Compliance of Tuberculosis Patients with Treatment Banke, Bardiya & Surkhet Districts

Abstract

Background: Patient non compliance with treatment is the main problem in TB control programme. DOTS strategy to treat TB patients has focused on non compliance problem but need to do study on it to solve the existing problem. The objective of this study is to determine the compliance of tuberculosis patients with treatment and identify main factors affecting compliance of tuberculosis patients with treatment. Methods: In this cross-sectional study, districts were selected purposively and DOTS treatment centers were randomly selected in Banke, Bardiya and Surkhet districts. All patients who completed one month or more treatment and came to helath facility for drug (n=380) were interviewed using a structured and semi-structured questionnaire. Collected data were processed and analyzed on computer. Results: Out of total respondents, 63.3% were economically productive with male and female ratio of 2:1. About 69% of the respondents were farmer. In employment status, labour group had statistically significant lower compliance (p value=0.004). Similarly low income status group and terai ethnic group had also lower compliance with p value=0.035 and 0.00073 respectively. Patient non compliance was higher in large family and statistically significant (p value<0.05). Among the 380 respondents, 94% were new TB patients and 46% were sputum positive. Based on respondents perception, 45% respondents were given information regarding taking regular medicine, 29% self protection, about disease 24%, 20% proper sputum disposal. Most of the non compliance group were not given information about disease and treatment had lower compliance with statistically significant association (p value<0.05). About 64% respondents collected drug once a week, 29% daily and rest of the others on a monthly basis. Those who collected drugs in short interval had higher compliance (p value=0.006). Conclusions: The compliance of TB patients is found to be quite high in the study area. Poverty, large family size, low education status, inadequate awareness about disease and treatment arisen by health worker and no proper advice given by the private practitioners were causes of non compliance. In order to reduce the number of non compliance, it is suggested to improve information, education and communication prior to TB treatment and follow up. Keywords: compliance; control; DOTS; non compliance; patients; services; tuberculosis.