# Predictors of treatment failure among patients with pulmonary tuberculosis attending public health facilities in Nairobi county

## TL;DR

The study identifies factors that predict treatment failure in pulmonary tuberculosis patients in Nairobi, Kenya, to help improve public health interventions.

## Contribution

The study identifies affordable predictors of TB treatment failure in a resource-limited setting to inform targeted public health interventions.

## Key findings

- Prior exposure to first-line anti-TB drugs is significantly associated with treatment failure.
- Positive sputum smear at 2 months of treatment is a significant predictor of treatment failure.
- Suboptimal adherence to anti-TB treatment is linked to higher treatment failure rates.

## Abstract

Tuberculosis (TB) is one of the infectious diseases of public health concern globally. Kenya is ranked 15th among the 22 high TB burden countries worldwide, which collectively contribute to 80% of the world’s TB cases. TB Treatment failure is one of the threats to the control of TB. The research aimed at determining affordable predictors of TB treatment failure in a resource limited setting to inform policy in designing public health interventions that are best suited to the country’s needs. To determine the predictors of treatment failure among patients with sputum smear positive pulmonary TB attending selected public health facilities in Nairobi Count. Data was abstracted and summarized from both patients and their medical records, focusing on socio-demographic, behavioral, and clinical exposure data. Data was collected from 4 Sub-counties, a total of 21 public health facilities with high case load of pulmonary TB were reached. Utilizing an unmatched case-control design, the study enrolled 81 patients diagnosed with TB treatment failure (cases) and 162 patients who were declared cured after completing their anti-TB treatment (controls. Strengthen contact tracing, screening, and documentation of TB treatment failure cases. Conduct further studies to elucidate the association between HIV and TB treatment failure. The factors significantly associated with treatment failure in this study encompassed prior exposure to first-line anti-Tuberculosis drugs, positive sputum smear at 2 months of treatment, and suboptimal adherence to anti-TB treatment. These findings contribute valuable insights into the identification of simple predictors of TB treatment failure such as utilizing sputum microscopy or gene expert testing at 2 months of treatment to detect individuals at risk and strengthen the implementation of DOT and TB treatment failure contact tracing protocol.