Assessment of Tuberculosis Preventive Therapy (TPT) Uptake among Healthcare Workers at Meru Teaching and Referral Hospital, Kenya: Barriers and Recommendations
Lilian Kinya Kinyua *
School of Health Sciences, Meru University of Science and Technology, Meru, Kenya.
Jane Rutto
School of Health Sciences, Meru University of Science and Technology, Meru, Kenya.
Elias Kinoti
School of Health Sciences, Meru University of Science and Technology, Meru, Kenya.
Fredrick Otieno
School of Health Sciences, Meru University of Science and Technology, Meru, Kenya.
*Author to whom correspondence should be addressed.
Abstract
Background: Healthcare workers (HCWs) in high-burden tuberculosis (TB) settings face elevated occupational risk of latent TB infection (LTBI). Although Tuberculosis Preventive Therapy (TPT) reduces progression risk by 60–90%, uptake among Kenyan HCWs remains suboptimal.
Aim: To assess TPT uptake, adherence, knowledge, and factors influencing uptake among HCWs at Meru Teaching and Referral Hospital (MeTRH), Kenya.
Methods: A descriptive cross-sectional survey was conducted among 214 HCWs selected by simple random sampling from a target population of 560 (response rate 94.3%). Data were collected using a structured self-administered questionnaire aligned with World Health Organization TPT guidelines. Descriptive statistics, Pearson’s chi-square tests, Spearman’s correlations, and binary logistic regression (unadjusted and adjusted) were performed. The level of statistical significance was set at p < 0.05.
Results: Only 39.3% (84/214) of respondents had ever initiated TPT despite 78.5% reporting occupational TB exposure. Among initiates, 66.7% completed the full course; side effects (35.7%), work-related time constraints (21.4%), and financial limitations (17.9%) were the main reasons for non-completion. Formal training was reported by 44.9% and was significantly associated with uptake (χ² = 16.25, p < .001). Self-rated knowledge was also associated with uptake (χ² = 13.34, p = .010). After adjustment, formal training remained the strongest independent predictor (adjusted OR 2.71, 95% CI 1.47–4.99, p = .001). Gender, age, and stigma were not statistically significant.
Conclusions: TPT uptake and completion among HCWs at MeTRH, Kenya, remain inadequate and are constrained primarily by modifiable programme-related factors, especially gaps in structured training, rather than demographic characteristics. Mandatory recurrent training, strengthened pre-initiation counselling, proactive follow-up, workplace-based dispensing, and expanded access to shorter regimens are recommended.
Keywords: Tuberculosis preventive therapy, latent TB infection, healthcare workers, uptake, adherence, knowledge, Kenya, occupational health