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 < 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.