Determinants of Tuberculosis Treatment Adherence Among Patients Receiving Tuberculosis Treatment at Federal University Teaching Hospital, Lafia, Nasarawa State

Background Tuberculosis (TB) remains a public health challenge in Nigeria, ranking first in Africa and sixth globally. In Nasarawa State, rising cases and suboptimal treatment outcomes highlight adherence gaps, with over 7,000 cases reported in recent years. Poor adherence contributes to treatment failure, drug-resistance, and transmission. This study investigated determinants of TB treatment adherence among patients at Federal University Teaching Hospital (FUTH) Lafia, using the PRECEDE model to assess predisposing, reinforcing, and enabling factors. Methods A descriptive cross-sectional design was used, surveying 156 TB patients via systematic random sampling from a population of 216. Data were collected using a structured questionnaire covering demographics, knowledge, social support, quality of care, and adherence. Reliability was confirmed with a Cronbach’s alpha of 0.793. A 97.44% response rate (152/156) was achieved. Data was analyzed using SPSS version 27.0, with descriptive statistics, Pearson’s correlation, and logistic regression (significance at p ≤ 0.05). Ethical approvals were obtained from Babcock University and FUTH Lafia. Results Findings revealed moderate TB knowledge (mean = 7.76 ± 2.058). Emotional support was strong (92.8% received medication reminders), but practical support was weak (23.6%). Quality of care scored highest (mean = 17.32 ± 1.836). Treatment adherence was 71.5% (mean = 8.58 ± 1.811), below WHO’s 90% target. Logistic regression showed quality of care significantly predicted adherence (AOR = 2.386, 95% CI = 1.564–3.640, p < 0.001); knowledge and social support were non-significant. Conclusion The study concluded that quality of care is the strongest determinant of adherence, recommending tailored education, practical support, and further research.