Prevalence and associated factors of anti-tb treatment Non-adherence among pulmonary tuberculosis patients in Public health care facilities in dawuro zone, south west Ethiopia

Abstract

Background: Non-adherence to treatment remains a major obstacle to efficient tuberculosis control in developing countries. Patients’ adherence to their medication regimens and sputum re-examination was influenced by the interaction of a number of factors. High adherence of patients to their treatment and successful follow up is the major mechanism to prevent the emerging of multi drug-resistance and extensive drug-resistant form of tuberculosis. Objective: The main objective of this study was to estimate prevalence and assess the associated factors of anti-tuberculosis treatment non-adherence among pulmonary tuberculosis patient in public health care facilities, Dawuro Zone, South Nation Nationality Peoples Region. Methods: A cross-sectional study on 261 patients receiving anti-tuberculosis treatment was conducted. Patients were directly interviewed and clinical data were collected from registration book. In addition, in-depth interview was conducted on 10 participants to supplement quantitative data. Patients who had missed 10% of their total prescribed doses of TB drugs were considered as non-adherent. To identify independent predictors of treatment non-adherence, multivariate logistic regression was used. Result: Among total pulmonary tuberculosis patients, 24.5% of patients had missed more than 10% of their total prescribed dose of medication. In multivariate analysis, knowledge of disease and its treatment (AOR=4.6, 95%CI=1.4-15.6), travelling cost to get treatment (AOR=4.7 95%CI=1.7-13.4), availability of health education at every visit (AOR=3, 95% CI=1.1-8.4) and distance of treatment center from individual home (AOR= 5.7, 95%CI=1.9-16.8) were positively associated with treatment non-adherence. The in-depth interviews similarly indicated that financial burdens, distance of treatment center and lack of awareness were potential factors accounted for non-adherence. Conclusion: Prevalence of treatment non-adherence was higher in study area. More emphasis should be given to improve patient’s adherence by resolving such contributing factors for treatment non-adherence. Making tuberculosis treatment services more accessible to users, organizing counseling and health education sessions at the treatment center improve patient’s treatment adherence status.