The prevalence of and reasons for interruption of anti-tuberculosis treatment by patients at Mbekweni Health Centre in the King Sabata Dalindyebo (KSD) District in the Eastern Cape province

Abstract

Background: In spite of effective therapy, tuberculosis (TB) is still a major health problem in developing countries. In 1993, therefore, the World Health Organization declared TB a global emergency. In South Africa, TB is one of the most prevalent diseases, with an incidence of 556 per 100 000 population. In spite of free TB drugs in the public service and the directly observed treatment short course (DOTS) strategies, there is still a high prevalence of TB and a high treatment interruption rate in rural South Africa. Methods: The objectives of this study were to establish the prevalence of TB and reasons for the interruption of TB treatment by patients attending Mbekweni Health Centre in King Sabata Dalidyebo (KSD) district in the Eastern Cape province. This was a crosssectional study in which data were collected from 15 July 2004 to 15 January 2005 from patients who were on TB treatment and interrupted their treatment between 6 August 2001 and 30 December 2003. Results: Of the 255 TB patients who attended for treatment, 121 (47.5%) had interrupted their treatment. Reasons given for interruption included change of living place (18.96%), no money to go to the clinic (15.52%), feeling better (13.78%), side effects of the drug (6.90%), did not know the treatment course (5.17%), physical disability either old or too sick to collect treatment and nobody to help (5.17%), clinic too far (1.73%), drug not available in the clinic (13.83%) and no reasons (8.62%). Conclusion: The prevalence of treatment interruption was high in this study. Change of living place, lack of money for visiting the clinic to collect treatment, feeling better, and no drugs at the clinic were the major reasons given for interruption of treatment. Ensuring the availability of TB drugs at the health centre/clinic, patient education about TB and strengthening the DOTS programme, including a stipend for the DOTS supervisors, would help to reduce the prevalence of treatment interruption. This article has been peer reviewed. Full text available at www.safpj.co.za SA Fam Pract 2008;50(6):47

Factors associated with interruption of tuberculosis treatment among patients in Nandi County, Kenya 2015

“…This also provides an opportunity for early intervention in the course of treatment. TB interruption rates from as low as 1% in good health systems to as high as 70% in worse performing areas have been found [ 13 , 15 ]. Studies conducted in Delhi, India and Nairobi, Kenya, found the average time to interrupt was six (± 3) weeks after initiation of treatment [ 16 , 17 ].…”

“…Others have assessed factors associated with TB treatment interruption [ 13 , 17 , 18 ]. Treatment interruption has been associated with long transportation time to treatment centre, being male, patients with low level of information about TB, poor quality of communication between patients and health workers, distance to treatment centres, cigarette smoking and inadequate knowledge of TB treatment duration among patients [ 15 , 18 , 19 ].…”

Medicinal plants used for the treatment of tuberculosis by Bapedi traditional healers in three districts of the Limpopo province, South Africa

“…However, previous studies by Needham et al (1998) and Russell (2004) noted that rural patients often delay TB treatment, as they cannot afford to travel to treatment centres (DOTS clinics) daily to have a health worker watch them take their drugs. Kandel et al (2008) found that of the 255 TB patients who came for treatment at Mbekweni Health Centre in the King Sabata Dalidyebo (KSD) district in the Eastern Cape Province, South Africa, 121 had interrupted their treatment. Reasons for interruption included change of living place, side effects of the drug, lack of knowledge about the treatment course, physical disability (either too sick or old) to collect treatment, clinic too far and drug not available in the clinic (Kandel et al, 2008).…”

“…Kandel et al (2008) found that of the 255 TB patients who came for treatment at Mbekweni Health Centre in the King Sabata Dalidyebo (KSD) district in the Eastern Cape Province, South Africa, 121 had interrupted their treatment. Reasons for interruption included change of living place, side effects of the drug, lack of knowledge about the treatment course, physical disability (either too sick or old) to collect treatment, clinic too far and drug not available in the clinic (Kandel et al, 2008). With the rapid increase in infection in sub Saharan Africa and due to the relatively high cost and limited access to synthetically derived drugs, communities in Africa have relied on traditional healers to treat infectious diseases (WHO, 2003).…”

Evaluation of tuberculosis defaulters in Yemen from the perspective of health care service

“…Many studies have reported similar results, i.e. 29% in Zambia, [70] 13.7% in South Africa, [71,72] 11% in Nairobi, [30] 10% in Armenia, [67] 14% in South India, [73] 11% in Maharashtra-India [74] and 10% in Karachi, Pakistan. [64] Other studies have reported that improved health condition occurs mostly during the intensive phase of treatment because the number of tubercle bacilli in the body is reduced, thus, the patient feels better.…”