Factors Determining Non-Adherence to Drug Treatment Among Tuberculosis Patients In Halaba Special District: Case- Control Study

Abstract

Background: Adherence is defined as the extent to which patients take anti-TB drugs as prescribed by their health care providers for the entire length of time. Non-adherence is the patient’s inability or refusal to take anti-TB drugs as prescribed by health professionals. Nonadherence to anti-tuberculosis treatments increases the risks of morbidity, mortality and multi drug resistance TB (MDR-TB) at both the individual and community levels. Objective: To identify factors that determine non-adherence to anti-TB treatment among TB patients in Halaba special district 2014. Methods: Multi facility based Unmatched Case control study was conducted in eight-health facilities (seven-health center and one primary hospital) on 166 cases and 166 controls were participated to assess predisposing factors that associated with non-adherence to anti-TB treatment among TB patients from 2-27 March 2014. Both cases and controls were selected from TB registration books. Socio demographic, patient related factors, health facility related factors and health care provider related factors were assessed using structured questionnaires. Finally, the data were entered Epidata virsion3.5.1database and analyzed using SPSS windows version 16. Descriptive statistics was performed to measure summery of data. Binary logistic regression analysis was conducted to see the association between independent and dependent variables. Those significant variables in bivariate analysis were entered to multivariable logistic regression and final model was constructed. Result: Males constitute 84(50.6%) of the cases and 96 (57.8%) of controls. Major pre disposing factors to anti-TB treatment non-adherence were, anti-TB drug side effect, (AOR=5.46,95%, CI:2.03-14.63), Pills burden, (AOR=5.09,95% CI:2.94-8.82), Feeling better, (AOR=4.04,95% CI:1.48-11.04 ) and lack of service satisfaction(AOR=3.27,95% CI:1.71-6.26). Conclusion: The major risk factors for non-adherence among the study participants were antiTB drug side effect, pills burden, feeling better, lack of service satisfaction, being female, and lack of safe water access.