Facility Level Factors Influencing Adherence to TB Treatment in Mwingi East Sub County, Kitui County, Kenya

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.