Abstract:
Background: Successful treatment of tuberculosis (TB) involves taking anti-tuberculosis drugs for at least six months. Poor adherence to treatment means patients remain infectious for a longer period, and are more likely to relapse or succumb to tuberculosis and could result in treatment failure as well as foster emergence of drug resistant tuberculosis. Sierra Leone is among countries with high tuberculosis burden globally.
Objective: To identify factors associated with default from treatment among tuberculosis patients in Western Sierra Leone.
Method: A case-control study was conducted between September 2012 to August 2013 in
Western, Sierra Leone. The study population consisted of tuberculosis patients on treatment who default (non-compliant) and those who have completed treatment (compliant) at the Connaught Chest Clinic. A sample size of 240, 120 for compliant and 120 for non compliant.
Respondents completed structured questionnaire for socio-demographic characteristics, patient related factors, socio-economic variables, healthcare system related factors, default factors, stigma and discrimination and disease and medicine related factors. Factors associated with default were analyzed using logistic regression, bivariatr and multivariate analysis.
Results: Among the 120 defaulters interviewed, 34.2% (41) attributed their default to inadequate supply of medicines, 30.8% (37) to feeling better, 11.7% (14) not feeling better,
8.3% (10) lack of family support, 6.7% (8) no reason, 5% (6) stigma and discrimination and
3.3% (4) side effects . On multivariate analysis, food availability (OR=6.93,p=0.01) , patient waiting time (OR =0.09,p<0.01) , availability of medicine (OR=0.006,p<0.01),treatment should be taken until six months(OR=0.007,p<0.01),leaving with friends(OR=5.85,p<0.01) were independently associated with default.
Conclusion: Non-availability of medicines, non-availability of food, long waiting times at the clinic, perception that TB treatment should be taken until six months, type of person living with the patient ,duration of stay in the current abode, disease classification ,HIV status and patients taking other medicines besides TB treatment had significant association with default from treatment among TB patients in Western Sierra Leone.
Key words: Tuberculosis, Compliance, Defaulter, Western Sierra Leone
