Gender-Specific Determinants of Tuberculosis Treatment Interruption in an Urban High- Burden African Setting: A Retrospective Cohort Study of Males in Nairobi, Kenya (2019– 2023)
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Background Tuberculosis remains a major global public health challenge despite the availability of effective treatment. Treatment interruption undermines tuberculosis control by increasing disease transmission, treatment failure, and mortality. In Kenya, men account for most tuberculosis cases and experience poorer treatment outcomes, yet determinants of treatment interruption among men in urban settings remain insufficiently studied. In this study we examined the association between comorbidities, therapy-related factors, and health system factors and tuberculosis treatment interruption among males in Nairobi, Kenya. Methods A retrospective cohort study was conducted using routinely collected tuberculosis surveillance data from Nairobi County between January 2019 and June 2023. The data included 24,794 males aged 15 years and older who were newly diagnosed with tuberculosis and notified within Nairobi. The primary outcome was treatment interruption. Variables included comorbidities (diabetes and malnutrition), therapy-related factors (adverse drug reactions), and health system engagement measured by the frequency of clinic visits for sputum monitoring and drug refills. Descriptive statistics summarized patient characteristics, and bivariate associations were assessed using chi-square tests. Multivariable logistic regression models were used to estimate adjusted odds ratios and 95% confidence intervals for factors associated with treatment interruption. Results Overall, 7.9% of patients experienced treatment interruption. Malnutrition was independently associated with higher odds of interruption (adjusted odds ratio 1.23, 95% confidence interval 1.12–1.35). Adverse drug reactions, though based on few recorded events, were strongly associated with interruption (adjusted odds ratio 10.62, 95% confidence interval 3.53–31.95). In contrast, consistent clinic attendance demonstrated a strong protective effect; each additional clinic visit was associated with a substantial reduction in the likelihood of treatment interruption (adjusted odds ratio 0.30, 95% confidence interval 0.28–0.31). Alcohol use and pulmonary tuberculosis were also associated with higher interruption risk. Conclusions Treatment interruption among men receiving tuberculosis care in Nairobi was influenced by both patient vulnerabilities and health system engagement. Integrating nutritional support, strengthening monitoring and management of adverse drug reactions, and expanding patient-centered service delivery models that facilitate regular clinic follow-up may improve treatment continuity. Targeted interventions addressing these factors could strengthen treatment outcomes and support progress toward tuberculosis control goals in urban high-burden settings.
Source: Research Square
Institutions: Centre for Health Solutions, Ministry of Health
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7207618930