An assessment of factors contributing to treatment adherence and knowledge of TB transmission among patients on TB treatment

Abstract

BackgroundThe treatment guidelines for tuberculosis treatment under Directly Observed Treatment, Short-course (DOTS) have been a common strategy for TB treatment in Zambia. The study was carried out in Ndola, Zambia, to investigate factors contributing to treatment non-adherence and knowledge of TB transmission among patients on TB treatment, in order to design a community-based intervention, that would promote compliance.MethodsA household-based survey was conducted in six randomly selected catchment areas of Ndola, where 400 out of 736 patients receiving TB treatment within the six months period, were recruited through the District's Health Management Board (DHMB) clinics. All patients were interviewed using a pre-tested structured questionnaire, consisting of i. Socio-demographic characteristics ii. Socio-economic factors iii. Knowledge about TB transmission and prevention iv. Patterns in health seeking behaviour and v. TB treatment practices at household level.ResultsMost male TB patient respondents tended to be older and more educated than the female TB patient respondents. Overall, 29.8% of the patients stopped taking their medication. There were 39.1% of the females and 33.9% of the males, who reported that TB patients stopped taking their medication within the first 2 months of commencing treatment. Age, marital status and educational levels were not significantly associated with compliance. The major factors leading to non-compliance included patients beginning to feel better (45.1% and 38.6%), lack of knowledge on the benefits of completing a course (25.7%), running out of drugs at home (25.4%) and TB drugs too strong (20.1% and 20.2%). There was a significant difference [OR = 1.66, 95% CI 1.23, 2.26] in TB knowledge, with more males than females reporting sharing of cups as a means for TB transmission, after adjusting for age, marital status and educational levels. Significantly [p = 0.016] more patients who had resided in the study for less than two years (59%) were more likely to report mother to child transmission of TB, compared to 41.2% of those who had been in the area for more than 2 years.ConclusionThis study established that 29.8% of TB patients failed to comply with TB drug taking regimen once they started feeling better.

Commnity knowledge, attitudes and practices towards tberculosis and its treatment inMpwapwa District, central Tanzania

“…In this study, contracting TB through sexual acts is likely to have been associated with the similarity of the disease and HIV/AIDS, which is widely known to be contracted through unprotected sexual acts. Similar findings regarding belief in TB transmission through sexual acts have been observed in a study in Zambia (Kaona et al, 2004).…”

“…DOTS as a strategy, entails that medication is taken in the presence of the the care provider (WHO, 2002). Providing TB patients with drugs at distanced health facilities and later sending them to continue taking their treatment at home under supervision, poses serious challenges on compliance (Kaona et al, 2004).…”

Efeito do incentivo alimentício sobre o desfecho do tratamento de pacientes com tuberculose em uma unidade primária de saúde no município de Duque de Caxias, Rio de Janeiro

“…(11) In developing countries, the preoccupation with adherence to treatment has also motivated studies aimed at identifying the principal factors involved. (8,12,13) Socioeconomic aspects and obstacles to obtaining treatment, as well as limited understanding of the disease and of chemotherapy, were found to be common factors. In the present study, a more specific approach was not taken, due to the lack of such data on the medical charts.…”

“…Within this context, various authors have attempted to define the incentives to adhere to treatment. (8)(9)(10) Among poor populations in the United States, financial and nonfinancial incentives have both been shown to improve adherence to the supervised treatment known as directly observed therapy, short-course (DOTS). (9) Another study conducted in the United States showed that the increasing number of benefits offered during treatment resulted in an inversely proportional decrease in treatment abandonment rates.…”

Knowledge, attitude and practices regarding pulmonary tuberculosis in a rural area of Tamil Nadu, India: a cross sectional study

“…[2][3][4] Apart from these, lack of financial sources, poor accessibility to health facilities and lack of knowledge about the symptoms, mode of spread and available treatment among the population affects the health seeking behaviour of patients and might promote delay in diagnosis, improper treatment, poor compliance to medications and development of drug resistance. 5,6 According to the World Health Organisation (WHO), TB is the leading infectious cause of death worldwide and there were 10.4 million TB cases and 1.7 million deaths in the year 2016. 7 Access to TB care has improved worldwide and TB mortality rate has shown 37% decline since 2000.…”