FACTORS CONTRIBUTING TO TUBERCULOSIS TREATMENT DEFAULT IN KALINGALINGA COMPOUND IN LUSAKA ZAMBIA

Abstract Treatment default in tuberculosis care undermines disease control efforts, contributing to ongoing transmission, drug resistance, and adverse health outcomes. Zambia, like many high-burden countries, continues to face challenges with patient adherence to tuberculosis (TB) treatment, especially in urban informal settlements. Despite the national TB program’s efforts, limited research has specifically explored the causes of treatment default in these settings. This study was conducted in Kalingalinga Compound, Lusaka, to identify and understand the factors contributing to default from TB treatment, and to inform the development of more effective, context-specific interventions. Methods A cross-sectional study was conducted among 180 tuberculosis patients who had defaulted on treatment in Kalingalinga Compound, Lusaka. Participants were selected using stratified random sampling based on age, gender, and socio-economic status to ensure adequate representation. Data were collected through structured questionnaires covering socio-demographic characteristics, patient-related factors, and health system influences. The data were analysed using Statistical Package for the Social Sciences (SPSS) Version 26. Descriptive statistics were used to summarise the data, while inferential statistics including chi-square tests and logistic regression were applied to determine associations and predictors of treatment default, with results reported at a 95% confidence interval. Results The study found that male gender (AOR = 1.86, p = 0.041), age group 30–49 years (AOR = 2.74, p = 0.006), and low education levels (AOR = 3.12, p = 0.004) were significant demographic predictors of TB treatment default. Patient-related factors such as fear of stigma (AOR = 4.21, p < 0.001), substance abuse (AOR = 2.85, p = 0.004), and inadequate knowledge of TB (AOR = 3.17, p = 0.004) were strongly associated with default. Health system deficiencies, including inadequate counselling services (AOR = 5.12, p < 0.001), inconsistent medication availability (AOR = 3.89, p < 0.001), and long distances to health facilities (AOR = 3.44, p < 0.001), significantly contributed to non-adherence. Conclusion The findings highlight the multifaceted nature of TB treatment default in Kalingalinga Compound. Interventions should address gender and age-specific barriers, enhance patient knowledge, reduce stigma, and improve healthcare system delivery. Holistic and locally tailored strategies are necessary to improve adherence and reduce the TB burden in Zambia.