Determinants of adherence to anti-TB treatment and associated factors among adult TB patients in Gondar city administration, Northwest, Ethiopia: based on health belief model perspective

Abstract

Background Adherence is crucial in treating Tuberculosis to achieve the required treatment success rate. However, due to the longer treatment duration, adherence to Tuberculosis treatment is the most challenging factor affecting Tuberculosis control. Furthermore, although several studies have reported the determinants of Tuberculosis treatment adherence, few of them have used Health Belief Model (HBM) as the guiding principle to determine the individual perception of health-related decisions as much or more than medical concerns with Tuberculosis treatment adherence. Therefore, this study aims to assess adherence to anti-Tuberculosis treatment and associated factors among adult Tuberculosis patients in Gondar city, Northwest Ethiopia, in 2020. Methods Institution-based cross-sectional study was conducted among Tuberculosis patients following anti-Tuberculosis treatment in Gondar city health facilities from February 20 to March 26, 2020. A total of 265 Tuberculosis patients were selected by systematic random sampling techniques that include patients who were on treatment follow up for ≥ 1 month and whose age is ≥ 18 years. Data were collected by trained data collectors using interviewer administer and structured questionnaires. EPI DATA version 4.2 was used for data entry and SPSS version 24 for analysis. The logistic regression model was used to indicate the association between independent variables with adherence to anti Tuberculosis treatment. Results The overall rate of adherence to anti-Tuberculosis treatment was 90.6% within the last 4 weeks and 96.6% within the last 4 days. Multivariable analysis revealed that having treatment supporter [AOR = 3.51, 95% CI (1.15, 10.75)], difficulties in taking TB drugs regularly [AOR = 0.07, 95% CI (0.01, 0.31)], perceived benefit [AOR = 3.45, 95% CI (1.07, 11.08)] and perceived self-efficacy [AOR = 0.22, 95% CI (0.07, 0.63)] were independently associated with adherence to anti-Tuberculosis treatment. Conclusion The treatment adherence rate of the patients was low in the last month before the data survey. Treatment supporters, difficulties in taking anti Tuberculosis drugs regularly, perceived benefit, and perceived self-efficacy were identified as affecting adherence to anti-TB treatment.

Adherence to Tuberculosis Treatment and Its Associated Factors among Drug-susceptible Tuberculosis Patients in Lira District, Northern Uganda

“…The 84.6% adherence rate observed in this study is lower than the 90% targeted by the national TB and leprosy program (USAID, 2022). Our findings are also lower than the 90.6% reported in Ethiopia (Gebremariam et al, 2021) but higher than 67% to 77% in Uganda in 2019 (Sekandi et al, 2020b), 64.2% in Ethiopia in 2021 (Gashu et al, 2021), 56.5% in South Korea in 2021 (Bea et al, 2021), and 78.7% pooled prevalence from a systematic review conducted in Ethiopia in 2019 (Zegeye et al, 2019). This discrepancy may be attributed to differences in cultures, sample size, and settings.…”

The Influence of Parents on Medication Adherence of Their Children in China: A Cross-Sectional Online Investigation Based on Health Belief Model

“…Self-efficacy refers to an individual's perception of his or her competence to successfully perform a behavior ( 37 ). Multiple studies have shown that patients with chronic diseases (such as hypertension, type 2 diabetes, and tuberculosis) with higher levels of self-efficacy tend to have higher treatment adherence ( 38 – 42 ). Parents with higher scores on the self-efficacy dimension have the higher subjective initiative in improving children's medication adherence, so their children's medication adherence scores are relatively higher, which suggests that improving parents' self-efficacy may be an effective way to improve children's medication adherence.…”

Impact of early diagnosis of impaired glucose regulation in tuberculosis: Comparison of clinical outcomes in people with tuberculosis in Tanzania

“…TB participants with IGR and/or HIV received care as per Tanzania standard guidelines for collaborative care and control of TB/HIV and/or DM, which were integrated at the TB clinic [22]. Participants were evaluated by using self‐reporting and pills refill techniques [23] for monitoring expected treatment adherence (“expected” adherence to anti‐TB was defined by participants who took ≥95% of the prescribed anti‐TB drugs,) [24], and sputum smear conversion and/or sputum culture for all TB patients (newly and previously treated TB) was evaluated at 2 and 5–6 months of TB treatment. If sputum smears remained positive at 2 months of treatment, an Xpert MTB/RIF test was performed to rule out DR‐TB.…”