FACTORS INFLUENCING ADHERENCE TO ANTI -TUBERCULOSIS DRUGS AMONG TUBERCULOSIS PATIENTS

ABSTRACT

Tuberculosis proves to be one of the most serious infections of the world with over 8.6m infections and 1.3m deaths recorded annually. Nigeria is one of the 22 high TB burden countries and is ranked 13th according to the World Health Organization (WHO). The cost of treatment of tuberculosis is going up due to the emergent of drug resistant strains of mycobacterium tuberculosis. Multi drug resistant tuberculosis (MDR) and extensive drug resistant tuberculosis (XDR) are a complication of poor adherence to anti-tuberculosis medication. Despite several efforts to reduce worldwide prevalence of TB various factors hamper these efforts. One of the prominent factors affecting TB is adherence to anti-TB medication which is determined by several factors including drug availability, side effects, and cost associated to treatment and patient provider relationship. The aim of this study was to identify patient factors which influence adherence to anti-TB treatment among TB patients at Primary Health Center Babban Dodo.Material and Methods: The study design adopted a cross-sectional study design. The choice of this design was due to fact that the study was to be carried out at one time or over a short time Stommel M et al, (2004). The rationale behind this research design was that, the study attempts to identify factors which influence a patient’s adherence to anti Tuberculosis treatment. Cross-sectional design was settled on because it is relatively easy, economical, and also considering time limitation to carry out study.Questionnaires were used to collect data. A pilot test was done to validate the questionnaire’s suitability. Descriptive analysis was done to analyze data.Results:  Findings on significant factors Influencing Adherence to anti Tuberculosis treatment include; demographic factors; age, educational status, support by family, gender and marital status. Also health service factors; TB treatment, access to TB treatment, staff attitude, patient provider relationship, also client-related factors; cultural believe, poverty and socioeconomic status, e.t.c, then social factor; stigma and discrimination, co-morbidities, etc.In conclusion: Patients with a high knowledge level of TB are more likely to adhere to taking their medications. Therefore, further cognitive interventions can be made to improve adherence and other treatment outcomes.

 

 

 

 

 

 

TABLE OF CONTENTS

Contents                                                                                                 Pages

Title page    –        –        –        –        –        –        –        –        –        –        i

Declaration  –        –        –        –        –        –        –        –        –        –        ii

Certification page  –        –        –        –        –        –        –        –        –        iii

Dedication   –        –        –        –        –        –        –        –        –        –        iv

Acknowledgment –        –        –        –        –        –        –        –        –        v

Abstract       –        –        –        –        –        –        –        –        –        –        viii

Table of content    –        –        –        –        –        –        –        –        –        ix

List of tables         –        –        –        –        –        –        –        –        –        xii

CHAPTER ONE:                   INTRODUCTION

1.1     Background of the study –        –        –        –        –        –        –        1

1.2     Statement of the problem –       –        –        –        –        –        –        6

1.3     Objectives of the study   –        –        –        –        –        –        –        7

1.4     Research questions-        –        –        –        –        –        –        –        8

1.5     Significance of the study-    –    –        –        –        –        –        –        8

1.6     Scope of the study /delimitation –                –        –        –        –        8

1.7     Operational definition of terms –        –        –        –        –        –        9

CHAPTER TWO:        LITERATURE REVIEW

2.0     Introduction          –        –        –        –        –        –        –        –        –        14

2.1     Initiation into TB Therapy       –        –        –        –        –        –        14

2.2     Compliance to TB Treatment   –        –        –        –        –        –        17

2.3     Non-Compliance level    –        –        –        –        –        –        –        20

2.4     Factors affecting Compliance to TB Treatment      –        –        –        22

2.5     Demographic Factors      –        –        –        –        –        –        –        22

2.6     Measuring Compliance   –        –        –        –        –        –        –        33

2.7     Theoretical Conceptual Based Literature      –        –        –        –        35

2.8     Summary of literature review   –        –        –        –        –        –        38

CHAPTER THREE:    RESEARCH METHODOLOGY

3.0     Introduction          –        –        –        –        –        –        –        –        –        40

3.1     Research Design   –        –        –        –        –        –        –        –        40

3.2     Area of Study-      –        –        –        –        –        –        –        –        40

3.3     Population of the Study  –        –        –        –        –        –        –        42

3.4     Sample and Sampling Techniques –   –        –        –        –        –        43

3.5     The Instruments Design –         –        –        –        –        –        –        –        43

3.6     Validity and Reliability of Instrument-         –        –        –        –        43

3.7     Method for Data Collection      –        –        –        –        –        –        44

3.8     Method of Data Analysis –       –        –        –        –        –        –        44

CHAPTER FOUR:       PRESENTATION AND ANALYSIS OF DATA

4.0     Introduction –        –        –        –        –        –        –        –        –        45

4.1     Data Presentation  –        –        –        –        –        –        –        –        45

CHAPTER FIVE

5.0     Introduction –        –        –        –        –        –        –        –        –        52

5.1     Discussion of Findings   –        –        –        –        –        –        –        52

5.2     Limitation of Findings    –        –        –        –        –        –        –        57

5.3     Conclusion  –        –        –        –        –        –        –        –        –        58

5.4     Recommendations of the study –        –        –        –        –        –        58

5.5     Suggestion for Further Studies-         –        –        –        –        –        –        60

Reference –  –        –        –        –        –        –        –        –        –        61

Appendix –  –        –        –        –        –        –        –        –        –        65

 

 

 

 

LIST OF TABLES

Tables        Description                                                                          Pages

4.1.1           Ages Of Respondents (Men)    –        –        –        –        –        46

4.1.2           Gender        –        –        –        –        –        –        –        –        46

4.1.3           Marital Status        –        –        –        –        –        –        –        47

4.1.4           Factors Influencing Adherence To Anti Tuberculosis

Drugs Among Patient Can Be  –        –        –        –        –        48

4.1.5           What Percent Of Patients Have Sound Knowledge

About Tuberculosis Treatment –        –        –        –        –        49

4.1.6           Do You Know The Factors Responsible For Non-Compliance

To Tuberculosis Treatment       –        –        –        –        –        50

4.1.7           What relationship exists between compliance and

socio-cultural behavior and patients   –        –        –        –        51