Reasons for Interruption, Knowledge, Attitude and Practices of Patients Treated for Tuberculosis in Nandi County, Kenya

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.