Abstract:
Introduction
Kenya is ranked 15th on the list of 22 high-TB burden countries as determined by the World Health Organization, with a case
notification rate of 440 cases per 100 000 persons. National TB treatment success rate is 85.5%, Nandi County lags behind at 77%.
The country has adopted WHO recommended short course since 2007 and direct observation of treatment (DOT) since 1993 to
mitigate against interruption of treatment. We conducted this study to determine the reasons for TB treatment interruption and the
factors relating to patient attitude and practices that influence interruption in Nandi County.
Methods
We randomly selected and interviewed 252 subjects using a pretested semi structured questionnaire. Data on social and demographic
factors, lifestyle, clinical information, family support, nutritional status, medication history was collected. Analysis was conducted
with Epi- Info Version 7.Outcome variable was treatment interruption. Analysis was by logistic regression at 95% CI and P<0.05
significance level.
Results
We interviewed 252 respondents of whom 149 (59.1%) were males. The most common age 69 (27.4%) was 30-39 years. The most
frequently given reason 50 (64.1%) for treatment interruption was “Too many pills”. Not knowing the risk of interrupting TB
treatment AOR 2.8 (1.43 – 5.62), ever ashamed because one had TB AOR 2.6 (1.33 – 4.93) and ever used herbal medicine during
treatment AOR 2.1 (1.04 – 4.22) were independently associated with treatment interruption.
Conclusion
Treatment interruption was associated with lack of knowledge on the risk of interrupting TB treatment, ever ashamed because one had
TB and ever used herbal medicine during treatment. These can be addressed by intensive pre-treatment counselling of patients and
care givers that focuses on the importance of adhering to treatment and reduction of stigma as well as sensitizing herbalists and
traditional medicine men on TB and engaging them in TB patient referral.
