Tuberculosis in Kenya

The study aimed to investigate the factors influencing tuberculosis (TB) medication adherence among patients at Kiambu Level Five Hospital in Kiambu County, Kenya. Despite the presence of various treatment interventions, non-adherence to TB medication remains a persistent challenge in the region. Using an analytical cross-sectional design, the study sampled 141 participants systematically from the hospital's TB clinic.

Demographically, the majority of participants were male (59.6%), while females accounted for 40.4%. The average age was 33.8 years (±12.60), with the largest age group being 25–34 years (39.0%), followed by 18–24 years (22.0%). Only a small proportion (2.8%) were aged 65 and above. Most participants were married (57.4%), while 27.0% had never married, and 15.6% were divorced or separated. Age was found to have a statistically significant association with adherence to TB medication (χ² = 22.873, df = 5, p = 0.001), whereas sex and marital status did not show significant associations.

In terms of education, 34.0% had completed secondary education, 31.9% had college or tertiary education, 22.0% had primary-level education, and 4.3% had attained university-level education. The average monthly income was Ksh. 19,990 (±18,532), with nearly half (46.8%) earning between Ksh. 10,000 and 19,000. A notable portion (17.1%) earned less than Ksh. 10,000, while another 17.7% earned more than Ksh. 30,000. Regarding employment, 27.7% were in informal (casual) work, 24.8% in formal employment, and 22.0% were unemployed. Both occupation (χ² = 27.056, df = 5, p = 0.001) and ownership of agricultural land (χ² = 4.626, df = 1, p = 0.031) were significantly associated with adherence to medication.

Knowledge about TB varied among participants, with 41.8% having moderate knowledge, 39.0% low knowledge, and only 19.2% possessing high knowledge. The mean knowledge score was 58.425 (±16.417). Knowledge was significantly linked to adherence (χ² = 10.102, df = 2, p = 0.006), with those having moderate and high knowledge levels being 14.8% and 18.2% more likely, respectively, to adhere to medication compared to those with low knowledge.

Health-related behaviors revealed that 30.5% had experienced a recent ailment, most commonly flu (32.6%), followed by diarrhea (18.6%), vomiting (18.6%), pneumonia (16.3%), and headache (14.0%). Only 4.3% of participants smoked tobacco, and 15.6% consumed alcohol—predominantly males (77.3%).

Medication adherence behaviors showed that 75.0% of respondents had high adherence, and 25.0% had moderate adherence. There were no reports of low adherence. However, some challenges were reported: 4.4% occasionally forgot to take their medication, 10.2% missed doses for reasons other than forgetfulness, 4.4% forgot medication while traveling, 1.4% missed a dose the previous day, 3.7% felt hassled about sticking to the regimen, and 5.2% often had difficulty remembering to take all their medication.

Further statistical analysis indicated that age significantly influenced adherence (p = 0.042, t = 2.071), with older participants showing better adherence. Although sex had a minor positive association with adherence, it was not statistically significant. Income showed a significant positive correlation with adherence (p = 0.010, t = 2.654), suggesting that higher income levels support better adherence. Interestingly, while occupation was not a significant predictor (p = 0.182), owning agricultural land positively influenced adherence (p = 0.025, t = 2.293).

In conclusion, the study identified age, income, land ownership, and TB knowledge as key determinants of TB medication adherence in Kiambu County. The findings emphasize the need for targeted interventions focusing on education, economic support, and knowledge dissemination to improve adherence rates and ultimately enhance TB treatment outcomes.

Source: Kamui, I. N. (2025). Determinants of tuberculosis medication adherence among TB patients at Kiambu Level Five Hospital, Kiambu County, Kenya. Journal of Medical and Health Sciences, 4(1), 1–15.