Relationship between health care system setup and adherence to tuberculosis treatment in Western Kenya

Abstract

Despite the concerted effort to detect and treat TB, there are still poor treatment outcomes in a significant number of the patients. These poor treatment outcomes have been significantly linked to poor adherence to TB treatment. Therefore, a cross sectional descriptive study was conducted in Kisumu East District to establish the relationship between health care system factors and TB treatment adherence among patients aged above 18 years attending TB clinics in Kisumu East District, in Western Kenya. A total sample of 250 respondents was surveyed. An interviewer administered structured questionnaire was used to collect data from the respondents on the social, demographic aspects of the patients and structural aspects of TB care. The data was analyzed using descriptive statistics for socio-demographic variables and bivariate analysis to determine the health care system factors that significantly predicted treatment adherence. P values, Odds Ratios with 95% confidence interval (CI) were used to demonstrate significance of association between the health system related predictors and adherence. Significance was assumed at P value ≤0.05. Behaviour of the health care workers (OR: 3.6; 95% CI1.1-12.1; P=0.031) and waiting time (OR: 7; 95%CI: 3-18; P<0.001) were the significant determinants of adherence related to health care set up. Health care system setup has a number of immediate modifiable predictors of adherence like waiting time and staff behaviour. It is important to establish the key predictors of adherence that are linked to health care system for quality TB treatment and care services in every TB care setting.