Facility Level Factors Influencing Adherence to TB Treatment in Mwingi East Sub County, Kitui County, Kenya
Jacinta Maluki Mumbe *
Department of Environmental Health and Disease Control, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya and Office of Dean of Students, Kenya Medical Training College, Kitui, Kenya.
Japheth Mativo Nzioki
School of Nursing, Andrews University, Berrien Springs, USA.
Joseph Mutai
Institute of Tropical Medicine and Infectious Disease, Kenya Medical Research Institute, Nairobi, Kenya.
Alex Karuiru Ndiritu
Department of Public Health, University of Kabianga, Kericho, Kenya.
*Author to whom correspondence should be addressed.
Abstract
Background: Tuberculosis treatment adherence is essential for successful treatment outcomes and control of drug resistance. This study assessed facility-level factors influencing adherence to tuberculosis treatment in Mwingi East Sub-County, Kitui County, Kenya.
Methods: A descriptive cross-sectional study was conducted in Nguni and Waita health centres from January to March 2022. A sample of 148 participants was included, with 74 participants selected from each facility. The two facilities were purposively selected, while participants were selected through random sampling. Data were collected using a structured questionnaire. Chi-square tests were used to assess associations between facility-level factors and treatment adherence, and binary regression analysis was used to determine factors influencing adherence.
Results: Overall, 65.3% of participants adhered to tuberculosis treatment, whereas 34.7% did not. Distance to the health facility was significantly associated with adherence (χ² = 7.872, df = 1, p = 0.005), as was availability of means of transport (χ² = 8.643, df = 1, p = 0.003). In regression analysis, distance (p = 0.002) and means of transport (p = 0.010) remained significant facility-related factors influencing adherence.
Conclusion: Tuberculosis treatment adherence in the study setting was below the stated recommended level. Geographical distance and transport accessibility were the principal facility-level factors associated with adherence, indicating the importance of improving access to treatment services in remote areas.
Keywords: Tuberculosis, treatment adherence, facility-level factors, healthcare access, distance to health facility, transport availability, rural health services, Mwingi East Sub-County, Kitui County, Kenya