Non-adherence to tuberculosis medication among patients in Rakai and Kyotera Districts

Abstract

Introduction

Poor adherence to anti-tuberculosis (TB) treatment is a bottleneck to treatment success, increases risk of community TB infection spread and fuels development drug resistance TB raising patient treatment cost. Non-adherence to TB treatment is still a major problem in Rakai and Kyotera districts as evidenced by high rates of MDR TB. The study aimed at assessing prevalence and factors associated with non-adherence to TB medication. Methods This was a cross-sectional study was conducted among TB patients aged 18 years selected from 8 highest caseload health facilities in Rakai and Kyotera districts. These were interviewed using an interviewer guided structured questionnaire. Non-adherence to TB medication was assessed using Hill-Bone 8 questions medication adherence questionnaire and a score of more than 10 points was regarded as non-adherence to TB medication. Data was analyzed using STATA version 15.1. Univariate and multivariable Poisson regression were conducted to determine association between independent variables and non-adherence to TB medication. Results A total of 355 participants were enrolled in the study with a mean age of 43.7 (SD+- 15.4 Over a half were male (198, 55.8%) were males, majority had primary education level (200,56.3%) while close to a third were HIV sero-negative. The prevalence of non-adherence to TB medication was 30% (95% CI=27-36). Non-adherence to anti-TB medication was high if patient was receiving treatment from Kakuuto HC IV (APR=3.13; 95% CI= 1.29-7.54), Mutukula HC III (APR=3.72; 95% CI=1.43-9.71) and Buyamba HC III (APR=4.26; 95% CI=1.81-10.0) compared to patients receiving treatment from Rakai Hospital. Having a Pulmonary Clinically Diagnosed (PCD) TB disease (APR=1.66; 95% CI=1.1-2.49), poor patient-provider relationship (APR=2.12; 95% CI=1.38-3.26) and using alcohol during TB treatment (APR=1.5; 95% CI=1-2.26) were significantly associated with non-adherence to TB medication. Conclusion Non-adherence to TB medication among patients was high. Receiving TB treatment from Kakuuto HC IV, Mutukula HC III and Buyamba HC III was associated with non-adherence to TB medication. Therefore, particular attention should be devoted to patients from those health facilities as well as patients who are clinically diagnosed with TB, have poor provider-patient relationship and those who consume alcohol.