Tuberculosis (TB) is a disease of major public health importance in Kenya. Despite the considerable investment done by the government and partners in TB care and prevention in the past 20 years, the disease is still the 4th leading cause of death, with Kenya listed by the World Health Organisation (WHO) among the 30 high burden states. Therefore, finding all people with TB disease and successfully treating them is an important priority for the country. Treatment adherence is a key factor for treatment success and inadequate adherence is associated with various adverse outcomes like the development of Multi-Drug Resistant TB (MDR-TB), relapse, continued transmission of the disease and even death.
The aim of this cross-sectional survey was to assess the level of adherence to TB treatment and determine associated factors. It was conducted through interview with 1,487 drug susceptible TB patients on treatment for at least one month across 156 public and private health facilities in 15 counties of Kenya.
The study established that the proportion of the patients found to be non-adherent was 35%. The results from this study suggest a range of (risk) factors associated with non-adherence to TB medication. These risks include: older age, male gender, presence of extra-pulmonary TB (EPTB), being HIV negative, intensive phase of treatment, having a treatment supporter, limited availability of food, experiencing medication-related side effects and increased cost of transport to health facility. The identification of these non-adherence risk factors indicate that specific strategies should be developed to address them.
The study recommends the National Tuberculosis, Leprosy and Lung Disease Program (NTLDProgram) should actively focus on supporting TB patient treatment adherence through health communication and awareness while leveraging the use social media platforms to help increase the reach of its public messages, paying special attention to key affected populations like men. In addition, the NTLD-Program and stakeholders should consider introducing digital health interventions like Short Messaging Services (SMS) reminders and medication monitors to help support patient adherence while strengthening TB/nutrition programs collaboration to help identify TB patients with food shortages and develop mechanisms for their support.”