Abstract:
Background: Tuberculosis control requires high level of adherence to the treatment regimen. If
adherence is poor, an emergence of new strains drug resistance bacteria and poor treatment outcomes
may develop. In Ethiopia usually less than one third of participant to Directly Observed Therapy
program complete full course of Tuberculosis treatment and the treatment success rate of Oromia in
general and Jimma town in particular was below the standard.
Objectives: To assess the level and associated factors of adherence to directly observed treatment short
course among pulmonary TB patients in Jimma town government health facilities.
Methods: An institution based cross-sectional study was conducted in six government health facilities
in Jimma Town between March 20 and April 30, 2016. Data was collected using face to face
interviewing method by trained data collectors using structured questionnaire. Data was cleaned, coded
and entered into EPI data version 3.1 and analyzed using SPSS version 16. Bi-variate and multivariate
logistic regression with 95% CI of AOR was used to judge statistical associations of factors with
tuberculosis treatment adherence.
Result: Out of 246 pulmonary tuberculosis patients who have been on Directly Observed Treatment
short course, 221 of them were taking their recommended 140 doses of five months therapy strictly. The
level of adherence was found to be 95.1 %. Those married (AOR=0.26, 95% CI= 0.1, 2.8), those with no
income (AOR=0.19, 95% CL=0.02, 1.81) were more adherent than the single’s (P=0.034) and those
who earn 500-1000 birr a month (p=0.018) respectively. Those who can read and write (AOR=1.25,
95% CL=0.50, 29.8) were less likely to be adherent when compared with those who complete primary
level education (p=0.009) and Being counseled on the duration of treatment (p=0.029), being counseled
on what to do for adverse drug reaction (p<0.0001) and presence of substance use (p=0.002) with 95%
CI maintained statistical significant association with treatment adherence on multivariate analysis.
Conclusion and Recommendations: The level of adherence observed in Jimma town is relatively high
and Service provider’s skill on appropriate pre-treatment counseling has important role in maintaining
adherence. Therefore Jimma town health office should work in collaboration with other concerned
organizations to scale-up counseling skills of care providers though sustainable refreshment trainings.
