Predictors of TB treatment failure among pulmonary patients attending Public Health Facilities Nairobi County, Kenya

Abstract

Background: Tuberculosis (TB) is one of the infectious diseases of public health concern globally. Kenya is ranked 15th among the 22  high TB burden countries worldwide. TB Treatment failure is one of the threats to the control of TB.

Aim/Goal: To determine affordable predictors of TB treatment failure in a resource limited setting to inform policy in designing public  health interventions that are best suited to the country’s needs.

Objective(s): To determine the predictors of treatment failure among patients with sputum smear positive pulmonary TB.

Design: Data was abstracted and summarized from both patients and their medical records, focusing on socio-demographic, behavioral,  and clinical exposure data.

Setting: Data was collected from 4 Sub-counties, a total of 21 public health facilities with high case load of  pulmonary TB were reached.

Subjects: Utilizing an unmatched case-control design, the study enrolled 81 patients diagnosed with TB  treatment failure (cases) and 162 patients who were declared cured after completing their anti-TB treatment (controls).

Main Outcome  Measures: The factors significantly associated with treatment failure in this study encompassed prior exposure to first-line anti- Tuberculosis drugs, positive sputum smear at 2 months of treatment, and suboptimal adherence to anti-TB treatment.

Results and  Conclusion: These findings contribute valuable insights into the identification of simple predictors of TB treatment failure such as  utilizing sputum microscopy testing at 2 months of treatment to detect individuals at risk and strengthen the implementation of DOT and  TB treatment failure contact tracing protocols.