Determinants of Adherence to Anti-Tuberculosis Treatment among Paediatric Patients in A Kenyan Tertiary Referral Hospital

Abstract

Background: Non-adherence to anti-tuberculosis treatment increases the risk for development of drug resistance, TB recurrence and mortality.

Objectives: This study was designed to determine the rate and predictors of adherence to anti-tuberculosis treatment in paediatric TB patients.

Methodology: This was a cross sectional study carried out at the Kenyatta National Hospital TB clinic. Caregivers of children were interviewed and the patients requested to provide a urine sample which was tested for the presence of isoniazid to verify adherence to medication.

Results: Adherence to anti-TB medications measured by urine testing and self-report, was 91.8% and 44.9% respectively. Patients who administered medication at 24 hour intervals were more likely to adhere to medication (OR = 7.70 [1.85 - 33.33], 95% CI). There was no significant association between adherence and regimen complexity factors, relationship between health care provider and caregiver or the pattern of healthcare delivery. The results suggested a slight agreement between self-reported adherence and the isoniazid urine test (κ= 0.20).

Conclusion: Adherence to anti-TB medication in this population of children was relatively high, and could be attributed to the structures that have been put in place to ensure that TB patients have access to treatment services at the community level.

Keywords: Adherence, tuberculosis in children, anti-tuberculosis treatment, isoniazid