A review of compliance to anti tuberculosis treatment and risk factors for defaulting treatment in Sub Saharan Africa.

Abstract

The aim of this study is to assess anti TB treatment compliance and the factors predictive for poor adherence in Sub-Saharan Africa in the last 10 years. We searched Medline for articles written in English using the terms: "Patient Compliance"[Mesh] OR "Medication Adherence"[Mesh])) AND "Tuberculosis"[Mesh]) AND "Africa South of the Sahara"[Mesh]. We identified 4 published manuscript and we included 1 study from the Infectious Diseases Institute. The proportion of patients defaulting varied from 11.3% (8) to 29.6%. Risk factors for defaulting treatment were: distance from the hospital, not being on the first course of TB medications, lack of repeated smears, unit transfer after the intensive phase, experiencing side effects, having no family support , poor knowledge about TB treatment, being more than 25 years old, and use of public transport. This review reveals high rate of losses to follow up in Sub-Saharan Africa; the information currently available is however too heterogeneous to draw conclusions on the reasons for this high rate of defaulters. It is imperative to understand predictive factors for treatment default so that programs can implement specific measure to target the population at risk.