Factors associated with interruption of treatment among Pulmonary Tuberculosis patients in Plateau State, Nigeria. 2011.
BACKGROUND
Nigeria has one of the highest tuberculosis (TB) burdens in the world with estimated incidence of 133 per 100,000 populations. Multi-drug resistant TB (MDR-TB) is an emerging threat of the TB control in Nigeria caused mainly by incomplete treatment. This study explored factors that affect adherence to treatment among patients undergoing direct observation of TB treatment in Plateau state, Nigeria.


METHODS
Between June and July 2011, we reviewed medical records and interviewed randomly selected pulmonary TB patients in their eighth month of treatment. Information on patients? clinical, socio-demographic and behavioral characteristics was collected using checklist and structured questionnaire for knowledge of treatment duration and reasons for interruption of treatment. We conducted focus group discussions with patients about barriers to treatment adherence. Data were analyzed with Epi Info software.


RESULTS
Of 378 records reviewed, 229 (61%) patients were male; mean age 37.6±13.5 years and 71 (19%) interrupted their treatment. Interruption of treatment was associated with living >5 km from TB treatment site (AOR: 11.3; CI 95%: 5.7-22.2), lack of knowledge of duration of treatment (AOR: 6.1; CI 95%: 2.8-13.2) and cigarette smoking (AOR: 3.4; CI 95%: 1.5- 8.0). Major reasons for the interruption were lack of transport fare (40%) and feeling well (25%). Focused group discussions revealed unfriendly attitudes of health care workers as barriers to adherence to treatment.


CONCLUSIONS
This study revealed knowledge of the patients on the duration of treatment, distance and health workers attitude as the major determinants of adherent to TB treatment. Training for health care workers on patient education was conducted during routine supportive supervision.
Nigeria Field Epidemiology and Laboratory Training Program, Nigeria.
Luka Mangveep
LM
Ibrahim
Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria.
Idris Suleiman
IS
Hadejia
Nigeria Field Epidemiology and Laboratory Training Program, Nigeria.
Patrick
P
Nguku
Nigeria Field Epidemiology and Laboratory Training Program, Nigeria.
Raymond
R
Dankoli
Nigeria Field Epidemiology and Laboratory Training Program, Nigeria.
Ndadilnasiya Endie
NE
Waziri
Nigeria Field Epidemiology and Laboratory Training Program, Nigeria.
Moses Obiemen
MO
Akhimien
World Health Organization, Nigeria.
Samuel
S
Ogiri
Nigeria Field Epidemiology and Laboratory Training Program, Nigeria.
Akin
A
Oyemakinde
Centers for Disease Control and Prevention, Nigeria Country Office, Abuja Nigeria.
Ibrahim
I
Dalhatu
Centers for Disease Control and Prevention, Nigeria Country Office, Abuja Nigeria.
Okey
O
Nwanyanwu
Global Public Health Solution, Decatur GA USA.
Peter
P
Nsubuga
D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D023801:Directly Observed Therapy; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D015994:Incidence; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010353:Patient Education as Topic / Q000379:methods; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology; D055815:Young Adult
D000995:Antitubercular Agents
Interruption; Nigeria; Tuberculosis; treatment