Determinants of non adherence to Tuberculosis Treatment among TB patients in four public health facilities of Gambella Region, Southwest Ethiopia

Abstract

Background: Ethiopia is among 30 TB/HIV high burden countries and has encountered the emergence of MDR-TB. In Gambella Region, low treatment success rate and high default rate raised the concerns for determining various determinants of non adherence to TB treatment. Therefore; the objective was to determine the determinants of non adherence to TB treatment among patients treated in four public health facilities of Gambella Region, Southwest Ethiopia. Methods: A case control study was conducted on a sample of TB patients who were on DOTs program in four public health facilities of Gambella Region, starting from March 1-27/201. The total sample size was 288 patients, (72 cases and 216 controls). A ratio of 1:3 was used to obtain sufficient sample for the purpose of inference. Cases were TB patients who missed 10% of the doses (18 days and above) while controls were those who completed 90% or more doses (162 days and above) during the treatment period. Both cases and controls were selected using systematic random sampling techniques from the lists of TB patients. Data collectors (students) from Gambella college and university traced the patients at their home and interviewed them using a structured questionnaires. Data were defined and double entered into Epidata 3.1 version and exported to SPSS version 20 and analyzed. Proportions, bivariate (crude odd ratios) and multivariate analysis (adjusted odd ratios) were reported. Ethical clearance was given from the IRB of Jimma University, College of Health Sciences. Results: Perception of being stigmatized (AOR=2.7); 95% CI (1.1, 6.6), not believing in the benefit of regular medication (AOR=6.8 ), 95% CI (1.8, 24.9), perceiving TB as not severe (AOR=8.4), 95% CI (2, 34.6), having not been ever counseled (AOR=35.5), 95% CI (10, 122), and being smoker (AOR=10.9), 95% CI (4, 29) were independently associated with non adherence to TB treatment. Conclusion and recommendation: Patient and provider related factors were found to be the predictors of non-adherence to TB treatment. Therefore, capacity building by providing a training and supervision to health care providers is highly recommended.