Limo J, Pahe C, Kathure I, Ndungu L, Mahihu A, Mwashumbe C, Mueni E, Momanyi H
Population Services Kenya, Nairobi, Kenya.
National Tuberculosis Programme, Nairobi, Kenya.
IJTLD Open. 2025 Jan 1;2(1):33-38. doi: 10.5588/ijtldopen.24.0534. eCollection 2025 Jan.
Drug-resistant TB (DR-TB) remains a public health concern in Kenya, with an estimated 2,500 individuals acquiring DR-TB annually. Despite significant progress in DR-TB management, the treatment success rate (TSR) in 2021 stood at 77%, falling short of the 85% target. This low TSR occurs amidst a complex range of treatment challenges, including psychosocial factors. The aim of this study was to assess the impact of integrating psychosocial and economic empowerment interventions into standard DR-TB care.
A convergent mixed-method approach was employed, involving interviews with 217 participants, including persons with DR-TB and key stakeholders, using a structured questionnaire. The study was conducted in Kenya's two highest DR-TB burden counties between October and November 2023.
The study found that 55% of respondents experienced psychological depression during treatment, with financial constraints identified as the primary trigger (70.6%). Only 49% of persons with DR-TB joined psychosocial support groups, and of these, 90% demonstrated improved treatment adherence. Additionally, individuals with DR-TB who participated in income-generating activities had a treatment adherence rate of 95%, compared to 88% among those not engaged in such activities.
Patient-centred approaches involving socio-economic support systems are crucial in addressing treatment adherence barriers, thereby leading to improved treatment outcomes.
耐多药结核病（DR-TB）仍是肯尼亚的一个公共卫生问题，估计每年有2500人感染耐多药结核病。尽管在耐多药结核病管理方面取得了重大进展，但2021年的治疗成功率（TSR）为77%，未达到85%的目标。这种低治疗成功率出现在一系列复杂的治疗挑战中，包括社会心理因素。本研究的目的是评估将社会心理和经济赋权干预措施纳入标准耐多药结核病护理的影响。
采用了一种趋同混合方法，使用结构化问卷对217名参与者进行访谈，包括耐多药结核病患者和关键利益相关者。该研究于2023年10月至11月在肯尼亚耐多药结核病负担最重的两个县进行。
研究发现，55%的受访者在治疗期间经历了心理抑郁，经济困难被确定为主要触发因素（70.6%）。只有49%的耐多药结核病患者加入了社会心理支持小组，其中90%的人治疗依从性得到改善。此外，参与创收活动的耐多药结核病患者的治疗依从率为95%，而未参与此类活动的患者为88%。
以患者为中心的方法，包括社会经济支持系统，对于解决治疗依从性障碍至关重要，从而导致治疗结果得到改善。
