Assessment of Patient Adherence to Tuberculosis Treatment in Dessie Referral Hospital, South Wollo, Ethiopia
DOI:
https://doi.org/10.18034/mjmbr.v2i2.391Keywords:
Adherence, Tuberculosis, EthiopiaAbstract
Background: Poor adherence to treatment of tuberculosis is common despite various interventions aimed at improving treatment completion. Lack of a comprehensive and holistic understanding of barriers to and facilitators of, treatment adherence is currently a major obstacle to find effective solutions.
Objective: The purpose of this study is to assess patient adherence to anti-tuberculosis treatment on DOTS regimen and factors that affect adherence.
Methods: In this study both quantitative methods was used. For the quantitative method the records of a cohort of patients were followed retrospectively to see the treatment outcome; patient registration book from January 2007 to June 2010 was reviewed.
Result: out of 1050 patients enrolled in the study 207(21.6%) of patients were non adherent and 188(90.82%) of the non-adherent patients were in the continuation phase of treatment. Patients outside 10km radius were 3.423 times non adherent than TB patients living in Dessie town and within 10km radius.
Conclusion: Patients’ decisions to stop taking medication were influenced by a number of interacting factors. Adherence to the long course of tuberculosis treatment is a complex, dynamic phenomenon with a wide range of interacting factors impacting on treatment taking behavior. The findings of this study could help inform the development of patient centered interventions and of interventions to address structural barriers to treatment adherence. It has been seen also that the non-adherence rate of this study setting is high, and the main determinant factors of treatment non adherence are address and HIV status of the patient.
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Abule T. Patient non-compliance with therapeutic regimens and factors of non-compliance in Gondar. Eth.J HD. 2000; 14(1):1-6 DOI: https://doi.org/10.4314/ejhd.v14i1.9924
Amahar National Regional State Health Beauro annual report: 2007- 2009. Unpublished.
American Thoracic Society/Centers for Disease Control andPrevention/Infectious Diseases Society of America. (2003). Treatment of tuberculosis. American J Res Crit Care Med.; 167:603–662. DOI: https://doi.org/10.1164/rccm.167.4.603
Asebe G, Ameni G and Tafess K. 2014. Ten years tuberculosis trend in Gambella Regional Hospital, South Western Ethiopia. Malaysian Journal of Medical and Biological Research, 1, 18-24. DOI: https://doi.org/10.18034/mjmbr.v1i1.371
Biru ES and Bernt L. (2007). Determinants of treatment adherence among smear-positive pulmonary tuberculosis patients in Southern Ethiopia. Plos Med.; 4(2): e37. DOI: https://doi.org/10.1371/journal.pmed.0040037
Burman WJ, Cohn DL, Rietmeijer CA, Judson FN, Sbarbao JA, and Reves RR. (1997).Noncompliance with directly observed therapy for tuberculosis: epidemiology and effect on the outcome of treatment. Chest.; 111:1168–73. DOI: https://doi.org/10.1378/chest.111.5.1168
CDC. (1993). Approaches to anti-TB therapy South Carolina and New York. 1986—1991.MMWR; 42: 74-5, 81.
Chaulk CP. and Kazandjia VA. (1998). Directly observed therapy for treatment completion of pulmonary tuberculosis. Consensus statement of the public health tuberculosis guidelines panel. JAMA.; 279:943. DOI: https://doi.org/10.1001/jama.279.12.943
Daiyu H, Xiaoyun L, Chen J, Wang Y, Wang T, Zeng W, Smith H., and Garner P. (2008). Direct observation and adherence to TB treatment in Chongqing, China: a descriptive study. Health policy and planning; 23(1):43-55. DOI: https://doi.org/10.1093/heapol/czm038
Daniel OJ, Oladap OT, and Alausa OK. (2006). Default from TB treatment program. Niger J Med.; 15(1):63-7. DOI: https://doi.org/10.4314/njm.v15i1.37119
De Vos PF (2002) Tuberculosis, adherence behavior the inner city. Unpublished Master’s thesis, University of Alberta, Canada.
Demissie M, Kebede D. Defaulting from tuberculosis treatment at the Addis Ababa Tuberculosis Center and factors associated with defaulting from treatment. Ethiopian MedJ1994; 32:97-106.
Diwan VK and Thorson A. Sex, gender, and tuberculosis. Lancet, 1999; 353: 1000—01. DOI: https://doi.org/10.1016/S0140-6736(99)01318-5
Elizabeth LC, Barbara M, Gavin JC, and Kevin MD.(2006).TB in sub Saharan Africa: Opportunities, challenges, and change in the era of antiretroviral treatment. Lancet; 367: 926-37. DOI: https://doi.org/10.1016/S0140-6736(06)68383-9
Ethiopia. (2010). Racing to contain MDRTB weekly report. Addis Ababa Ethiopia: 20(2): 48-53.
Farmer P (1997). Social scientists and the new tuberculosis. SocSci Med Vol. 44, No. 3, pp. 347-358 DOI: https://doi.org/10.1016/S0277-9536(96)00143-8
FMOH. (2008). TB, Leprosy and TB/HIV prevention and control program, manual. 4th ed. AddisAbaba,Ethiopia.
Fredrick AD, Mary T, Seter S, and Lenganji S. (2004).An assessment of factors contributing to treatment adherence and knowledge of TB transmission among patients on TB treatment. BMC.; 4: 68. DOI: https://doi.org/10.1186/1471-2458-4-68
Gemberu G. (2000). An assessment of Reasons for defaulting from Treatment among TB patients on follow up treatment at Agaro health center. Unpublished.
Getahun H. Medical and social consequences of tuberculosis in rural Ethiopia. Abstract. Ethiop. Med. J. 1997: 35:207.
Getinet KA. (2005).Study on DOTS strategy in terms of reducing defaultes at Ambo hospital west shoa zone, Western Ethiopia. Unpublished.
Horne R, Weinman J (2002) Self – regulation and self-management in asthma: Exploring the role of illness perceptions and treatment beliefs in explaining non-adherence to presenter medication. Psychol Health 17: 17-32. DOI: https://doi.org/10.1080/08870440290001502
Jaiswal A, Singh V, Ogden JA, Porter JDH, Sharma PP, Sarin R, Arora VK, Jain RC (2003) Adherence to tuberculosis treatment: lessons from the urban setting of Delhi, India. Trop Med Int Health 8: 625-633. DOI: https://doi.org/10.1046/j.1365-3156.2003.01061.x
Khan A, Walley J, Newell J, Imdad N (2000) Tuberculosis in Pakistan: socio-cultural constraints and opportunities in treatment. SocSci Med 50: 247-254. DOI: https://doi.org/10.1016/S0277-9536(99)00279-8
Klink WB (1969) Problems of regimen compliance in tuberculosis treatment, Unpublished PhD thesis, Columbia University, United States.
Leimane V, and Leimans J. (2006). Integrated DOTS and DOTS plus programs. Euro surveillance, 11(3): 29- 33. DOI: https://doi.org/10.2807/esm.11.03.00610-en
Lienhardt C, Ogden J, Sow O (2003) Rethinking the social context of illness: interdisciplinary approaches to tuberculosis control. In M, Gandy A, Zumal (Eds,) The Return of the White Plague: Global Poverty and the ‘New’ Tuberculosis (pp, 195-291) London: Verso.
Lienhardt C., MannehK..BouchierV..LahaiG.. Milligan P.J. and Mc Adam K.P. Factors determining the outcome of treatment of adult smear-positive tuberculosis cases in the Gambia. Int. J Tubercule. Lung.Dis. 1998: 2:7 12-7 18.
Marais BJ, Van ZS, and Schaaf HS. (2006). Adherence to isoniazid preventive chemotherapy: a prospective community based study. BMJ J.; 91:762-5. DOI: https://doi.org/10.1136/adc.2006.097220
Mesfin M.M, Tasew WT, Tareke GI, Mulugeta WM.G, and Richard M. (2005). Community knowledge, attitude, and practice on PTB and their choice of treatment supervisor in Tigray, North Ethiopia. Ethiop. J. Health dev. 2005; 19(special issue): 20-21 DOI: https://doi.org/10.4314/ejhd.v19i4.9994
Metabesi Z (2004) Living with TB: the career of the tuberculosis patient in the free state, SA. Unpublished PhD thesis, University of the Free State.
Ministry of Health of Ethiopia. (2005).TB/HIV implementation guideline. Addis Ababa Ethiopia
Munro SA, Lewin SA, Smith HJ, Engel ME, Fretheim A, and Volmink J. (2007). Patient adherence to tuberculosis treatment: A Systematc Review of Qualitative Research. PLoS Med. 4(7):e238. DOI: https://doi.org/10.1371/journal.pmed.0040238
Robert MJ, Christopher BS, Leach CG, Masea K, Dennis HO,and Charles LD. (2004). TB treatment outcomes DOT compared with Self administered therapy. American journal of respiratory and clinical med.; 170:561-566 DOI: https://doi.org/10.1164/rccm.200401-095OC
Shargie EB, Lindtjorn B. (2005). DOTS improves treatment outcomes and service coverage for tuberculosis in south Ethiopia: A retrospective trend analysis. BMC public Health. 5: 62. DOI: https://doi.org/10.1186/1471-2458-5-62
Sumartojo E (1993). When tuberculosis treatment fails: a social behavioural account of patient adherence. Am Rev Respir Dis 147: 1311-1320. DOI: https://doi.org/10.1164/ajrccm/147.5.1311
Sumartojo E (2000). Structural factors in HIV prevention: concepts, examples and implications for research. AIDS, 14 (suppl 1): S3-S10. DOI: https://doi.org/10.1097/00002030-200006001-00002
Teklu B. Reasons for failure in treatment of pulmonary tuberculosis in Ethiopians. Tubercle. 1984: 65: 17-2 1. DOI: https://doi.org/10.1016/0041-3879(84)90026-6
Tulsky JP, Hahn JA, Long HL, Chambers DB, Robetson MJ, Chesney MA, Moss AR (2004), can the poor adhere? Incentives for adherence to TB prevention in homeless adults. Int J Tuberc Lung Dis. 8:83-91.
Tulu T and Kahissay MH. 2014. Assessment of Multidrug Resistance Tuberclosis Treatment Outcome in St. Petre’s Tuberclosis Specialized Hospital, Addis Ababa, Ethiopia. Malaysian Journal of Medical and Biological Research, 1, 97-107. DOI: https://doi.org/10.18034/mjmbr.v2i1.381
Vermeire E, Hearnshaw H, van Royen P, Denekens J (2001), Patient adherence to treatment: three decades of research. A comprehensive review. J ClinPharmacolTher 26:331-342. DOI: https://doi.org/10.1046/j.1365-2710.2001.00363.x
Volmink J, Garner P (2006) Directly observed therapy for treating tuberculosis. Cochrane Database Syst Rev 2: CD003343.
Volmink J and Garner P. (2006).Directly observed therapy for treatig TB. Cochrane Database syst. Rev. ; 2: CD003343. DOI: https://doi.org/10.1002/14651858.CD003343.pub2
Weis SE, Slocum PC, Blais FX, King B, Nunn M, Matny GB, Gomez E, and Foresma BH. (1994).The effect of directly observed therapy (DOT) on the rate of drug resistance and relapse in TB.N Engl J Med; 330: 1179-84. DOI: https://doi.org/10.1056/NEJM199404283301702
WHO (2003) Adherence to long term therapies; evidence for action. Geneva
WHO (2005) Global tuberculosis control: surveillance, planning and financing: WHO report. Geneva: 349 :258.
WHO (2010) Report on MDRTB Nairobi Kenya 19, March 2010.
Xu W, Lu W, Zhou Y, Zhu L, Shen H, and Wang J. Adherence to TB treatment among pulmonary TB patients: a qualitative and quantitative study. BMC Health Serv Res. 2009; 9:169. DOI: https://doi.org/10.1186/1472-6963-9-169
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