Tuberculosis Medication Adherence among TB-HIV Co-infected Persons undergoing Concomitant Treatment in Selected Local Governments in a North Central State in Nigeria (original) (raw)
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Journal of Tuberculosis Research, 2020
Background: The WHO recommended DOTS has been proven to be very effective in the treatment of tuberculosis (TB) patients. However, despite its effectiveness, non-adherence to the treatment regimen remains a major concern in TB management. This has great consequences which include persistent infectiousness, higher rates of treatment failure, continued transmission, drug resistance, and untimely death. The aim of this study is to examine the factors and behavioural patterns that contribute to treatment adherence among TB patients in Kano State, Nigeria. Methods: A qualitative study design which included two focus group discussions (FGDs) and four key informant interviews (KIIs) were adopted for this study. In total, 20 participants were interviewed comprising 16 focus group discussion participants (8 patients on treatment and 8 individuals who have been cured) divided into two groups and four key informant interviews with 4 health workers in the selected treatment facilities. Data analysis was done by translating and transcribing the responses from the FGDs and KIIs. The transcribed data was analysed using a thematic framework procedure. Results: It was observed that having a good treatment supporter who was effective and very supportive was the most important factor contributing to treatment adherence. Other identified factors that contributed to treatment adherence included: good communication by health personnel, social support from relatives and communities, little or no side effects from drug usage, low cost of transportation to the health facilities, a positive mind set towards drug usage and treatment, support and motivation from health workers, feelings of wellness during treatment, and a balanced diet. All the respondents agreed that treatment adherence had far reaching effects on positive treatment outcomes. Conclusion:
EAS journal of pharmacy and pharmacology, 2024
Background of the study: Tuberculosis is curable and preventable as long as the infected patients take their medication as prescribed without interruption and all preventive measures observed both within the hospital and the community. Adherence to tuberculosis treatment by tuberculosis patients is key to the global control of tuberculosis. Methods: This cross sectional study was carried out at the Mile-4 hospital, a tuberculosis treatment center in Abakaliki, Ebonyi State, Nigeria. A total of 125 tuberculosis patients were recruited for the study and self-administered questionnaires and focus group discussions were used to get responses from the patients. Descriptive and inferential statistics with the aid of SPSS version 20 was used for data analysis. Results: Major reasons given for missing appointment and not following treatment schedule closely were lack of money, long distance from health facility, inadequate health education and non provision of food. Lack of money and long distance from health facility accounted for 60.9% of the reasons for not adhering to the treatment schedule by the tuberculosis patients. Conclusion: Adherence to tuberculosis treatment can be facilitated by extensive health education, minimal financial support and provision of food to tuberculosis patients. Distance from health facilities is also very important in the adherence to anti tuberculosis therapy by tuberculosis patients.
Abstract Tuberculosis remains one of the major health problems in many tropical countries. An estimated eight to ten million people develop overt tuberculosis annually worldwide as a result of primary infection, endogenous reactivation or exogenous re-infection. About half of all patients with TB do not complete treatment and this contributes to prolonged infectiousness, drug resistance, relapse and death. This study is aimed at assessing the adherence of TB patients to anti-TB medications as well as the factors influencing drug adherence in a tertiary health care institution in South-Eastern Nigeria. A descriptive cross-sectional study was conducted among 217 TB patients in Nnamdi Azikiwe University Teaching Hospital, Nnewi. Information was obtained using a self-administered and interviewer administered semi-structured questionnaire. The mean age of the respondents is 36.1 ± 13.3 years. More of the respondents were females (58.1%), while 41.9% were males. It was observed that 74.2% had never failed to take their anti-TB drugs while 24.2% agreed they had failed to take their drugs. The major reasons for failure to take drugs were no money for transport to collect new drugs and forgetfulness by 32.7% of the respondents respectively. The factors which influenced drug adherence were educational qualification, average monthly income, illhealth as a financial burden and receiving HIV drugs (P < 0.05). Adherence towards anti-TB medications is good. However, efforts need to be intensified to educate and encourage TB patients to adhere strictly to their drugs as this will be of great value to them and the community at large.
Adherence, Treatment and Health Communication among Tuberculosis Patients in Ekiti State, Nigeria
International Journal of Research, 2014
Health literacy is a challenge worldwide and most especially in Nigeria. Health of many in the society may be at risk because of the difficulty some patients experience in understanding and acting on health information which, in turn, has a negative impact on health outcomes and the entire health care system. This study seeks to examine the role of health communication on treatment of tuberculosis patients in Ekiti as well as the role of provider- patient relationship on treatment satisfaction. Theoretically, the study employed Health Belief Model, Symbolic Interactionism and Social Action Theory in explaining the phenomenon. Quantitative and qualitative research methods were adopted in the study. The study respondents consisted of patients and health providersthat were drawn from tertiary, secondary and primary health institutions with DOTS centers in Ekiti. 509 patients were selected in the study. The researcher made use of key informant interview of some medical professionals from 4 out of the 8 selected hospitals. The study was complimented with in-depth interview. The quantitative data were analyzed using SPSS V18 while qualitative data were analyzed using manual content analysis. The findings revealed that majority of the respondents (80.6%) were aware of their right to be informed about their health status while 18.7% were ignorant of their right. Total of 91.1% of the patients got their information through different sources. Consequently, the study provides better information that will improve communication between patients and providers, as well as impact on health outcomes and the entire health care system.
Tuberculosis is a global threat that contributes to disease burden especially in developing countries including Nigeria. Effect of non adherence to directly observed treatments short course (DOTS) leads to continuous infectivity, development of drug resistance and increased mortality associated with Tuberculosis (TB). Therefore, the objective of this study is to identify factors influencing non adherence to directly observed treatments short course among patients with tuberculosis. The study utilized descriptive research design survey. The sample consisted of 163 patients with Tuberculosis using simple random sampling technique. A selfdeveloped structured questionnaire with reliability index of 0.832 was used to collect data. Data collected were coded and analysed using SPSS version 25. Descriptive statistics of frequencies, percentages were used to answer the research questions while the stated hypotheses were analysed using regression. The results from the study revealed high level of non-adherence to DOTS, low level of knowledge on TB treatment. The results further revealed a significant relationship between socio-demographic factors, knowledge of TB treatment and non-adherence to TB medications at 0.05 level of significance. Therefore, the study established a very high level of non-adherence of TB patients to DOTS which is associated with sociodemographic factors and level of knowledge on TB treatments. It is recommended that the stakeholders in the management of TB patient should ensure frequent health educations, increase the numbers of health worker, reduce the duration of time spent in the hospital, improve follow up strategies, and other policies that can lead to improve adherence of TB patients to DOTs
Tuberculosis Research and Treatment
Annually, ten million cases of tuberculosis (TB) and about 1.8 million mortalities are recorded. Adherence to TB treatment not only reduces death outcomes but prevents prolonged sickness, transmission to others, and the development of multidrug-resistant TB. This study is aimed at determining the rate of treatment adherence, knowledge of TB infection, and the possible factors influencing adherence to TB treatment in the Ketu North District in the Volta Region of Ghana. A cross-sectional study design was employed. A semistructured questionnaire was used to obtain data from respondents. Adherence to TB treatment and knowledge level about TB infection were assessed. A Chi-square test analysis was used to determine the variables that were associated with treatment adherence. Logistic regression analysis was used to determine potential factors that contribute to treatment adherence. A total of 125 TB registrants were enrolled in the study. The majority (102 (81.6%)) adhered to the TB tre...
Factors Influencing Clients’ Compliance with Therapy of Tuberculosis in Ibadan, Nigeria
IOSR Journal of Nursing and Health Science, 2014
The study was carried out to investigate factors influencing clients' compliance with treatment of tuberculosis in Ibadan. The study was descriptive with a sample size of 212 randomly selected from three health centres. Sample selection were as follows: 50 respondents at the Catholic Hospital, Oluyoro; 67 at the Primary Health Care, Oniyanrin and 90 at the Chest Hospital, Jericho. The mean age of the respondents was 32 11.67. Males were 69.8% and female 30.2% with majority being Yorubas (59.9%) and Christians (76.9%) while as much as 61.3% were married. Educational status of the respondents showed only 19.8% possess bachelor degree, the rest others were school certificates (34.4%) and national diploma (15.6%) holders. As much as 33.5% of the respondents were unemployed, 24.5% Civil Servants and only 1.9% were self employed. On the respondents' knowledge of tuberculosis, majority (83.5%) of them knew tuberculosis as an infection of respiratory system, 85.9% knew it is caused by germ and 94.8% of them were aware it could be spread to other people through living in overcrowded places. All the respondents (100%) experienced coughing that lasted over four weeks before reporting in the hospital where tuberculosis was diagnosed. On the expected duration of cure of tuberculosis, majority (82%) of the respondents were aware that their ailment could take up to two years before they could get cured. They were however encouraged to comply with the treatment as 92.5% of them acknowledge the government largess in providing free treatment. The friendly attitude of the health personnel (without discrimination based on their health status)-90.1%, and coupled with failure of traditional treatment earlier sought before reporting in the orthodox hospital (76%), further encouraged the respondents to comply with treatment. Two hypotheses were tested. The results of the first hypothesis showed that there was a significant association between the respondents' knowledge and their compliance with tuberculosis treatment regimen. The result of the second hypothesis revealed that there was no significant association between the respondents' social stigma and their compliance with tuberculosis treatment regimen. It was therefore recommended that the Damien's Foundation, with collaboration of the Federal Government, should continue to provide free treatment of tuberculosis until the disease ceased to be public health problem in Nigeria.
Adherence to Tuberculosis Therapy in Unilorin Teaching Hospital, Ilorin, North-Central Nigeria
2013
Introduction: Non-adherence to treatment has been one of the main obstacles to the control of tuberculosis. The objective of this study is to investigate the rate of adherence to medication among Tuberculosis (TB) patients. Methodology: This study was a descriptive, cross-sectional survey with analysis of the observed variables in tuberculosis patients. All adults aged 18years and above who were accessing treatment for tuberculosis at the chest clinic of the University of Ilorin Teaching Hospital, Kwara Statewere recruited for the study until the desired sample size of 544 was obtained. The sample size was determined using Fisher’s Formula. Structured, pre-tested interviewer – administered questionnaire was used for data collection and data were analyzed using SPSS version 16. Frequency tables and cross-tabulation of variables were done and pvalue <0.05 was used to determine statistical significance. Result: Respondents who had taken Anti-Tuberculosis drugs for 3-6 months [mean d...
Texila International Journal of Public Health, 2020
Background: Medication Non-adherence in the treatment of patients with Tuberculosis (TB) is a major challenge in community-based clinical therapeutics. This has been attributed, in part, to duration and complexity of treatment regimens and toxic side-effects, which facilitates disease transmission with emerging resistance to anti-TB drugs. This study was undertaken to assess level of adherence to treatment and identify social determinants moderating medication-adherence guided by the PRECEDE framework among patients receiving treatment in Southwest zone of Nigeria. Method: This was a cross-sectional survey design conducted as a community-based study with 226 consenting patients receiving second-line drug treatment based on data obtained from all DR-TB OPD Health facilities within Southwest , Nigeria. The study adopted total enumeration sampling technique. Data analysis was performed using IBM SPSS version 22. Univariate and multivariate Regression analysis was conducted to validate the association between the independent variables (Reinforcing and Enabling factors) and outcome variables (medication-adherence and appointment keeping behavior). The test of significance was set at 5% for all statistical procedures. Results: Male participants in this study was 61.3%. Mean treatment-adherence prevalence was 84.75% (20.34±3.37 measured on 24-point scale). Social/Environmental factors correlated positively with treatment-adherence (r=0.165; p<0.01). Enabling factors with OR=1.44 (95% CI=1.08-1.92, p=0.013) predicted treatment-adherence more significantly than reinforcing factors for participants in this study. Conclusion: Patients' level of treatment-adherence was fair. Special attention should be given to enabling and reinforcing factors during patient education through social learning and structural support, which the study identified as inadequate, to optimize treatment-adherence in DR-TB patients.