peptic ulcer disease

among adults aged between 20-60 years attending Marigat sub-county hospital. The

researcher targeted a sample of 50 adults attending Marigat sub-county hospital. 30 adults

involved in the questionnaire and this was 100% response rates. Data analysis was done

through MS excel using tables and pie charts and text.

4.2 PART A: DEMOGRAPHIC DATA.

4.2.1 Age of Respondents.

Table 1 Age of Respondents.

Age Frequency Percentage(%)

20-30 6 20
31-40 12 40
41-50 8 27
51-60 4 13
TOTAL 30 100

The findings in Table 1 above indicated that prevalence of peptic ulcers is higher in adult

aged 31-40 and 41-50 and lower among adults aged 20-30 and 51-60

14
4.2.2 Gender

Table 2 Gender of the Respondents

Gender Frequency Percentage(%)

Male 10 33
Female 20 67
Total 30 100

The findings in Table 2 above indicated that prevalence of peptic ulcers is higher in female

than male

4.2.3 Religion

Table 3 Religious Background of the respondents.

Religion Frequency Percentage(%)

Muslim 20 67
Christian 10 33

Majority of the adults in the village are Christians taking about 67% of the total respondents.

0% of the respondents were pagans. 33% declared that they are Muslims.

PART B: Knowledge of Peptic Ulcer Disease

4.3.1.Awareness of peptic ulcer disease

Table 4 awareness of peptic ulcer disease

Knowledge Frequency Percentage(%)

Aware 12 40
Unaware 18 60

Table 4 above showed that the majority of the population are unaware of peptic ulcer disease

4.3.2. source of information about peptic ulcer disease

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Table 5 source of information on peptic ulcer disease

Source of information Frequency Percentage(%)

Radio 2 17
Health worker 5 42
Friends 2 17
Television 2 17
Internet 1 8

The table above indicated that majority of those who are informed about peptic ulcer disease

accessed information from health worker and the least from the internet.

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Section C:.Social Economic data

4.3.1 Level of Education of the Respondents

Bar graph on Level of Education of the Respondents

level of education

Primary School; 40%

Secondary School; 27%

Axis Title

College Level; 23%

University Level; 10%

Axis Title

Column1

From the finding in bar graph above shows40% of the respondents reached primary

school,27% secondary level,23% collage level and 10% university level. This showed that

those who reached primary level of education as the most group with high prevalence of

peptic ulcer disease probably due to lack of knowledge about the disease.

17
4.3.2.Distance to the nearest facility of the respondents

Table 4 Distance to the nearest facility of the respondents

Distance (km) Frequency Percentage(%)

<1 km 10 33
1-5 km 15 50
5-10 km 3 10
>10km 2 7

From the above finding it has showed that majority of the respondents 80% are able to access

health facility and only 17% a few move for a longer distance to get to a health facility.

Section D: social cultural data

4.4.1.Restriction of health services by the culture of the respondents

percentage

yes; 30; 100%

yes no

The chart above shows that there is no cultural restriction on seeking for health services

4.4.2 Food restriction by the culture of the respondents

Pie chart on food restriction by the culture

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 Food restriction by the culture

yes; 10; 33%

no; 20; 67%

yes no

The above pie chart showed that 67% do not have food restriction to the culture and 33%

have food restriction in that majority of them take local brews(busaa,muratina and changaa).

19
Section Social practices data

4.5.1. Health service providers of the respondents

Bar graph on health service provider of the respondents

Health service provider

health facility; 50

over the counter; 37

tradional healer; 13

Column1

The above bar graph illustrates that 50% of the respondents seek health services on health

facilities,37% over the counter and 13% from traditional healer

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 CHAPTER FIVE: SUMMARY OF THE FINDINGS CONCLUSION AND

RECOMMENDATION

5.1 Introduction

This chapter presents the summary of the study findings, conclusion of the study and

recommendation drawn from the study. The purpose of the study was to investigate the

factors determining the prevalence of peptic ulcers among adults aged between 20-60 yearsin

Marigat sub-county hospital in Baringo county. This was to help determine the causes of

prevalence of peptic ulcer disease

5.2 Summary of the Findings.

The study findings established that prevalence of peptic ulcers is higher in adult aged 31-40

and 41-50 and lower among adults aged 20-30 and 51-60 years with percentage of

40%,27%,20%and13% respectively.Also prevalence is higher in female than male among the

respondents in percentage of 67%in female and 33% in male.Majority of the adults in the

village are Christians taking about 67% of the total respondents. 0% of the respondents were

pagans. 33% declared that they are Muslims.

The study observed that most of the respondents, 40% of the population are conversant of

peptic ulcer disease while 60% are not conversant. Majority of those who are informed about

peptic ulcer disease accessed information from health worker were 42% and the least from

the internet 8%. Therefore, there is need for health providers to give intensive health talks

and sensitize clients on peptic ulcers disease.

The study findings established that 40% of the respondents reached primary school,27%

secondary level,23% collage level and 10% university level. This showed that those who

reached primary level of education as the most group with high prevalence of peptic ulcer

21
disease probably due to lack of knowledge about the disease. Thus need for more health talk

about the disease prevention and control.

According to the study findingsmajority of the respondents 83% are able to access health

facility and only 17% move for a longer distance to get to a health facility.There is no cultural

restriction on seeking for health services since 100% of the respondents attend to heath

facility when they are sick.The study established that that 67% do not have food restriction to

the culture and 33% have food restriction in that majority of them take local brews (busaa,

muratina and changaa).

Also the study found that 50% of the respondents seek health services on health

facilities,37% over the counter and 13% traditional healer.

5.3 CONCLUSION

The conclusion of this study is based on assumption that respondent’s response can be

generalized. The conclusion is that the prevalence of peptic ulcers is higher in adults aged

betwee20-40 years. However, females are more affected than male.it is evident that most of

the people don’t have knowledge about peptic ulcer in the area. also it was noted that cultural

practices and level of education contributed to the prevalence of the disease. Despite health

facilities are being accessible some people still opt for traditional healer and over the counter

medication which might be the factor of the prevalence.

5.4. Recommendation

There is need for health providers to give intensive health talks and sensitize clients about the
disease and this will help lower the prevalence of disease.

Health workers should follow up new clients to ensure complete eradication of the disease.

County government should enforce laws against illegal brews which are known to be risk
factor for the disease.

22
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Bello AK, Borodo MM, Yakasai AM, Tukur AD. Helicobacter pylori antibiotic sensitivity

pattern in dyspeptic patients in Kano, Nigeria. S Afr J Infect Dis. 2019;34(1), a125. https://

doi.org/10.4102/sajid. v34i1.125

James K.Y. Hooi Et al. 2017. “Global Prevalence of Helicobacter pylori Infection:

Systematic Review and Meta-Analysis”. 153:420–429

Javid G, Zargar SA et al, 2009. “Comparison of p.o. or i.v. proton pump inhibitors on 72-h

intragastric pH in bleeding peptic ulcer’. J GastroenterolHepatol. 2009 July.

Johnpaul IzuchukwuOffor. 2015. Characterization of patients with peptic ulcer disease in

northeastern Nigeria: influence of lifestyle, wealth, and environmental factors

Kenya National Bureau of Statistics, 2019

M. Plummer, Et al. 2015. “Global burden of gastric cancer attributable to Helicobacter

pylori,” International Journal of Cancer, vol. 136, 2015.

Muinah A Et al (2017).” Helicobacter pylori strains from a Nigerian cohort show divergent

antibiotic resistance rates and a uniform pathogenicity profile”

MwalesoKhamisi Said (2019). Prevalence of Helicobacter Pylori Infection among Patients

with Peptic Ulcers and the Associated Risk Factors in Mbagathi Level V Hospital, Nairobi

County, Kenya

Muinah A Et al (2017).” Helicobacter pylori strains from a Nigerian cohort show divergent

antibiotic resistance rates and a uniform pathogenicity profile”

23
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with Peptic Ulcers and the Associated Risk Factors in Mbagathi Level V Hospital, Nairobi

County, Kenya

Makanga W, Nyaoncha A (2014). Upper Gastrointestinal Disease in Nairobi and Nakuru

Counties, Kenya; a Two Year Comparative Endoscopy Study. July 2014. Volume II

Sung JJ, Kuipers EJ, EL-Serag HB 2009. Systematic review: the global incidence and

prevalence of peptic ulcer disease

World J. Gastroenterol, 2019 Helicobacter pylori infection: Beyond Gastric Manifestation Jul

14; 25(26).

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 APPENDICES

APPENDIX 1 : BUDGET

ITEM QUANTITY COST TOTAL

Foolscap 1 ream 400 400
File 1 80 80
Ball pen 5 20 100
Ruler 1 30 30
Browsing 500 minutes 2 KShs per minute 1000
Typing and Printing 50 copies 30 1500
Binding ______ 200 200
Questionnaire Copies 200 10 2000
Flash disk 1 1000 1000
Miscellaneous ______ 1000 1000

TOTAL ____________ KShs 7310.00

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Appendix II: Questionnaire

Section A: Demographic characteristics

1.Age a) 20-30 years

b) 31-40 years

c) 41-50 years

d) 51-60 years

2.Gender a) Male ( ) b) Female ( )

3.Marital status a) Married ( ) b) Single ( ) c)Divorce ( )

d) Widowed ( ) e) Separated

4.Religion a)Christian ( ) b) Muslim ( ) c) Hindu ( )

d) Others Specify ……………………

Section B: Knowledge of Peptic Ulcer Disease

5.Have you ever heard about Peptic Ulcer Disease a)Yes ( ) b) No ( )

If yes, what was the source of the information?

a) Radio ( ) b) Television ( ) c) Health worker ( )

c) Friends ( ) d) Internet ( ) e) Others (Specify) …………………

6. In your view, what causes Peptic Ulcer Disease

……………….. …………………. ………………. …………………..

Section C: Social Economic Data

7.Highest level of Education a) Primary ( ) b) Secondary ( ) c) College ( )

d) University ( )

8.What is your source of income a) Employment ( ) b)Business ( )

c) Family support ( ) d) Donation ( )

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9.What distance do you cover to your nearest health facility?

a) <1Km b)1-5 Km c)5-10 Km d)>10Km

Section D: Socio-Cultural Data

10.Does your culture restrict you from seeking health services from hospital?

a) Yes ( ) b) No ( )

If yes, explain

11.Are the food restricted by your culture?

a) Yes ( ) b) No ( )

If yes, explain

Section E: Social practices Data

13.When you are sick, where do you seek medication?

a) Traditional healer ( )

b) Health facility ( )

c) Over the counter ( )

d) Others (Specify)……………………………………………………….

27