Lived experiences of persons on tuberculosis treatment in Nairobi County, Kenya: a mixed methods study.

Publication date: Dec 18, 2024

Tuberculosis program effectiveness is majorly measured by disease severity and treatment response without integrating patient perspectives. Yet, it’s a critical dimension in clinical decision-making that enhances health worker-patient interactions and increases individuals’ sustained engagement with treatment, thereby benefiting the people affected and the wider public by mitigating the infection risk. This study assessed the lived experiences of persons affected by tuberculosis who were on treatment in Nairobi County, Kenya. A cross-sectional study was conducted in May 2023 among 392 persons with drug-susceptible pulmonary tuberculosis in five facilities in Nairobi County. Participants were selected through simple random sampling and interviewed by semi-structured questionnaires and focused group discussions. Data on prevention and control strategies, facility preference, medication burden, interaction with healthcare workers, and the socio-economic effects of the disease were collected. Quantitative data was analyzed descriptively using frequencies, percentages, means, and standard deviations while qualitative data was transcribed, coded, and thematically analyzed. The sample consisted of 245 males and 147 females aged between 3 and 74 years. Despite the high rating of their interactions with the healthcare workers, the findings show insufficient knowledge of the prevention and control strategies of TB. Additionally, food insecurity resulting from an inability to afford recommended meals, medication burden such as high pill burden especially where there are coexisting medical conditions, undesirable taste and size of the TB tablets, adverse drug events, economic burden due to loss of income, and stigma from the family and community were reported to affect treatment outcomes. Treatment outcomes are influenced by multi-level factors such as low knowledge of TB prevention and control strategies, stigma, food insecurity, medication burdens like pill number, size, taste, and adverse drug reactions, facility preference, and economic hardships including loss of income. Understanding the individual needs of persons with TB will help develop interventions that are specific to them for better treatment outcomes.

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Concepts Keywords
Healthcare Adolescent
Kenya Adult
Taste Adverse drug events
Tuberculosis Aged
Workers Antitubercular Agents
Antitubercular Agents
Child
Child, Preschool
Cross-Sectional Studies
Disease severity
Female
Focus Groups
Humans
Kenya
Male
Middle Aged
Patients
Qualitative Research
Socio-economic
Surveys and Questionnaires
Tuberculosis
Tuberculosis
Tuberculosis, Pulmonary
Young Adult

Semantics

Type Source Name
disease MESH tuberculosis
pathway KEGG Tuberculosis
disease MESH infection
disease MESH pulmonary tuberculosis
disease IDO facility
disease MESH adverse drug events
drug DRUGBANK Tropicamide
pathway REACTOME Reproduction
drug DRUGBANK Coenzyme M
disease IDO country
disease MESH relapse
drug DRUGBANK Isoniazid
drug DRUGBANK Rifampicin
drug DRUGBANK Pyrazinamide
drug DRUGBANK Ethambutol
drug DRUGBANK Trestolone
disease MESH treatment failure
disease MESH death
disease IDO quality
disease MESH substance abuse
disease IDO process
drug DRUGBANK L-Valine
disease MESH Marital Status
drug DRUGBANK Cysteamine
drug DRUGBANK Etoperidone
disease MESH hypertension
drug DRUGBANK Pentaerythritol tetranitrate
disease MESH community transmission
disease MESH Aura
drug DRUGBANK Albendazole
disease MESH chronic illness
disease MESH Leprosy

Original Article

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