Socio-Cultural Factors Associated with Non-Adherence to Tuberculosis Treatment and Medical Education Interventions in Selected Counties of Kenya

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. Objectives: The study set out to identify the socio-cultural factors associated with non-adherence to TB treatment. 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 traced non-adherent smear positive TB patients (defaulters) and health care workers within the past six months (June-December 2015) at the commencement date of the study. Interview schedules and questionnaires were used to collect data. Data analysis was done with aid of SPSS platform that generated graphs and tables. Results: Some of the factors which contributed to non-adherence to TB treatment were socio-demographic factors and ignorance on need for treatment adherence. Socio-cultural/economic factors which included stigma, alcoholism, poverty, low income, living alone, and poorly prepared healthcare workers on Tb treatment also contributed to non-adherence to treatment. Conclusion: Socio-demographica nd socio-cultural/economic factors associated with non-adherence to treatment included ignorance on need for treatment adherence, stigma, alcoholism, poverty, low income, living alone. Inadequately prepared healthcare workers seem to have also contributed to non-adherence to medication. 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.