Abstract
Tuberculosis (TB) continues to be a major cause of high morbidity and mortality in Kenya. Adherence to TB treatment is one of the interventions that lead to increase in cure rate thus reducing mortality and emergence of Multi drug resistant tuberculosis (MDR) and high cost of treatment. This study focused on TB patients in urban and rural areas of Kericho and Nakuru Counties. The study was to determine the patient factors which contribute to non-adherence to TB treatment. A purposive sampling method was used to carry out a cross sectional descriptive survey with retrospective cohort of non-adherent TB patients. Target population was smear positive TB patients registered in the TB registers in the two counties, within the past six months at the commencement date of the study. Data was collected using adopted/ developed observation forms/checklists, interview schedules and questionnaires. Respondents were traced non-adherent smear positive TB patients (defaulters), care supporters and health care workers. Collected data was analyzed using SPSS platform. Age, gender, inadequate knowledge, ignorance on need for treatment adherence, stigma, alcoholism, social and economic factors such as low income, lack of social support, low education, financial problems, drug side effects were analyzed. Feeling well soon after medication initiation, drug side effects, low educational level, poor financial status, unemployment, shortage of Tb drugs including unavailability of pyridoxine which is essential in counteracting drug side effects and were associated with defaulting. Staff should also intensify adherence counselling targeting effect of personal factor to adherence. The County of Nakuru and Kericho’s Ministry of Health to increase awareness on Tb and make the public aware of the importance of TB control.
Highlights
Non adherence to TB treatment leads to high increase in morbidity and mortality, prolonged TB infectiousness, multidrug resistance, relapse and death and high cost of TB treatment which translates to increased burden to the nation but to the community TB control interventions
The defaulters’ marital status in Nakuru County was; Single 26 (52%), Married 24 (48%) while in Kericho county Singles were 34 (55%) and Married 28 (45%). These findings indicate that more than 50% of the defaulters are single which is supported by a study in Kenya
The study concludes that Patient factors leading to nonadherence range from Feeling well soon after medication, Alcoholism, self-denial, Drug side effects, pill burden, lack of food and low educational level
Summary
[3] global TB control has faced many challenges, with an estimated 8.7 million incident cases in 2011 and 1.4 million deaths from TB since 2011. Non adherence to TB treatment leads to high increase in morbidity and mortality, prolonged TB infectiousness, multidrug resistance, relapse and death and high cost of TB treatment which translates to increased burden to the nation but to the community TB control interventions. Richard Kiplangat Arap Sang et al.: Patient Factors Which Contribute to Non-adherence to TB Treatment in Kericho and Nakuru Counties of Kenya once they start treatment. Progress in responding to multidrug-resistant TB (MDR-TB) remains slow, [3] in high-burden countries where the incidence of MDR-TB is unacceptably high [3, 4]. Global economic crises and reduced investments in health services threaten national tuberculosis control programs. [3, 5]
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