Non-Adherence to Anti-Tuberculosis Treatment and Its Determinants Among Tuberculosis Patients in Tanzania

Non-adherence to anti-tuberculosis (TB) treatment remains a major barrier to effective TB control, contributing to poor treatment outcomes, relapse, and the emergence of drug-resistant TB. Evidence on the magnitude and determinants of non-adherence in Tanzania is limited. This study assessed the prevalence of non-adherence to anti-TB treatment and its associated factors. A hospital-based cross-sectional study was conducted among adult TB patients receiving treatment at Mwananyamala Regional Referral Hospital. 245 participants were recruited using systematic random sampling. Data were collected using a structured interviewer-administered questionnaire. Descriptive statistics were used to summarize participant characteristics. Log-binomial regression analysis was performed to estimate crude and adjusted prevalence ratios (PRs) with 95% confidence intervals (CIs) for factors associated with non-adherence, with significance set at p < 0.05. The prevalence of anti-TB non-adherence was 33.5%. Experiencing side effects (aPR = 1.664; 95% CI: 1.129-2.449) and poor knowledge about TB (aPR = 1.704; 95% CI: 1.062-2.732) were associated with increased likelihood of non-adherence. Family support was associated with a lower likelihood of non-adherence (aPR = 0.696; 95% CI: 0.487-0.994). Other socio-demographic, clinical, and health system factors were not significantly associated with non-adherence. Non-adherence to anti-TB treatment remains high in Tanzania, affecting approximately one-third of patients. Medication side effects and poor TB knowledge are key drivers of non-adherence, while family support plays a protective role. Interventions focusing on patient education, effective management of treatment side effects, and strengthening family and community support systems are essential to improve adherence and enhance TB control efforts.