Abstract:
Background: Evidence exists pointing out how non-adherence to treatment remains a major hurdle to efficient
tuberculosis control in developing countries. Many tuberculosis (Tb) patients do not complete their six-month
course of anti-tuberculosis medications and are not aware of the importance of sputum re-examinations, thereby
putting themselves at risk of developing multidrug-resistant and extensively drug-resistant forms of tuberculosis
and relapse. However, there is a dearth of publications about non-adherence towards anti-Tb medication in these
settings. We assessed the prevalence of and associated factors for anti-Tb treatment non-adherence in public health
care facilities of South Ethiopia.
Methods: This was a cross-sectional survey using both quantitative and qualitative methods. The quantitative study
was conducted among 261 Tb patients from 17 health centers and one general hospital. The qualitative aspect
included an in-depth interview of 14 key informants. For quantitative data, the analysis of descriptive statistics,
bivariate and multiple logistic regression was carried out, while thematic framework analysis was applied for the
qualitative data.
Results: The prevalence of non-adherence towards anti-Tb treatment was 24.5%. Multiple logistic regression
analysis demonstrated that poor knowledge towards tuberculosis and its treatment (AOR = 4.6, 95%CI: 1.4-15.6),
cost of medication other than Tb (AOR = 4.7, 95%CI: 1.7-13.4), having of health information at every visit (AOR = 3,
95% CI: 1.1-8.4) and distance of DOTS center from individual home (AOR = 5.7, 95%CI: 1.9-16.8) showed statistically
significant association with non-adherence towards anti- tuberculosis treatment. Qualitative study also revealed that
distance, lack of awareness about importance of treatment completion and cost of transportation were the major
barriers for adherence.
Conclusions: A quarter of Tb patients interrupted their treatment due to knowledge, availability and accessibility of
DOTS service. We recommend creating awareness about anti-Tb treatment, and decentralization of drug pick-ups to
the lowest level of health institutions
