Assessment of Tuberculosis Preventive Therapy (TPT) Uptake among Healthcare Workers at Meru Teaching and Referral Hospital, Kenya: Barriers and Recommendations

Abstract

Background: Healthcare workers (HCWs) in high-burden tuberculosis (TB) settings face elevated occupational risk of latent TB infection (LTBI). Although Tuberculosis Preventive Therapy (TPT) reduces progression risk by 60–90%, uptake among Kenyan HCWs remains suboptimal. Aim: To assess TPT uptake, adherence, knowledge, and factors influencing uptake among HCWs at Meru Teaching and Referral Hospital (MeTRH), Kenya. Methods: A descriptive cross-sectional survey was conducted among 214 HCWs selected by simple random sampling from a target population of 560 (response rate 94.3%). Data were collected using a structured self-administered questionnaire aligned with World Health Organization TPT guidelines. Descriptive statistics, Pearson’s chi-square tests, Spearman’s correlations, and binary logistic regression (unadjusted and adjusted) were performed. The level of statistical significance was set at p < 0.05. Results: Only 39.3% (84/214) of respondents had ever initiated TPT despite 78.5% reporting occupational TB exposure. Among initiates, 66.7% completed the full course; side effects (35.7%), work-related time constraints (21.4%), and financial limitations (17.9%) were the main reasons for non-completion. Formal training was reported by 44.9% and was significantly associated with uptake (χ² = 16.25, p < .001). Self-rated knowledge was also associated with uptake (χ² = 13.34, p = .010). After adjustment, formal training remained the strongest independent predictor (adjusted OR 2.71, 95% CI 1.47–4.99, p = .001). Gender, age, and stigma were not statistically significant. Conclusions: TPT uptake and completion among HCWs at MeTRH, Kenya, remain inadequate and are constrained primarily by modifiable programme-related factors, especially gaps in structured training, rather than demographic characteristics. Mandatory recurrent training, strengthened pre-initiation counselling, proactive follow-up, workplace-based dispensing, and expanded access to shorter regimens are recommended.