Prevalence and factors associated with non-adherence to multi-drug resistant tuberculosis (MDR-TB) treatment at Mulago National Referral Hospital, Kampala, Uganda
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
African Health Sciences
Abstract
In Uganda, 12% of previously treated TB cases and 1.6% of new cases have MDR-TB and require specialized
treatment and care. Adherence is crucial for improving MDR-TB treatment outcomes. There is paucity of information on
the extent to which these patients adhere to treatment and what the drivers of non-adherence are.
Methods: We conducted a cohort study using retrospectively collected routine program data for patients treated for MDRTB
between January 2012 – May 2016 at Mulago Hospital. We extracted anonymized data on non-adherence (missing 10%
or more of DOT), socio-economic, demographic, and treatment characteristics of the patients. All participants were sensitive
to MDR-TB drugs after second line Drug Susceptible Testing (DST) at entry into the study. Factors associated with
non-adherence to MDR-TB treatment were determined using generalized linear models for the binomial family with log link
and robust standard errors. We considered a p- value less than 0.05 as statistically significant.
Results: The records of 227 MDR- TB patients met the inclusion criteria, 39.4% of whom were female, 32.6% aged between
25 – 34 years, and 54.6% living with HIV/AIDS. About 11.9% of the patients were non-adherent. The main driver
for non-adherence was history of previous DR-TB treatment; previously treated DR-TB patients were 3.46 (Adjusted prevalence
ratio: 3.46, 95 % CI: 1.68 - 7.14) times more likely to be non-adherent.
Conclusion: One in 10 MDR-TB patients treated at Mulago hospital is non-adherent to treatment. History of previous DRTB
treatment was significantly associated with non-adherence in this study. MDR-TB program should strengthen adherence
counselling, strengthen DST surveillance, and close monitoring for previously treated DR-TB patients.
Description
Keywords
Non-adherence, Multi-drug resistant tuberculosis, Treatment
Citation
Batte C, Namusobya MS, Kirabo R, Mukisa J, Adakun S, Katamba A. Prevalence and factors associated with nonadherence to multi-drug resistant tuberculosis (MDR-TB) treatment at Mulago National Referral Hospital, Kampala, Uganda. Afri Health Sci. 2021;21(1):238-47. https://dx.doi.org/10.4314/ahs.v21i1.31