Determinants of Non-adherence and Loss to Follow-up Among Tuberculosis Patients on Treatment at Mbagathi County Hospital

Abstract

Introduction: Tuberculosis is a communicable disease caused by the bacillus Mycobacterium tuberculosis. It is one of the leading causes of death from infectious diseases in the world, and is a serious public health issue in Kenya Tuberculosis treatment non-adherence and lost to follow up is widespread. The rate of non-adherence in Kenya is high but the current burden is not well understood. Non-adherence and loss to follow up leads to development of drug resistance, treatment failure and relapse, increased transmission of the bacilli and prolonged morbidity and mortality. Main objective: To determine factors associated with non-adherence and loss to follow up among tuberculosis patients on treatment at Mbagathi county hospital Methodology: The study design was mixed methods research where 137 participants, selected by simple random sampling, were interviewed using a structured questionnaire. A focused group discussion was conducted on 6 healthcare workers at the Tuberculosis clinic. Data was populated in Microsoft Excel 2010 then analyzed using Stata 13 software. Descriptive and inferential analysis (logistic regression) was done and significance set at an alpha of 0.05 Results. Out of the 137 participants who agreed to participate in the study, 90 (65.69%) were males. Participants who were non-adherent were (7.30%). Six participants lost to follow up translating to a prevalence of 2.76%. Five (83.33%) were males. Travel was a major cause of loss to follow up. Regimen complexity was associated with higher odds of non-adherence (aOR 14.67 95% CI 2.44,88.07). Forgetting to take medication was associated with higher odds of non- adherence (aOR 9.11 95% CI 1.16,71.54). Those who reported to occasionally forget to take medications had higher odds of non-adherence (aOR 27.69 95% CI 3.72,206.09) Conclusion: Non-adherence and loss to follow up are widespread in medical setup. Medication complexity and forgetting to take medications were identified as the significant factors determining non-adherence to tuberculosis medications while travel was the major cause of loss to follow up