The prevalence and factors associated for anti-TB treatment non-adherence among pulmonary TB patients in public health care facilities in South Ethiopia: a cross-sectional study
Abstract
Background
Evidence exists pointing
out how non-adherence to treatment remains a major hurdle to
efficient tuberculosis control in developing countries. Many
tuberculosis (Tb) patients do not complete their six-month
course of anti-tuberculosis medications and are not aware of the
importance of sputum re-examinations, thereby putting themselves
at risk of developing multidrug-resistant and extensively
drug-resistant forms of tuberculosis and relapse. However, there
is a dearth of publications about non-adherence towards anti-Tb
medication in these settings. We assessed the prevalence of and
associated factors for anti-Tb treatment non-adherence in public
health care facilities of South Ethiopia.
Methods
This was a cross-sectional
survey using both quantitative and qualitative methods. The
quantitative study was conducted among 261 Tb patients from 17
health centers and one general hospital. The qualitative aspect
included an in-depth interview of 14 key informants. For
quantitative data, the analysis of descriptive statistics,
bivariate and multiple logistic regression was carried out,
while thematic framework analysis was applied for the
qualitative data.
Results
The prevalence of
non-adherence towards anti-Tb treatment was 24.5%. Multiple
logistic regression analysis demonstrated that poor knowledge
towards tuberculosis and its treatment (AOR = 4.6, 95%CI:
1.4-15.6), cost of medication other than Tb (AOR = 4.7, 95%CI:
1.7-13.4), having of health information at every visit (AOR = 3,
95% CI: 1.1-8.4) and distance of DOTS center from individual
home (AOR = 5.7, 95%CI: 1.9-16.8) showed statistically
significant association with non-adherence towards anti-
tuberculosis treatment. Qualitative study also revealed that
distance, lack of awareness about importance of treatment
completion and cost of transportation were the major barriers
for adherence.
Conclusions
A quarter of TB patients
interrupted their treatment due to knowledge, availability and
accessibility of DOTS service. We recommend creating awareness
about anti-Tb treatment, and decentralization of drug pick-ups
to the lowest level of health institutions.
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Source:
BMC Public Health
