Factors influencing compliance in patients with tuberculosis on directly observed therapy at Ile-Ife, Nigeria

Abstract

Background: Increased morbidity and mortality of tuberculosis have been blamed on neglect of the human dimension of tuberculosis control. One of such factors included in human dimension is non-compliance, a behavioural parameter, which has led to the emergence of multi-drug resistant tuberculosis, and poor treatment outcome. Objective: To explore the impact of directly observed therapy (DOT) on compliance and the factors influencing it. Design: A retrospective study. Setting: Chest clinic of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Methods: Directly observed therapy (DOT) was employed. Records of the socio-demographic characteristics, treatment categories, complications developed, results of investigations, level of compliance and treatment outcome for the patients were kept. The data for the patients seen between May 1996 and April 1997 were retrieved and analysed. Those that complied were compared with those that did not comply. Results: One hundred and ninety nine patients comprising ninety one males and 108 females, were seen during the period .They were mostly between the ages of 16 years and 45 years(mean ± SD = 31.7±14.98). One hundred and fifty eight (73%) complied and all of them were cured. The only factor that significantly influenced rate of compliance was proximity to the chest clinic. Conclusion: DOT improves the rate of compliance. No socio-demographic factors considered significantly influenced the rate of compliance under DOT, and as such they are not reliable predictive factors. Locating chest units in the existing primary health care facilities will improve the rate of compliance with antituberculosis therapy. More attention should be paid to behavioural aspect of tuberculosis control.

Prevalence of Treatment Failure among Pulmonary Tuberculosis Patients in Federal Medical Centre, Gombe, Northeastern Nigeria

“…ese factors were all excluded in our study participants. In a study in IleIfe, Nigeria, the only factor that signi�cantly in�uenced the rate of compliance with antituberculosis treatment was proximity to the chest clinic [23]. Our patients who participated in this study resided within Gombe town, and the distance from their residence to the DOT centre was not more than �ve kilometers.…”

Psychiatric Morbidity and Other Factors Affecting Treatment Adherence in Pulmonary Tuberculosis Patients

“…Psychopathology may be a very important negative factor to treatment adherence [169] for patients with somatic disease, and nonadherence to treatment is a major setback for effective tuberculosis control in the community, possibly responsible for the appearance of drug-resistant TB which is caused by inconsistent or partial treatment of the disease [215] and probably responsible for nonadherence with latent TB therapy, which may increase risk of progression from latent TB to active TB. Additionally, psychiatric disorders may hinder adaptation to chronic disease conditions, and it is known that adaptation is a crucial survival factor in chronic diseases [216].…”

Prevalence of psychosis in tuberculosis patients and their nontuberculosis family contacts in a multidrug treatment-resistant treatment center in Nigeria

“…Specifically in Nigeria, it has been reported that patients with comorbid psychiatric disorders have problems with treatment adherence in TB, thereby constituting major difficulty in the effective treatment of TB [38]. Lack of access to mental health service in Nigeria is a hurdle in Nigeria [39], and the picture could be gloomier because of the stigma and discrimination associated with TB [13].…”