Non-adherence to anti-TB drugs among TB/HIV co-infected patients in Mbarara Hospital Uganda: prevalence and associated factors.
BACKGROUND
Non-adherence to treatment remains a major obstacle to efficient tuberculosis control in developing countries. The dual infection of Tuberculosis and HIV presents further adherence problems because of high pill burden and adverse effects. This poses a risk of increased multi-drug resistant TB. However, the prevalence of non-adherence and its associated factors have not been studied in these patients in Uganda.


OBJECTIVE
To determine the prevalence and factors associated with non-adherence to anti-TB drugs among TB/HIV co-infected patients in Mbarara hospital.


METHODS
A cross-sectional study with qualitative and quantitative data collection methods was conducted among TB/HIV co-infected adults in Mbarara hospital from January to March 2008. Consecutive sampling was used to select 140 participants. Adherence was assessed over a 5-day period prior to the interview using patients self-reports. Data was collected using an interviewer administered questionnaire. Qualitative data was collected through key informant interviews using a topic guide and was analyzed manually. Quantitative data was analyzed using STATA version 8. Logistic regression was used to determine factors associated with nonadherence.


RESULTS
The prevalence of non-adherence was 25% (95% CI=17.8-32%). Being on continuous phase of the TB regimen was significantly associated with non-adherence (OR=6.24, p<0.001). Alcohol consumption, being on antiretroviral therapy and smoking confounded the relationship between stage of the TB regimen and non-adherence.


CONCLUSIONS
The prevalence of non-adherence was high. Patients that are on continuous phase of TB treatment should be supported to continue taking their drugs. In addition, patients that drink alcohol; smoke and those not on ART should be targeted with interventions to improve adherence.
Amuha
Monica G
MG
Department of Pharmacy, Faculty of Medicine, Makerere University, Kampala, Uganda.
Kutyabami
Paul
P
Kitutu
Freddy E
FE
Odoi-Adome
Richard
R
Kalyango
Joan N
JN
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D015995:Prevalence; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D014454:Uganda; D055815:Young Adult
D000995:Antitubercular Agents