DETERMINANTS OF NON COMPLIANCE TO ANTI TUBERCULOSIS TREATMENT AMONG PATIENTS ATTENDING DOTS CLINICS IN IBADAN, NIGERIA

Abstract

Tuberculosis (TB) remains a serious public health problem globally, despite being a curable disease. Effective TB treatment has been shown to have a significant effect on its control. Major contributors to both treatment failure and the rise of multidrug-resistant TB are inadequate and incomplete treatment. Efforts to control the tuberculosis epidemic depend largely on patient's compliance to tuberculosis treatment. Previous studies of noncompliance to TB treatment focused on single facilities. The study investigates factors influencing noncompliance in DOTS centers in Ibadan. A total of 302 patients diagnosed with tuberculosis and currently in the continuation phase of treatment in Ibadan were selected from all DOT centers in Ibadan. Proportional allocation technique was used to obtain the required number of study participants and patients met at time of visit were recruited until desired number met. Patients were interviewed using pretested questionnaire to seek information on factors responsible for noncompliance to TB treatment. Knowledge was assessed using 20 points scale and those who scored <10 were classified as poor knowledge and ≥10 were classified as good knowledge. . The mean age was 36.8 ± 11.1, 44.3% were aged between 18-29 years, male sex were 61.9% , 39.7% attained secondary level of education and 90.2% were Yoruba by tribe. Prevalence of noncompliance was 14.2%. Major reasons given for noncompliance were being too busy, improvement in health, side effects of drugs. Younger age (OR =3.6 CI=1.46-8.6), male sex (OR=2.6 CI=1.24-5.68), smoking of cigarettes (OR= 3.4 CI= 1.61-3.94) were found to be significantly associated with compliance to TB treatment. Respondents with support from families and friends were 5.4 times more likely to comply than those without (OR=5.4, Cl=2.62-11.47). As regards knowledge about TB, respondents with good knowledge of TB were 3 times more likely to comply to TB treatment than those with poor knowledge about TB (OR=3.0, CI= 1.35-6.69). There is low prevalence of noncompliance to TB treatment in Ibadan. Health education which could serve as a reminder should be intensified to further address factors influencing noncompliance.