Defaulting rate and associated factors among patients attending methadone maintenance clinics in Nairobi City County, Kenya

Sharon Akoth Owuor; Isaac J. M. Mwanzo; Alloys S. S. Orago

doi:10.18203/2394-6040.ijcmph20243281

Authors

Sharon Akoth Owuor Department of Family Medicine Community Health and Epidemiology, Kenyatta University, Nairobi, Kenya
Isaac J. M. Mwanzo Department of Family Medicine Community Health and Epidemiology, Kenyatta University, Nairobi, Kenya
Alloys S. S. Orago Department of Medical Microbiology and Parasitology, Kenyatta University, Nairobi, Kenya

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20243281

Keywords:

Associated factors, Defaulting, Methadone maintenance treatment

Abstract

Background: Defaulting from MMT clinics is a major public health problem affecting people globally resulting in high transmission of HIV, hepatitis B and C, increased crime rate, and reduced productivity of an individual. However, defaulting rate in the MMT clinics in Nairobi City County in Kenya remains understudied. This study was aimed at determining the defaulting rate and its associated factors from MMT clinics in Nairobi City County, Kenya.

Methods: A cross-sectional analytical study design was employed. Simple random sampling, purposive sampling and stratified sampling were utilized in this study. A sample size of 388 patients was randomly selected. A semi-structured questionnaire was used for data collection. SPSS V.24 was used for data analysis.

Results: A response rate of 95% (369) was achieved. Most were youths aged 18-35yrs (60.7%, n=224), male (76.4%, n=282), married (39%, n=144), Christians (51.8%, n=191). The defaulting rate was 53% with marital status, religion, education level, and income source being significantly associated with defaulting (p<0.05).

Conclusions: The defaulting rate from MMT was relatively high in Nairobi City County. Defaulting was linked to education, cocaine use before MMT and concurrent drug use during treatment. A number of interventional strategies were proposed by this study to improve MMT programming.

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References

UNODC. World Drug Report, 2014. Available at: https://www.unodc.org/documents/wdr2014/World_Drug_Report_2014_web.pdf. Accessed on 9 June 2014.

Durand L, Boland F, O’Driscoll D, Bennett K, Barry J, Keenan E, et al. Factors associated with early and later defaulting from methadone maintenance treatment in specialist addiction clinics: a six-year cohort study using proportional hazards frailty models for recurrent treatment episodes. Drug Alcohol Depend. 2021;219:108-66.

Mogaka B, Kiburi SK, Mutinda M, Kendagor M. Estimate cost of providing methadone maintenance treatment at a methadone clinic in Nairobi, Kenya: Direct costs. Pan Afr Med J. 2021;38:84-91.

Li L, Wu Z, Liang L, Lin C, Luo S, Cao X, et al. An intervention trial targeting methadone maintenance treatment provider to improve clients’ treatment retention in China. Drug Alcohol Depend. 2019;194:143-50.

Quyen BT, Nguyen LT, Phuong VT, Hoang LT. Quality of life in methadone maintenance treated patients in Long An, a southern province of Vietnam. Health Psychol Open. 2020;7:2055102920953051.

Ngarachu EW, Kiburi SK, Owiti FR, Kangethe R. The prevalence and pattern of cannabis use among patients attending a methadone treatment clinic in Nairobi, Kenya. Kabarak J Res Innov. 2022;12:85-101.

Degenhardt L, Grebely J, Stone J, Hickman M, Vickerman P, Marshall BD, et al. Global patterns of opioid use and dependence: Harms to populations, interventions, and future action. Lancet. 2019;394:1560-79.

UNODC. World Drug Report, 2022. Available at: https://www.unodc.org/res/wdr2022/MS/WDR22_Booklet_1.pdf. Accessed on 1 October 2022.

Oguya FO, Kenya PR, Ongecha F, Mureithi P, Musyoka H, Muraguri N, et al. Rapid situational assessment of people who inject drugs (PWID) in Nairobi and coastal regions of Kenya: a respondent-driven sampling survey. BMC Public Health. 2021;21:113.

Kiburi S. Sociodemographic, clinical profile and the association with retention in treatment among patients receiving methadone treatment in Nairobi, Kenya. Afr J Alcohol Drug Abuse. 2021;3:54-78.

Sapkota B, Tulachan P, Ojha S, Chapagai M, Dhungana S. Factors influencing client retention in methadone maintenance treatment clinics in the Kathmandu Valley. J Psychiatr Assoc Nepal. 2019;8:9-14.

Mlaki DA, Mbwambo JK, McCurdy S, Masao FA, Kaduri PA. Twelve-month treatment retention and associated factors: a comparison of 2 medically assisted therapy clinics in Dar es Salaam, Tanzania. J Addict Med. 2022;16:e382-9.

Kiiru RN, Waithima CW, Mwangi PK. Factors influencing polydrug use among methadone-assisted therapy patients in selected clinics in Nairobi, Kenya. J Sci Innov Creat. 2022;1:10-31.

Le TA, Ha GH, Le MQ, Tran LM, Pham DT, Tran NH, et al. Treatment adherence amongst drug users attending public and private methadone maintenance clinics in a northern province of Vietnam. Subst Abus Treat Prev Polic. 2020;15:30-54.

Roux P, Lions C, Vilotitch A, Michel L, Mora M, Maradan G, et al. Correlates of cocaine use during methadone treatment: Implications for screening and clinical management (ANRS Methaville study). Harm Reduct J. 2016;13:98-121.

Eibl JK, Wilton AS, Franklyn AM, Kurdyak P, Marsh DC. Evaluating the impact of prescribed versus nonprescribed benzodiazepine use in methadone maintenance therapy: Results from a population-based retrospective cohort study. J Addict Med. 2019;13:182-7.

Knight D, Nkya IH, West NS, Yang C, Kidorf M, Latkin C, et al. Economic, social, and clinic influences on opioid treatment program retention in Dar es Salaam, Tanzania: a qualitative study. Addict Sci Clin Pract. 2023;18:372-4.

Kermode M, Choudhurimayum RS, Rajkumar LS, Haregu T, Armstrong G. Retention and outcomes for clients attending a methadone clinic in a resource-constrained setting: a mixed methods prospective cohort study in Imphal, northeast India. Harm Reduct J. 2020;17:49-61.