Patient attitudes towards community-based tuberculosis DOT and adherence to treatment in an urban setting; Kampala, Uganda. Pan Afr Med J 2017;27:1
Date
07/28/2017Pubmed ID
28748003Pubmed Central ID
PMC5511727DOI
10.11604/pamj.2017.27.1.11119Scopus ID
2-s2.0-85020180482 (requires institutional sign-in at Scopus site) 11 CitationsAbstract
INTRODUCTION: High Tuberculosis treatment default rate (17%) and sub-optimal treatment completion rates (45%) has burdened Kampala. Nevertheless, there are observable increase in the number of patients on TB DOT; from 6% to 29% in two consecutive annual reports. The main objective was to determine the association of TB patient attitudes towards community-based observers on the TB drug adherence on directly observed treatment for TB in Kampala.
METHODS: A cross-sectional study was carried out in Lubaga division, Kampala. A total of 201 patients in continuation phase of treatment for Pulmonary TB (i.e. 8 to 20 weeks of TB treatment) were included in the study. Patient attitudes were measured using a 4-point Likert scale aggregated into a binary outcome with ''agree'' and ''disagree'' responses. Poisson regression model using a forward fitting approach in STATA v12 was used to determine the association between patient attitude towards CB-DOTs observers and adherence to TB treatment.
RESULTS: Among the 201 patients, 66% reported their treatment was being observed by someone. Relatives were the commonest (82%) treatment observers, 26% were non adherent to their TB treatment. Perceiving ''no need for a treatment observer'' and ''people rejecting TB patients'' were predictors of non-adherence to TB treatment (IRR=1.6,95%CI 1.00-2.57;p=0.048) and (IRR=0.6, 95%CI 0.35-0.95; p=0.019) respectively.
CONCLUSION: Patient's perceived attitude and stigma towards treatment observers contribute to non-adherence on TB treatment. For improved local TB control, more emphasis is needed to build a friendly environment between treatment supporters and patients during the course of TB treatment.
Author List
Hassard S, Ronald A, Angella KAuthor
Ronald Anguzu MD, PhD Assistant Professor in the Institute for Health and Equity department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Antitubercular Agents
Attitude to Health
Community Health Services
Cross-Sectional Studies
Directly Observed Therapy
Female
Humans
Male
Medication Adherence
Middle Aged
Poisson Distribution
Social Stigma
Tuberculosis, Pulmonary
Uganda
Urban Population
Young Adult
