Factors Influencing Treatment Adherence among TB Patients at Mbale Regional Referral Hospital in Mbale city, Eastern Uganda
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Date
2026
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Busitema University
Abstract
Background: Tuberculosis (TB) remains a major global public health challenge despite being preventable and curable. Poor adherence to TB treatment contributes significantly to treatment failure, relapse, prolonged infectiousness, increased transmission, and the emergence of drug-resistant TB, particularly in low- and middle-income countries such as Uganda. In Eastern Uganda, treatment adherence remains suboptimal despite the implementation of patient-centered TB control interventions.
Aim of the Study: The study aimed to determine the prevalence and factors influencing treatment adherence among TB patients attending Mbale Regional Referral Hospital in Mbale City, Eastern Uganda.
Methodology: A hospital-based cross-sectional study employing quantitative methods was conducted among 121 TB patients receiving treatment at Mbale Regional Referral Hospital. Participants aged 18 years and above who had been on anti-TB treatment for at least one month were selected using systematic random sampling. Data were collected using a structured interviewer-administered questionnaire programmed in KoBoCollect. The questionnaire captured socio-demographic characteristics, patient-related factors, health system factors, and socio-economic and cultural determinants of treatment adherence. Data were cleaned, coded, and analyzed using Stata statistical software. Descriptive statistics were used to summarize participant characteristics, while bivariable and multivariable analyses were conducted to determine factors associated with treatment adherence. Crude and adjusted prevalence ratios with corresponding 95% confidence intervals were computed, and statistical significance was considered at p-value <0.05.
Results: A total of 121 participants were enrolled in the study, of whom 43 (35.5%) were adherent to TB treatment while 78 (64.5%) were non-adherent, indicating a low prevalence of treatment adherence. Most participants were aged 35 years and above (55.4%), and the study population was almost equally distributed by sex. At bivariable analysis, level of education, herbal medicine use, availability of TB medicines, transport challenges, and stigma or discrimination were significantly associated with treatment adherence. In multivariable analysis, participants involved in other occupations were significantly less likely to adhere to treatment compared to business persons (APR=0.56, 95% CI: 0.34–0.92, p=0.022). Herbal medicine users were also less likely to adhere to treatment compared to non-users (APR=0.51, 95% CI: 0.27–0.96, p=0.038). Similarly, participants who experienced stigma or discrimination had significantly lower adherence to treatment compared to those who did not experience stigma (APR=0.31, 95% CI: 0.17–0.57, p<0.001).
Conclusion: The prevalence of treatment adherence among TB patients attending Mbale Regional Referral Hospital was low. Herbal medicine use, stigma or discrimination, and occupation were significant factors associated with treatment adherence among the study participants.
Recommendation: Healthcare providers and hospital management should strengthen adherence counselling, patient follow-up, and psychosocial support programs to improve TB treatment adherence. Community sensitization initiatives should also be enhanced to reduce stigma and discourage the use of herbal medicine during TB treatment.
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Chebet, J. K. (2026). Factors Influencing Treatment Adherence among TB Patients at Mbale Regional Referral Hospital in Mbale city, Eastern Uganda: A cross-sectional study. Busitema University