The spotlight is back on the high number of tuberculosis patients who default on treatment, increasing the risk of infecting others and causing drug-resistant TB to spread.
A research study conducted in Nairobi by experts from the Ministry of Health and Kenyatta University, Department of Pathology, insists that the rate of default should be a cause of concern to the Government and organisations waging war on TB.
"Poor adherence to treatment means patients remain infectious for longer, are more likely to relapse or succumb to tuberculosis and could result in treatment failure as well as foster emergence of drug resistant tuberculosis," concludes the study.
The research zeroed in on 1,978 patients, including 945 defaulters randomly selected in 30 high volume sites within Nairobi.
The purpose of the study was to determine the duration tuberculosis patients stay in treatment before defaulting and factors associated with default in Nairobi.
Of 945 defaulters, 22.7 per cent (215) and 20.4 per cent (193) abandoned treatment within first and second months (intensive phase) of treatment respectively.
Successful treatment of tuberculosis involves taking anti-tuberculosis drugs for at least six months.
Kenya is among countries with high tuberculosis burden globally. In 2008, Kenya was ranked 13th among the 22 countries with high TB burden globally.
Patients whose treatment is interrupted for two consecutive months or more, as defined by World Health Organisation, are reported as ‘Out of Control’ at the end of treatment period.
Among 120 defaulters interviewed for the study published in an online journal Biomedcentral, 16.7 per cent (20) attributed their default to ignorance, 12.5 per cent (15) to travelling away from treatment site, 11.7 per cent (14) to feeling better and 10.8 per cent (13) to side-effects.
The researchers include Bernard Muture, Margaret Keraka, Peter Kimuu, Ephantus Kabiru, Victor Ombeka and Francis Oguya.
Other factors blamed for default include limited access to health care, waiting too long for services and lack of sufficient food.
Further, the weekly collection of drugs comes with transport costs to hospital. Majority (66.1 per cent) of the study patients were unemployed indicating resources for transport could have been a challenge.
By Ally Jamah
The Standard