Factors affecting patients' compliance to anti-tuberculosis treatment in Yemen

Anaam, Mohamed Saif; Ibrahim, Mohamed Izham Mohamed; Serouri, Abdul Wahed Al; Aldobhani, Adel

doi:10.1111/jphs.12012

Cited by 11 publications

(20 citation statements)

References 11 publications

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“…Other studies have found long travel times to be associated with poor treatment adherence [24, 25]. This is a potential problem for people undergoing treatment in the Balimo region.…”

Section: Resultsmentioning

confidence: 99%

The social determinants of tuberculosis treatment adherence in a remote region of Papua New Guinea

Diefenbach-Elstob

Plummer

Dowi³

et al. 2017

BMC Public Health

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BackgroundPapua New Guinea (PNG) is a diverse and culturally-rich country with severe infrastructural and health problems. Tuberculosis (TB) is widespread, and the number of cases with drug resistance is rising. Treatment adherence is known to be important for both effective treatment and limiting the emergence of drug resistance. The aim of this study was to construct a matrix of the factors that act as facilitators or barriers to TB treatment adherence in a remote region of PNG.MethodsThe study was based in the Balimo region of the Western Province. People known to have undergone TB treatment, as well as staff involved in managing people with TB, were asked to participate in an in-depth interview about their experiences. Purposive sampling was used to identify a diverse range of participants, from different geographic locations, social backgrounds, and with successful and unsuccessful treatment outcomes. The interview data was analysed based on grounded theory methodology.ResultsThe study identified a range of factors that influence TB treatment adherence, with these being classified as personal, systems, and sociocultural. These factors are presented along with suggested recommendations for adaptations to DOTS-based treatment in this region. Barriers included the challenges associated with travel to treatment sites, and the difficulties of undertaking treatment alongside the daily need to maintain subsistence food production. However, facilitators were also identified, including the positive influence of religious beliefs, and high confidence in the ability of DOTS-based treatment to cure TB.ConclusionsDocumenting the wide range of factors that influence treatment adherence in a severely affected remote population will assist in improving TB control. These results provide impetus for further community-based efforts aimed at improving access to TB diagnosis and treatment, and maintaining successful treatment outcomes in the face of emerging drug resistance.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3935-7) contains supplementary material, which is available to authorized users.

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“…Other studies have found long travel times to be associated with poor treatment adherence [24, 25]. This is a potential problem for people undergoing treatment in the Balimo region.…”

Section: Resultsmentioning

confidence: 99%

The social determinants of tuberculosis treatment adherence in a remote region of Papua New Guinea

Diefenbach-Elstob

Plummer

Dowi³

et al. 2017

BMC Public Health

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“…Another similar study was conducted in Yemen to determine the role of gender and literacy in the diagnosis and reported that a high percentage of TB patients are illiterate [ 23 ]. Contrary to our study, a survey was conducted to find the factors that affect the compliance of TB patients to treatment in Yemen reported; the survey reported that the majority of patients were literate [ 24 ]. Our finding is considered normal, considering that the majority of people in Yemen are illiterate.…”

Section: Discussionmentioning

confidence: 98%

“…Our study shows that the majority of TB patients were below 45 years old, demonstrating that those productive ages are under a major risk of contracting TB in Yemen. A similar prospective study was conducted in Yemen to identify the risk factor associated with non-compliance to TB treatment and found that the majority of TB patients enrolled in the study were of productive age [ 24 ]. Another study was conducted in North India to assess the HRQoL Pulmonary TB and reported that the majority of patients were in their productive age [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Likewise, Study performed in Yemen to find the effectiveness of khat in mood by using Hospital anxiety and depression scale found that khat leads to mood disturbance due to sympathomimetic effect of cathinone on CNS [ 56 ]. Moreover, a Study performed in Yemen indicates that khat chewing result in health complication such as stress, sleep disturbances, and anorexia [ 19 ] [ 57 ] [ 58 ] [ 24 ], which may affect the QoL of patients and consequently result in poor treatment outcome.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Health-Related Quality of Life among Tuberculosis Patients in Two Cities in Yemen

et al. 2016

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BackgroundThe health-related quality of life (HRQoL) of Tuberculosis (TB) patients is important because it directly influences the outcome of TB patients in several aspects. The current study aims to evaluate and to find the factors influencing the HRQoL of TB patients in two major TB-prevalent cities (Taiz and Alhodidah) in Yemen.MethodsA prospective study was conducted, and all TB patients meeting the HRQoL criteria were asked to complete the HRQoL SF-36 survey. The records of TB patients were examined for disease confirmation, and a follow-up was consequently performed for patients during treatment between March 2013 and February 2014 in Taiz and Alhodidah Cities. HRQol scores were calculated by using QM scoring software version 4.5, in which the physical component score (PCS) and mental component score (MCS) were obtained. The scores obtained between 47–53 normal based score (NBS) were considered equivalent to the US normal score. Low scores indicate the poor health situation of TB patientsResultsA total of 243 TB patients enrolled in the study at the beginning of the treatment. A total of 235 and 197 TB patients completed the questionnaire at the end of the intensive phase (I.P.) and continuation phase (C.P.), respectively. The final dropout rate was 16.2%. The mean PCS and MCS scores at the beginning of treatment were low, thus showing the poor health situation of TB patients. The mean PCS scores at the beginning of treatment, end of I.P., and end of treatment were (36.1), (44.9), and (48), respectively. Moreover, the mean MCS score at the beginning of treatment, end of I.P., and end of treatment were (35.1), (42.2), and (44.3), respectively. The result shows that significant increases are observed at the end of I.P. for PCS and MCS because of the treatment and slight changes at the end of C.P. Despite this finding, the MCS score remains below the normal range (47), thus indicating a significant risk of depression among TB patients. Furthermore, general linear repeated measure ANOVA was performed for selected variables, to examine the changes of PCS and MCS over time. It was found that Alhodiah city, chewing khat habit, stigmatization, and duration of treatment more than six months were greatly associated with low mean MCS score of TB patient, indicating great risk of depression which may result in poor treatment outcome.ConclusionTB patients in Yemen were found to have poor QoL, with a significant likelihood of depression. Highly risk depression was found among TB patients in Alhodiah city, khat chewers, stigmatization and having a duration of treatment more than 6 months. Therefore, additional efforts should be made to improve their QoL because it may affect the final clinical outcome of patients.

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“…[8] Non-adherence to treatment often results from inadequate knowledge or understanding of the disease and its treatment. [9][10][11][12][13][14] Literature indicates that TB control can significantly be enhanced if more concern is given to improve knowledge and attitudes towards disease. [15] To the best of our knowledge and through extensive literature review, no studies have been reported from Yemen focusing on knowledge of TB and its treatment.…”

Section: Introductionmentioning

confidence: 99%

Knowledge of Tuberculosis and Influencing Factors among New Pulmonary Tuberculosis Patients in Yemen

Anaam¹,

Alsahali²,

Alfadly³

et al. 2018

JPPCM

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Background: Tuberculosis (TB) remains a serious cause of illness in Yemen. Knowledge is believed to be associated with patients' willingness to seek treatment and adherence to treatment. Objectives: To assess patients' knowledge of TB and identify possible influencing factors. Methods: A cross-sectional study was conducted for a period of three months (October to December, 2013) to assess knowledge of TB among new TB patients in five Yemini regions. Descriptive results were presented as frequencies and percentage. Kolmogorov-Smirnov test (K-S test) was used for normality test. Chi-square (Χ 2) testing and Kruskal-Wallis H test were used to describe differences between groups. Multiple linear regression was performed to identify factors influencing the knowledge. Multicollinearity was considered before performing multiple linear regression. SPSS version 18 (Chicago, IL) was used for data analysis. Results: A total of 450 patients with a mean age (±SD) of 32.7 (±13.6) years (range 15-80 years) were interviewed; 59.3% of respondents were males, 64.4% of respondents reported receiving TB information from the health staff. Slightly more than half (55.6%) of the patients' were aware about the method of TB transmission. The majority (82.2%) of the respondents knew that TB is a curable disease. About two thirds (71.8%) of the tuberculosis patients were found to be aware about duration of treatment. About 271 (60.2%) of the respondents were categorized as having a good level of knowledge about TB. The median knowledge score was 4.0. Kruskal-Wallis H test showed significant differences in the medians between groups with regard to gender, age, education status, marital status, living status, stigma and receiving health education. However, multiple linear regression analysis showed that age, education status, stigma and receiving health education at health centers were the only factors that significantly influencing the knowledge. About 44% of the patients expressed fear of being known as tuberculosis patients in the community. Conclusion: The knowledge of TB and its treatment was generally moderate with a median score of 4. Majority of the patients knew that TB is a curable disease with regular treatment and recommended duration. This will psychologically encourage them to adhere to treatment instructions.

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Factors affecting patients' compliance to anti-tuberculosis treatment in Yemen

Cited by 11 publications

References 11 publications

The social determinants of tuberculosis treatment adherence in a remote region of Papua New Guinea

The social determinants of tuberculosis treatment adherence in a remote region of Papua New Guinea

Evaluation of Health-Related Quality of Life among Tuberculosis Patients in Two Cities in Yemen

Knowledge of Tuberculosis and Influencing Factors among New Pulmonary Tuberculosis Patients in Yemen

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