Patient attitudes towards community-based tuberculosis DOT and adherence to treatment in an urban setting; Kampala, Uganda

Sempeera, Hassard; Anguzu, Ronald; Angella, Kawooya

doi:10.11604/pamj.2017.27.1.11119

Cited by 18 publications

(19 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies have suggested that the impact of stigma on TB treatment adherence varies [72–74], with some suggesting a decrease [75] and others an increase [76, 77] in adherence. The predominance of cross-sectional data limits the ability to tease apart this relationship.…”

Section: Resultsmentioning

confidence: 99%

A scoping review of health-related stigma outcomes for high-burden diseases in low- and middle-income countries

Kane

Elafros²,

Murray

et al. 2019

BMC Med

220

159

View full text Add to dashboard Cite

Background Stigma is associated with health conditions that drive disease burden in low- and middle-income countries (LMICs), including HIV, tuberculosis, mental health problems, epilepsy, and substance use disorders. However, the literature discussing the relationship between stigma and health outcomes is largely fragmented within disease-specific siloes, thus limiting the identification of common moderators or mechanisms through which stigma potentiates adverse health outcomes as well as the development of broadly relevant stigma mitigation interventions. Methods We conducted a scoping review to provide a critical overview of the breadth of research on stigma for each of the five aforementioned conditions in LMICs, including their methodological strengths and limitations. Results Across the range of diseases and disorders studied, stigma is associated with poor health outcomes, including help- and treatment-seeking behaviors. Common methodological limitations include a lack of prospective studies, non-representative samples resulting in limited generalizability, and a dearth of data on mediators and moderators of the relationship between stigma and health outcomes. Conclusions Implementing effective stigma mitigation interventions at scale necessitates transdisciplinary longitudinal studies that examine how stigma potentiates the risk for adverse outcomes for high-burden health conditions in community-based samples in LMICs. Electronic supplementary material The online version of this article (10.1186/s12916-019-1250-8) contains supplementary material, which is available to authorized users.

show abstract

Section: Resultsmentioning

confidence: 99%

A scoping review of health-related stigma outcomes for high-burden diseases in low- and middle-income countries

Kane

Elafros²,

Murray

et al. 2019

BMC Med

220

159

View full text Add to dashboard Cite

show abstract

“…Supervision of PWTB by a community volunteer or family member promotes adherence to medical advice and good treatment outcomes (Soomro et al, 2012). Without a treatment observer, treatment non-adherence is common (Hassard et al, 2017). In Uganda, the National TB and Leprosy Control Program requires PWTB to have a treatment supporter, ideally someone trusted and respected like a family member or friend with whom PWTB declares a good mutual relationship.…”

Section: Discussionmentioning

confidence: 99%

Treatment supporters and level of health facility influence completion of sputum smear monitoring among tuberculosis patients in rural Uganda: A mixed-methods study

Izudi

Tamwesigire

Bajunirwe

2020

International Journal of Infectious Diseases

View full text Add to dashboard Cite

To investigate whether treatment supporters influence the completion of sputum smear monitoring (SSM) among adult persons with bacteriologically confirmed pulmonary tuberculosis (BC-PTB), and to explore the reasons for incomplete SSM according to healthcare workers, persons with BC-PTB, and their treatment supporters in rural eastern Uganda. Methods: A mixed-methods design was used. Quantitative data were abstracted from tuberculosis unit registers, while qualitative data were obtained through key informant interviews with healthcare workers and in-depth interviews with persons with BC-PTB and their treatment supporters. Quantitative data were analyzed with Stata. Qualitative data were transcribed verbatim and analyzed using a thematic content approach. Results: Records were abstracted for 817 patients. Of these, 226 (27.7%) completed SSM. Factors independently associated with SSM completion included having a treatment supporter (adjusted risk ratio (ARR) 2.40, 95% confidence interval (CI) 1.23-4.70), treatment at a district hospital (ARR 1.61, 95% CI 1.04-2.49), treatment at a regional referral hospital (ARR 2.00, 95% CI 1.46-2.73), and every additional year since 2015 (ARR 1.29, 95% CI 1.17-1.43). Reasons for incomplete SSM related to health system, patient, treatment supporter, and healthcare provider factors. Conclusions: Completion of SSM was low. Persons with BC-PTB who have a treatment supporter were more likely to complete SSM compared to those without, and those receiving treatment at higher level facilities were more likely to complete SSM compared to those at lower level ones.

show abstract

“…Stigmatization might limit the acceptability of evriMED. Several studies have shown that levels of stigmatization among TB patients are high [53–55]. We believe that the appearance of the evriMED box might contribute to higher levels of stigmatization.…”

Section: Discussionmentioning

confidence: 80%

Implementation and effectiveness of evriMED with short messages service (SMS) reminders and tailored feedback compared to standard care on adherence to treatment among tuberculosis patients in Kilimanjaro, Tanzania: proposal for a cluster randomized controlled trial

Boer

Ngowi

Chelangwa³

et al. 2019

Trials

View full text Add to dashboard Cite

Background Adherence to tuberculosis (TB) treatment is challenging because of many factors. The World Health Organization has recommended the use of digital adherence monitoring technologies in its End TB Strategy. However, evidence on improving adherence is limited. EvriMED is a real-time medication-monitoring device which was found to be feasible and acceptable in a few studies in Asia. In Tanzania, however, there may be challenges in implementing evriMED due to stigmatization, network and power access, accuracy, and cost effectiveness, which may have implications for treatment outcome. We propose a pragmatic cluster randomized trial to investigate the effectiveness of evriMED with reminder cues and tailored feedback on adherence to TB treatment in Kilimanjaro, Tanzania. Methods/design We will create clusters in Kilimanjaro based on level of health care facility. Clusters will be randomized in an intervention arm, where evriMED will be implemented, or a control arm, where standard practice directly observed treatment will be followed. TB patients in intervention clusters will take their medication from the evriMED pillbox and receive tailored feedback. We will use the ‘Stages of Change’ model, which assumes that a person has to go through the stages of pre-contemplation, contemplation, preparation, action, and evaluation to change behavior for tailored feedback on adherence reports from the device. Discussion If the intervention shows a significant effect on adherence and the devices are accepted, accurate, and sustainable, the intervention can be scaled up within the National Tuberculosis Programmes. Trial registration Pan African Clinical Trials Registry, PACTR201811755733759 . Registered on 8 November 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3483-4) contains supplementary material, which is available to authorized users.

show abstract

Patient attitudes towards community-based tuberculosis DOT and adherence to treatment in an urban setting; Kampala, Uganda

Cited by 18 publications

References 17 publications

A scoping review of health-related stigma outcomes for high-burden diseases in low- and middle-income countries

A scoping review of health-related stigma outcomes for high-burden diseases in low- and middle-income countries

Treatment supporters and level of health facility influence completion of sputum smear monitoring among tuberculosis patients in rural Uganda: A mixed-methods study

Implementation and effectiveness of evriMED with short messages service (SMS) reminders and tailored feedback compared to standard care on adherence to treatment among tuberculosis patients in Kilimanjaro, Tanzania: proposal for a cluster randomized controlled trial

Contact Info

Product

Resources

About