Adherence to Anti-Tuberculosis Treatment among Patients Attending Tuberculosis Clinics in Nyatike Sub-County, Migori County, Kenya
| dc.contributor.author | Babere, Patrick Kerata | |
| dc.date.accessioned | 2025-08-12T12:50:05Z | |
| dc.date.available | 2025-08-12T12:50:05Z | |
| dc.date.issued | 2024-09 | |
| dc.description | A Research Thesis Submitted in Partial Fulfillment for the Requirements of the Award of The Degree of Master of Public Health (Epidemiology and Disease Control) in the School of Health Sciences of Kenyatta University, September 2024. Supervisor 1. Mary W. Gitahi 2. Rosebella A. Iseme | |
| dc.description.abstract | Tuberculosis is a communicable disease whose cause is Mycobacterium tuberculosis. Main mode of spread is through coughing or sneezing from an infected person, which expels the droplets and when they remain suspended in the air, a susceptible host inhales the contaminated air, they get lodged in the lungs and later cause an active TB disease when not suppressed by the immune system. Symptoms most reported include: persistent cough with sputum, night sweats, appetite loss, weight loss among others. Approximately 10.6 M people contacted the disease and 1.30M died from it in the year 2022. Of all the TB disease burden globally, 23% are from Africa but the region led in mortalities, being 33%. Kenya had an incident rate of 233 per 100,000 and mortality rate of 32 per 100,000. Adherence in Kenya according to a national survey was 75% and several factors had been found to affect it including socio-demographic, individual and health system related factor. The study aimed determine factors affecting adherence to anti-TB treatment in all treatment phases among patients in Migori County. In Nyatike, there were concerns in rising cases of re-treated TB patients and rifampicin resistant cases. The cure rate in Nyatike was 76% which was lower than Migori County which was at 81.3%. The study therefore sought to ascertain the adherence level among the TB patients in Nyatike sub-county. This would be important to help the healthcare givers to know how much to invest in adherence given the high incidence rate in the sub-county (209 per 100,000) against that of the sub-county (155 per 100,000). The study`s main objective was to assess adherence to anti-tuberculosis treatment among patients attending tuberculosis clinics in Nyatike, Migori County, Kenya. Specific objectives were to: determine the demographic, individual and health system factors associated with adherence to anti-TB treatment, to determine the knowledge level and its association to adherence among patients in Nyatike sub-county and to determine the prevalence of adherence levels among patients in Nyatike sub-county. The study`s area was Nyatike, which is among the sub-counties in Migori with a population of 176,162 people. The area`s major economic activities include fishing, farming, livestock keeping, gold mining and bee keeping. Cross sectional was the Study design of choice. Census method was the sampling technique used to sample participants while purposive sampling was used to sample FGD and KII participants. A total of 200 participants, 18 years or more and consented to participate were included in this study. Questionnaires, key informant guide and FGD guides were the data collection tools with the pre-test done in Kuria West sub-county. Morisky medication adherence scale (MMAS-8) and Knowledge assessment was adopted from the Global TB community advisory board (TBCAB) were adopted in the study to measure adherence and knowledge levels respectively to ensure validity. Data was analysed using SPSS version 25 after a descriptive summary while qualitative data was summarised and organised into themes. Data dissemination was in form of tables, graphs and pie charts for quantitative and captions for qualitative data. Due ethical clearance was granted from KU ethics review committee, NACOSTI and Migori County health authority. Factors found to be associated with adherence following a regression analysis included: HIV status (AOR1.152; 95%CI: 0.408-3.691, p=0.029), money for other needs (AOR2.363: 95%CI: 0.934-5.981, p= 0.007), use of other non-TB drugs (AOR 0.418; 95%CI: 0.157-1.109, p=0.008) and knowledge (OR: 2.856; 95%CI: 1.282-6.365; P= 0.01). No socio-demographic and health system factors were found to be statistically significant. Adherence level among participants was 78% whereas the knowledge level was 70%. Stock-out of pyridoxine drug and lack of regular update from the TB program among healthcare givers in the private hospitals were the challenges facing the health system. Organization of Peer-to-peer groups among TB patients at the health facility level, incorporation of community health practitioners in TB care for patients, conducting health education to the communities and advocacy as well as provision of nutrition guidance for TB patients in the sub-county were among the recommendations arrived at from this study. Conducting adherence study among children under 18 years, knowledge assessment among TB patients in other parts of the County and conducting a similar study in future to ascertain whether demographic and health system factors are associated with adherence are the recommendations for future studies. | |
| dc.description.sponsorship | Kenyatta University | |
| dc.identifier.uri | https://ir-library.ku.ac.ke/handle/123456789/31186 | |
| dc.language.iso | en | |
| dc.publisher | Kenyatta University | |
| dc.title | Adherence to Anti-Tuberculosis Treatment among Patients Attending Tuberculosis Clinics in Nyatike Sub-County, Migori County, Kenya | |
| dc.type | Thesis |