Non-adherence and its predictors among pediatric household contacts on tuberculosis preventive therapy in the 3HP era: A multicenter observational study.

IF 3.8 Q2 INFECTIOUS DISEASES

Therapeutic Advances in Infectious Disease Pub Date : 2026-03-05 eCollection Date: 2026-01-01 DOI:10.1177/20499361261426969

Woretaw Sisay Zewdu, Muluken Adela Alemu, Tilaye Arega Moges, Sisay Sitotaw Anberbr, Desalegn Addis Mussie, Abel Temeche Kassaw, Demewoz Kefale, Tigabu Eskeziya Zerihun, Fisseha Nigussie Dagnew, Samuel Berihun Dagnew

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Abstract

Background: Despite prophylactic pharmacotherapy being ranked as the best intervention yet, poor treatment adherence tempers tuberculosis preventive therapy (TPT) efficacy.

Objectives: This study aimed to investigate TPT non-adherence among household contacts and its determinants following the rollout of the 3HP regimen in northwest Ethiopia.

Design: A facility-based multicenter retrospective study was conducted in selected hospitals of northwest Ethiopia from October 17 to February 21, 2024.

Methods: Target populations were TPT-eligible household contacts (⩽15 years old) based on the national tuberculosis treatment guideline. Univariate and multivariate binary logistic regression model was fitted to identify potential predictors. p-Value < 0.05 was employed to adjudicate the significance level.

Results: Among 494 household contacts (HHCs) enrolled in this study, 27.94% were non-adherent. Age (5-10 years: adjusted odds ratio (AOR) (95% CI): 1.92 (1.05-3.19); 10-15 years: AOR (95% CI): 2.04 (1.01-4.12)), parental status (AOR (95% CI): 1.87 (1.02-5.24)), comorbidity (AOR (95% CI): 2.92 (1.08-5.69)), poor nutritional status (AOR (95% CI): 1.30 (1.06-2.43)), adverse drug reactions (AOR (95% CI): 4.01 (1.03-8.20)), adherence support (AOR (95% CI): 1.56 (1.08-6.69)) and TPT regimen type (AOR (95% CI): 4.23 (1.85-6.53)) predicts non-adherence.

Conclusion: Altogether, this study revealed a high level of non-adherence among HHCs in northwest Ethiopia, falling short of the national 2025/26 TPT targets. TPT should be accompanied by firm counseling and routine supervision to improve adherence.

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3HP时代儿童家庭接触者结核病预防治疗依从性及其预测因素：一项多中心观察性研究

背景：尽管预防性药物治疗被列为最好的干预措施，但治疗依从性差影响了结核病预防治疗（TPT）的疗效。目的：本研究旨在调查埃塞俄比亚西北部3HP方案推出后家庭接触者中TPT不依从性及其决定因素。设计：于2024年10月17日至2月21日在埃塞俄比亚西北部选定的医院进行了一项基于设施的多中心回顾性研究。方法：目标人群为符合tpt标准的家庭接触者（≥15岁）。拟合单变量和多变量二元logistic回归模型以确定潜在的预测因子。p值结果：在纳入本研究的494名家庭接触者中，27.94%为非依从性接触者。年龄（5-10岁）：调整优势比（AOR）（95% CI）： 1.92 (1.05-3.19)；10-15岁：AOR (95% CI): 2.04(1.01-4.12))，父母状况(AOR (95% CI): 1.87(1.02-5.24))，共病(AOR (95% CI): 2.92(1.08-5.69))，营养状况不良(AOR (95% CI): 1.30(1.06-2.43))，药物不良反应(AOR (95% CI): 4.01(1.03-8.20))，依从性支持(AOR （95% CI): 1.56(1.08-6.69)）和TPT方案类型(AOR （95% CI): 4.23(1.85-6.53)）预测不依从性。结论：总的来说，本研究揭示了埃塞俄比亚西北部hhc的高依从性，未达到2025/26年国家TPT目标。TPT应辅以坚定的咨询和日常监督，以提高依从性。

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