Adherence to Directly Observed Therapy and Associated Factors Among Pulmonary Tuberculosis Patients in Government Health Facilities in Jimma Town, Southwest Ethiopia, 2016

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.