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

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 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.