Prevalence of non-adherance to anti-tuberculosis drugs, loss to follow up and associated factors among tuberculosis patients in Jinja Regional Referral Hospital

Abstract

Introduction: Tuberculosis (TB) is a major cause of mortality and morbidity with about 10.4 million new TB cases globally. In Uganda, Long term treatment for TB may predispose to non- adherence as well as loss to follow up. Treatment for tuberculosis involves taking tuberculosis drugs for atleast six months. A study in Mulago National Referral Hospital found out 11.9% patients were non-adherent to Anti –tuberclosis dugs (Batte c et al 2021). Non-adherence to anti-TB drugs and loss to follow up of TB patients results into Multi drug resistance, increased mortality, increased morbidity and increased cost of treatment. Objectives: This study determined the prevalence of non-adherence to anti-tuberculosis drugs, loss to follow up and associated factors among tuberculosis patients in Jinja Regional Referral Hospital. Methods: objecctive 1 and 2used cross sectional study design with qualitative and quantitative methods. Objective 3 and 4 used a retrospective cohort study design with quantitative methods. Non-adherence to TB medication was defined as missing ≥ 10% of the prescribed drugs in a previous month and was assessed using self-reporting. Loss to follow up was defined as TB patient whose treatment was interrupted for two consecutive months or more and was assessed by review of records in the treatment register. Participants were selected using systematic sampling. Samples of 175 and 255 patients were enrolled in sub study 1 and sub study 2 respectively. Results: The prevalence of non-adherence to anti-TB drugs was 17.7% and it was independently highly associated with being from urban settings (AOR: 2.305, 80% CI: 1.261-4.214, p-0.076)and being on HERZ/RHZ drug regimen(AOR: 1.530, 80% CI: 1.202-3.222, p-0.058),while ever being stigmatized (AOR: 0.375, 80% CI: 0.185-0.760, p-0.075), and knowing drug resistance as the danger of not taking TB medication(AOR: 0.278, 80% CI: 0.115-0.670, p-0.062) were negatively associated with non-adherence to anti-TB drugs. The magnitudeof loss to follow up was at 13.8% and loss to follow up was highly associated with being extra pulmonary TB classification (AOR: 2.846, 80% CI: 1.113-7.277, p-0.153) and less likely among female participants (AOR: 0.456, 80% CI: 10.301-0.691, p-0.015). Conclusions: The study found that prevalence of non-adherence to anti-TB drugs was high and it was associated with urban settings, drug regimens and stigmatization. Loss to follow up was high and was influenced by type of TB and gender. The study therefore recommends intensification of health education to communities in their residential area, communities and outreaches.