Adherence to Pulmonary Tuberculosis Treatment in Murang’a County, Kenya
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Date
2020-03
Authors
Gitonga, Charles Muthui
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Non-adherence to Tuberculosis treatment is a major barrier for TB control programs because incomplete treatment may result in prolonged infectiousness, drug resistance, relapse and death. Successful treatment of TB involves taking anti TB drugs for at least six months as per the doctors advise. Currently, Tuberculosis has become a resurgent public Health problem in developing countries and is the leading cause of death from any single infectious agent. The purpose of the study was to identify factors contributing to non-adherence to TB treatment amongst pulmonary TB patients in Maragua Sub-County of Murang’a County. The objectives included were to determine the social-economic related, healthcare-related, patient-related and disease and medicine related factors associated with non-adherence of TB treatment amongst patients in Murang’a County. The study was guided by the Health Belief model as the theoretical framework. A cross-sectional survey study design was used. Census method was used and all 270 people were considered. Data was collected using a mixed method approach of interview guides, questionnaires and Focus Group Discussions. A total of 270 adult Pulmonary TB patients, amongst whom 59 (47%) were adherents and 67(53%) non adherents with TB treatment, who received treatment in 2017 and had completed treatment, Community Health workers, and Health Personnel in the TB clinic participated in the study. Data was entered to EPI INFO version 3.5.3 and analysed using Statistical Package for Social Sciences (SPSS) version 22. Multiple logistic regressions was used to identify associations and to control potential confounding variables. Chi Square was used to test independence of categorical variables with p value of less than 0.05 at 95% confidence interval being considered significant. Data presentation was done using figures and tables. From the results of the study only the distance taken to collect drugs in the health facility was found to be associated with non-adherence to TB treatment (n=9 ,13%). The study recommends that measures should be undertaken so as to reduce the non-adherence level to TB treatment by ensuring anti-Tb treatment is accessible to patients at the nearest Health facility from their residence. Additionally, the study proposes that the patients should be sensitized on the importance of adherence to TB drug mediction. Interventions with Health promotion initiatives emphasizing the benefits of treatment adherence should be enhanced in the communities by further large scale multicentred studies and that an enabling environment which is conducive for good patient interactions should be created. The study concludes that there are challenges facing adherence of TB treatment which ought to be addressed. The study, suggests that measures to improve drug adherence such as improving health conditions, increasing the availability of drugs and conducting health educations to the patients is essential in minimizing the drug non-adherence to TB drugs.
Description
A Research Thesis Submitted in Partial Fulfilment of The Requirements for the Award of the Degree of Master of Science in Environmental Health in the School of Public Health and Applied Human Sciences of Kenyatta University, March 2020
Keywords
Pulmonary Tuberculosis, Murang’a County, Kenya