The Effects of Antituberculosis Drugs Side Effects on Treatment Adherence Among Tb Patients at Kenyatta National Hospital

Abstract

Background: Side effects are one of the major causes that result to poor adherence of anti-TB treatment. Poor adherence could lead to prolonged treatment, drug resistance, treatment failure, increased morbidity and mortality of disease(WHO, 2017).Little is known about the effects of anti-tuberculosis drugs’ side effects on treatment adherence at KNH. Study objective: The main objective of this study was to determine the effect of anti-tuberculosis drugs side effects on treatment adherence among TB patients at KNH. Study area: The study was conducted at KNH. The study design was a descriptive cross sectional design at the CCC, TB clinic, medical wards 7A,7B,7C, 7D, 8A, 8B,8C and 8D.The sample size was calculated using the fisher’s formula. A total of 169 patients were meeting the inclusion criteria of this study. The respondents were sampled using the purposive method of sampling. Data collection and analysis: Quantitative data was collected using a structured questionnaire and analyzed using SPSS Version 24.0. Data was summarized in form of bar graphs and pie charts. Qualitative data was collected using interviews as per the objectives and then analyzed using N-Vivo software 11 where themes and sub- themes that constituted narrative based on research objectives were generated. Results: The level of adherence at KNH was poor 34.9% (n=51). Side effects occurred among many respondents 77.9% (n=114) and this made a significant proportion 62% (n=71) of those who experienced side effects to default on treatment. There was a significant association between minor side effects of anti-tuberculosis drugs and adherence to TB treatment as indicated by nausea/vomiting (p= 0.034), loss of color vision (p =0.015), skin rash (p =0.003) and discoloration of body fluids (p=0.001). There was a significant association between major side effects of anti-tuberculosis and adherence to TB treatment as indicated by jaundice (p = 0.014), joint pain (p=0.003) and ankle swelling (p= 0.001). Other factors associated with adherence included being male (p=0.037) Increasing age (p=0.027) and high education level (p=0.001). Alcoholism (p=0.003) was associated with non-adherence to anti-tuberculosis medication. Conclusion: The level of adherence among TB patients at KNH hospital is poor 34.9% (n=51). Minor side effects of anti-tuberculosis drugs result to poor adherence of TB treatment. (Nausea / vomiting (p=0.034), discoloration of body fluids (p=0.001), loss of color vision (p=0.015) and skin rash (p=0.003).Major side effects of anti-tuberculosis drugs result to poor adherence of TB treatment.(jaundice (p=0.014), joint pain (p=0.003), ankle swelling (p=0.001). Alcoholism (p=0.003) also contributed to poor- adherence in this study. Recommendations: Health care workers should emphasize the importance of adherence to TB patients on anti –tuberculosis drugs regardless of experiencing side effects. The patients need to be educated on possible side effects of anti-tuberculosis drugs and how to handle them. Health care workers should manage the side effects of anti-tuberculosis drugs so as to ensure adherence.