Understanding predictors of medication adherence and treatment outcomes among TB patients in the Western Region, Ghana: strategies for strengthening TB control efforts

Background Tuberculosis (TB) remains a major public health challenge in low- and middle-income countries, including Ghana. In the Effia-Kwesimintsim Municipality of the Western Region, high treatment default rates raise concerns about multidrug-resistant TB. Since medication adherence is key to successful treatment, this study examined the predictors of TB treatment adherence and their associations with treatment outcomes. Methods A cross-sectional study was conducted among 139 adult TB patients identified from the district TB register. Data were collected using structured questionnaires at participants' households. Data was analyzed using STATA version 17. Descriptive statistics were used to present results in tables and charts. Chi-square tests and multivariable logistic regression were employed to assess associations between socio-demographic, community, and health system variables and TB medication adherence and treatment outcomes. Variables with p Results The overall adherence rate was 84.2%, while treatment success stood at 55%. Key predictors of adherence included employment status (aOR = 25.75, 95% CI: 1.71-87.59), presence of a treatment supporter (aOR = 14.21, 95% CI: 2.23-19.70), and receiving a support package from a health facility (aOR = 13.83, 95% CI: 1.11-17.02). Adherence was strongly associated with treatment success (aOR = 5.22, 95% CI: 1.22, 12.48), and employed individuals had increased odds of successful treatment (aOR = 3.1, 95% CI: 1.28-7.57). Fear of stigma, economic barriers, and lack of social support were reported as primary reasons for non-adherence. Conclusion Medication adherence is strongly associated with TB treatment success, surpassing individual factors like age and gender. The findings highlight the importance of strengthening adherence through social support systems, economic assistance, community-based interventions, and employment-related policies. Enhancing access to care through CHPS initiatives, aligning TB care with Ghana's universal health coverage and social protection frameworks, may support better health outcomes and contribute to achieving national and global TB control targets.