Healthcare Givers’ Factors that Contribute to Non-Adherence to Tuberculosis Treatment among Tb Patients in Kericho and Nakuru Counties, Kenya
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Date
2017-11-28
Journal Title
Journal ISSN
Volume Title
Publisher
IOSR Journal of Dental and Medical Sciences
Abstract
Background:Tuberculosis (TB) continues to be a major cause of high morbidity and mortality in Kenya.
Adherence to TB treatment is one of the interventions that lead to increase in cure rate thus reducing mortality
and emergence of Multi drug resistant tuberculosis (MDR) and high cost of treatment. This study focused on TB
patients in urban and rural areas of Kericho and Nakuru Counties of Kenya.
Objective: The objective of the study was to isolate the healthcare givers’ factors that contribute to non
adherence to medication among Tb patients. Methods: A purposive sampling method was used to carry out a
cross sectional descriptive survey with retrospective cohort of non-adherent TB patients.
Target population was smear positive TB patients registered
in the TB registers in the two counties, within the past six months (June-December 2015) at the commencement
date of the study. Data was collected using developed interview schedules and questionnaires. Respondents
were traced non-adherent smear positive TB patients (defaulters) and health care workers. Age, gender,
inadequate knowledge, ignorance on need for treatment adherence, stigma, alcoholism, social and economic
factors such as low income, lack of social support, low education, financial problems, drug side effects were
analyzed using SPSS platform that generated graphs and tables.
Results: Feeling well soon after medication initiation, drug side effects, stigma, alcoholism, low educational
level, poor financial status, unemployment, shortage of Tb drugs including unavailability of pyridoxine which is
essential in counteracting drug side effects were associated with defaulting. Healthcare workers were found to
be poorly prepared to treat Tb patients. Existing training curricula in training institutions are deficient and
wanting in components of management skills and devoid of soft skills applications.
Conclusion: Socio-demographic and socio-cultural/economic factors associated with non-adherence to
treatment included ignorance on need for treatment adherence, stigma, alcoholism, poverty, low income and
inadequately prepared healthcare workers who seemed poor in treating Tb patients. Available training
curricula in training institutions are inappropriate.
Recommendations: A deliberate and sustained plan on patients’ health education regarding adherence to
medication and stigma reduction must be emphasized. Staffs’ updates on Tb treatment must be regularly
enhanced through continuing medical education forums. Existing training curricula in training institutions need
to be revised and updated to include practical components that touch on patients’ management skills reinforced
with mandatory hands on soft skills applications for all trainees.
Description
Journal Article
Keywords
Non-Adherence, TB Treatment, Defaulter, Patient Factor, Tuberculosis
Citation
Sang, R. K.A. , Kangethe, S., Ayiro, L.P. & Changeiywo, J. M. Healthcare Givers’ Factors that Contribute to Non-Adherence to Tuberculosis Treatment among Tb Patients in Kericho and Nakuru Counties, Kenya. IOSR Journal of Dental and Medical Sciences. 16(11). pp 84-93. 10.9790/0853-1611118493