Directly Observed Treatment Short-Course Compliance and Associated Factors among Adult Tuberclosis Cases in Public Health Institutions of Hadiya Zone; Southern Ethiopia: Cross-Sectional Study

Abstract

Background: Tuberculosis (TB) is a major public health problem in Ethiopia. This is at various levels of prevention; connected to early detection, prompt treatment seeking and compliance behavior of patients. In addition, development of MDR-TB is another emerging agenda which mainly happens as a result of poor compliance to treatment regimen. Objective: the main aim of this study is assessing treatment compliance and associated factors among adult patients of TB treatment service. Methods: Facility based cross- sectional study triangulated with in-depth interview was conducted between March and April, 2015 in public health facilities of Hadiya zone. Data were collected from 203 respondents selected by simple random sampling using pre-tested structured questionnaire. Ethical clearance was collected from the ethical clearance committee of Jimma University, College of health science. We used adapted instrument composed of behavioral, therapy, social and facility related variables. Descriptive statistic and logistic regression analysis were employed to identify factors associated with DOTS compliance in TB patients. We used odds ratio and 95%CI to declare significant factor fits. Then quantitative data were triangulated with qualititative data. Finally, the findings were presented in narrative texts, tables and graphs. Result: A total of 203 tuberculosis patients were interviewed; 51.7% were females and nearly three quarters (75.9) were rural dwellers.142(70%) of the respondents were compliant with in the last seven days. Majority (84%) of the respondents were morning time compliant. Average number of day that patient takes the drug in 1 week is 6.6 and most of them (72.50%) takes seven days. Phase of treatment, knowledge, getting encouragement, perceived severity, distance from health facilityand getting advice were significantly associated at pv<0.05 with DOTS compliance. Moreover distance and getting advice in intensive phase and absence of symptom, waiting time and getting encouragement in continuation phase were significantly associated. Conclusions: Getting social support, increased knowledge on TB, getting advice from health professional and being in intensive phase of treatment increase DOTS compliance but perceived severity, long waiting time, being far to health facility during an intensive phase and absence of symptom in continuation phase decreases DOTS compliance. Special attention on compliance counseling should be given for those patients who have no symptom in continuation phase, distant patients in intensive phase and those who did not get social support.