Factors Associated With Interruption of Tuberculosis Treatment among Patients in Nandi County, Kenya

Abstract

Tuberculosis is the second leading cause of mortality among that ascribed to infectious agents in the world. About two billion people are infected with Mycobacterium tuberculosis. Of the world burden, 80% is held by 22 countries, 9 of which are in Africa, Kenya being among them. A case, if untreated will infect 10-15 people annually. In 2015, about 80% of patients initiated on treatment completed their course. The objective of the study was to establish factors associated with TB treatment interruption. A cross sectional study using a semi structured pretested questionnaire on 252 randomly selected patients in the TB register of Nandi County for the year 2013/2014 was conducted. Data on sociodemographic factors, clinical information, family support, nutritional status and medication history was collected and analyzed by Epi- Info Version 7 (CDC, USA Atlanta). The overall interruption rate in Nandi County was 30.95%. Most of respondents were males and most of the patients were aged 30-39 years. There was low partner HIV testing (31.35%). The following factors were significantly associated with interruption on bivariate analysis; Alcohol use (OR 5.024), Smoking (OR 3.848), Perceiving disease as mild (OR 2.498) and Perceiving distance as a barrier (3.836), Being accompanied by family member (OR 0.494), Perceiving inadequate funds as a barrier (OR 4.137), Low Personal monthly income (OR 4.997), Being informed of diagnosis (OR 0.294), Experiencing side effects (OR 2.467), Seeking alternative treatment (OR 2.597), Having a negative HIV result (OR 0.519), Waiting time below 1 hour (OR 0.205), Living less than 10km from the treatment site (OR 0.227) and Use of herbal medicine during treatment (OR 2.614). Unconditional logistic regression indicated that Personal income (AOR 0.254), Alcohol use (AOR 2.843), Waiting time at the health facility (AOR 3.322), Perceiving distance as a barrier (AOR 2.046) and Perceiving inadequate funds as a barrier (AOR 2.800) independently influenced treatment interruption. This means that the aforementioned five factors are the most significant determinants of TB treatment interruption and should be addressed to reduce TB treatment interruption. This study has shown that one in every three patients interrupt treatment in the county. This could probably be attributed lack of confidence in the prescribed treatment leading to use ofalternative therapy. It is recommended that intensive pretreatment counselling that focuses on the importance of adhering to treatment throughout the treatment period, expansion of DOT services and education of caregivers and alternative medicine providers be undertaken.