Prevalence of TB medication non-adherence and associated factors among adults attending a Regional Referral Hospital in Dar es Salaam, Tanzania

Abstract

Abstract Background Non-adherence to tuberculosis (TB) medication is a significant public health problem, associated with poor treatment outcomes such as drug resistance, relapse, increased morbidity and mortality. Ensuring adherence to TB medication is key for treatment success. To effectively promote adherence, it is important to have a clear understanding of the factors associated with non-adherence. Objective The study aimed to determine the prevalence and factors associated with non-adherence to medications among TB patients attending a Regional Referral Hospital in Dar es Salaam. Methodology A cross-sectional study was conducted at the TB clinic of this hospital. A total of 362 participants were selected using a systematic random sampling method. Data were collected through face-to-face interviews after obtaining informed consent. Non-adherence was assessed based on responses to four questions addressing forgetfulness, intentional breaks and recent missed doses. Participants answering “No” to all questions were classified as adherent; a “Yes” to any indicated non-adherence. Factors independently associated with non-adherence were determined using multivariable modified Poisson regression analysis. Results The median age of study participants was 38 years (interquartile range: 30–46 years). The majority, 267 (73.8%) were aged between 18 and 45 years. Most participants, 246 (68%), were male. The prevalence of non-adherence to TB medications was 14.4%. In the multivariable modified Poisson regression model, non-adherence to TB medications was positively associated with methadone use (adjusted prevalence ratio (aPR) = 3.04; 95% CI: 1.69–5.46), spending 1–2 h at the hospital (aPR = 4.44; 95% CI: 1.16–16.97) and reporting a strong healthcare worker-patient relationship (aPR = 2.55; 95% CI: 1.56–4.17). Conclusions Non-adherence to TB medication was relatively low compared to previous reports from sub-Saharan Africa (18.4% – 30.5%). Methadone use, shorter clinic visits duration and a very good relationship with HCWs were significantly associated with non-adherence to TB medications. These findings highlight the need to integrate substance use services with TB care and to explore how healthcare interactions and clinic processes influence treatment adherence. Clinical trial number Not applicable.