Tuberculosis Treatment Adherence among Patients Taking Anti-TB Drugs in Kilifi County, Kenya.
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Date
2022
Authors
Chebet, Nancy Auguct
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Tuberculosis is a still global public health problem, despite numerous interventions in place to reduce its spread and burden among the poor. Despite TB being a treatable, curable and preventable disease, there has been very minimal decline of below 2% to TB incidence in the past years, with over 4 million cases neither diagnosed nor treated. TB has no empirical measure for treatment adherence. WHO, defines treatment adherence as either process or outcome oriented. Process oriented include the use of pill count and appointment date keeping, whilst outcome orient includes use of cure rate as a measure of success. Kilifi County has case notification rate of 189/100000 which are higher than the national standing of 154/100000. Malindi subcounty reported low treatment success rate and cure are of 68% and 68% respectively which are way below the national target of 90% cure rate, less than 5% loss to follow-up (LTFU), <5% TB deaths and 0% patients not accounted for. Further in the recent years there has been increasing loss to follow up cases of 8% in 2017, to 42% in 2018 as reported by TIBU. The study adopted a descriptive cross-sectional study to determine individual factors, behavioural factor, societal factors and health facility factors that influence TB patients into adhering to treatment in Malindi subcounty, Kilifi County. The data was collected from structured questionnaire from Morisky adherence scale and focused group discussion. The study was pretested in Kilifi County Referral Hospital-TB clinic for Validity and reliability. The findings were analysed using SPSS version 20.0, further analysed through using Odd Ratio to measure the strength of variables to treatment adherence. The findings indicated TB treatment adherence in Kilifi County was at 75% which was below the National target of 90%. Sociodemographic factors like living with family and level of knowledge on TB specifically what causes TB, who can get TB and duration of treatment were associated with TB treatment adherence. Behavioural factors of perceived severity, perceived susceptibility, Societal factors like stigma and health facility factors like patients’ satisfaction were factors associated to TB treatment adherence. We recommend the Ministry of Health increase health advocacy on TB at the community to increase knowledge and reduce stigma. Secondly, Policy makers should recommend regular patient trainings on behaviour change campaigns to increase perceived severity and perceived susceptibility during treatment regime. Thirdly, refresher trainings for health care workers on service delivery to patient satisfactions
Description
A Research Project Submitted in Partial Fulfillment for the Requirments for the Award of the Degree of Master of Science in Public Health Systems Management and Application in the School of Public Health and Applied Health Sciences of Kenyatta University, June, 2022
Keywords
Tuberculosis, Treatment Adherence, Patients Taking, Anti-TB Drugs, Kilifi County, Kenya.