Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. In 2021, 10.6 million individuals got infected with TB globally and TB incidence in Kenya was 251 cases per 100,000 population. Between 2019–2021, Mandera County had 1223 cases of which 68 (6%) were lost to follow up (LTFU) and 55 died giving case fatality rate of 4.5%. The LTFU and mortality could be attributed to lack of access to TB care that may also result in drug resistant TB. Access to TB care is the timely use of all the healthcare services provided at the TB clinic for patients to achieve the desired outcome which is to complete treatment.
Objectives: To determine patient related and health-facility-related factors associated with access to TB care among TB patients in Mandera East sub-County.
Method: A cross-sectional study was used. The target population were individuals aged 18 years and above who were diagnosed with tuberculosis in Mandera County. Using a sampling frame of 1223 from TIBU system, a total of 394 TB patients were selected using simple random sampling. Structured questionnaires were used to collect data from the selected patients on health facility and patient related variables. Descriptive analysis was done by calculating frequencies and proportions for categorical variables. Inferential analysis was conducted using prevalence odds ratio (POR).
Results: Most respondents were male at 64.5% (231/358), urban residents were 83.2% (298/358). Those who had means of transport to the facility were 83.2% (298/358) while those with fare were 20.9% (75/358). Those who did not experience adverse drug reactions (ADR) were 79.9% (286/358). Majority, 70.4% (252/358) had a TB clinic in their town of residence, while 77.7% (278/358) were able to access the TB clinic because they lived within 5 kilometers radius to a clinic. Those who experienced lack of privacy at the health facility were 16.5% (59/358). Females had higher odds of access to TB care in comparison to males (POR=3.5, P=0.004). Respondents from urban setup had higher odds of accessing TB care in comparison to the ones from rural residence (POR=82.0, P<0.001). Respondents with formal occupation had 0.6 times odds of accessing TB care in comparison to the ones with informal occupation (POR=0.6, P=0.242). The odds of accessing TB care was higher in those who had means of transport in comparison to the ones who did not have (POR=82.0, P<0.001). Those who had privacy at the health facility had higher odds of accessing TB care (POR=66.4, P<0.001) in comparison to the ones who did not.
Conclusion: Being female, urban residence, transport to the facility, lack of privacy and availability of TB clinic were more likely to access TB care. Formal occupation was not significantly related to access to TB care in Mandera East sub-County.