Adherence to Tuberculosis Treatment among Migrant Pulmonary Tuberculosis Patients in Shandong, China: A Quantitative Survey Study

Abstract

Adherence to TB treatment is the most important requirement for efficient TB control. Migrant TB patients’ “migratory” nature affects the adherence negatively, which presents an important barrier for National TB Control Program in China. Therefore, TB control among migrants is of high importance.The aim of this study is to describe adherence to TB treatment among migrant TB patients and to identify factors associated with adherence. A total of 12 counties/districts of Shandong Province, China were selected as study sites. 314 confirmed smear positive TB patients were enrolled between August 2nd 2008 and October 17th 2008, 16% of whom were non-adherent to TB therapy. Risk factors for non-adherence were: the divorced or bereft of spouse, patients not receiving TB-related health education before chemotherapy, weak incentives for treatment adherence, and self supervision on treatment. Based on the risk factors identified, measures are recommended such as implementing health education for all migrant patients before chemotherapy and encouraging primary care workers to supervise patients.

Non-Adherence to Anti-TB Drugs and Its Predictors among TB/HIV Co- Infected Patients in Mekelle, Ethiopia

“…However, some studies have shown an association between non-adherence and gender of the patients [9,13]. Some studies indicated that educational status [8,14] and marital status [15] were associated with anti-TB medication adherence unlike this study.…”

Complex relation among Health Belief Model components in TB prevention and care

“…Compared with urban residents, rural-to-urban migrant workers are often lack of medical insurance and are in a disadvantage position in access to health care because of the low income. In Zhou's study, 65% of the migrant TB patients in Shanghai did not have any kind of health insurance 13 and in another study among migrants population in East China, only 6.5% of new pulmonary tuberculosis cases had medical insurance. 4 The situation is worse as the cost of medical care has risen dramatically in recent years.…”

A study of adherence to DOTS regimen among pulmonary tuberculosis patients in West Tripura District

“…This shows that supervised first dose of the week motivates the patients and imparts the importance of compliance to the regimen even in the continuation phase. Similar studies conducted in China, 18 Malaysia, 19 and Nepal 20 showed that when the treatments were supervised as per the guidelines of DOTS it significantly increased the treatment adherence. Hence it is of great importance to advocate the supervised therapy among the patients to improve treatment outcome.…”