Patient non adherence to tuberculosis treatment in Sudan: socio demographic factors influencing non adherence to tuberculosis therapy in Khartoum State

Abstract

IntroductionDespite the Treatment pulmonary TB patients, defaulting from treatment may remain the major challenge to control TB. In addition, it increases the risk of drug resistance, relapse, and death and may prolong infectiousness. Our objective was to identify determinants of treatment defaulting among TB patients in Khartoum State, Sudan.MethodsWe conducted a case-control study where the patients defaulting from treatment were considered as ‘cases’ and those completing treatment as ‘controls’. Between May 2010 to May 2011.ResultsThere were 2727 TB patients who attended TB treatment clinics during study period. Out of these 2399 patients (86%) had continued their treatment while 328 patients (14%) had interrupted it. 105 cases were traced and interviewed. In addition 210 patients who had continued their treatment were included (controls). In the multivariate analysis the variables that remained in the model were: residential locality (rural area) (OR 2.58; 95% CI 1.4 -4.67), patients moving or changing address (OR 5.47; 95% CI 2,90- 10-35), absence of family support (OR 2.14; 95% CI 1.12 - 4.11), and occupation (blue collar work) (OR 2.38; 95% CI 1.39 -4.10).ConclusionThe results of this study conclude some socio-demographic factors influence defaulting of TB treatment. We believe that the findings are applicable to current situation of TB management and control in Sudan and other developing countries

High non-compliance rate with anti-tuberculosis treatment: a need to shift facility-based directly observed therapy short course (DOTS) to community mobile outreach team supervision in Saudi Arabia

“…The high success rate appears to justify its incorporation into future NTCPP activities. Although the compliance rate was lower (around 78%) in the facility-based treatment group, it was still in accordance with the 77% of a study conducted by Ali et al [9], and much better than the 60–69% mentioned in some South African and Indian studies [34–37].…”

Non-adherence to anti-tuberculosis treatment, reasons and associated factors among TB patients attending at Gondar town health centers, Northwest Ethiopia

“…However, it is higher than studies done in North Gondar Zone- Northwest Ethiopia (10% and 13.6%) [ 16 ], Khartoum state, Sudan (14%) [ 18 ], State of Parana (8.5% %) [ 19 ], Kosovo (14.5%) [ 6 ], and Thailand (15.6%) [ 8 ]. This difference might be due to differences in socio-demographic characteristic, sample size, study designs, settings and time difference.…”

Mycobacterium tuberculosisComplex Lineage 3 as Causative Agent of Pulmonary Tuberculosis, Eastern Sudan1

“…This patient was the first patient in our study cohort infected with a fully first-line drug-resistant strain, clearly emphasizing the importance of adopting focused TB control measures, including rapid detection and effective treatment of patients with MDR TB, to better contain transmission of MDR strains and prevent development of further drug resistances in the region. However, these measures are far from reality because proper TB diagnostics are virtually absent in eastern Sudan; other impeding factors are social stigma, lack of motivation, and poor awareness of TB treatment, with default rates of 14%-57% (38,39). This situation may even lead to a further aggravation of the drug resistance problem through selection of MDR clones with additional drug resistances in failing treatment regimens and further transmission of fully first-line resistant MDR strains (14,39).…”

“…However, these measures are far from reality because proper TB diagnostics are virtually absent in eastern Sudan; other impeding factors are social stigma, lack of motivation, and poor awareness of TB treatment, with default rates of 14%-57% (38,39). This situation may even lead to a further aggravation of the drug resistance problem through selection of MDR clones with additional drug resistances in failing treatment regimens and further transmission of fully first-line resistant MDR strains (14,39). However, our WGS analysis revealed that MDR isolates did not exhibit mutations mediating resistances to second-line drugs (except for isoniazid/ETH cross resistance), leaving reasonable therapeutic options for patients in eastern Sudan with MDR TB.…”