Clinic Attendance Default among Patients with Chronic Hepatitis B Infection in a Low- Income Setting: A Cause for Concern

Abstract

Background: Nigeria carries a heavy burden of the disease as about 25 million Nigerians are chronically infected with the disease. It is conventionally believed that default rates are high among CHB patients attending gastroenterology clinics across Nigeria but the actual rates and the reasons for such among the patients have not been quantitatively evaluated. We, therefore, evaluated the clinic attendance default rate and the factors influencing this among chronic hepatitis B patients attending the Gastroenterology Clinic of a Nigerian tertiary healthcare facility. Material and Methods: The study was a descriptive cross-sectional survey involving chronic hepatitis B patients that attended a Gastroenterology Clinic between July 2011 to December 2016. Case files of patients were retrieved from the medical record department from which their phone numbers and relevant data were obtained. A predesigned questionnaire containing questions relating socio-demographic characteristics, knowledge of chronic hepatitis B, reasons for clinic attendance default and what could be done to make the patient keep clinic appointments was administered to each participant. Results: A total of 87 subjects aged 18 to 55 years were interviewed. The clinic attendance default rate was 87.4% and 61.8% of the defaulters did so after the first clinic appointment. HBV knowledge [ OR = 9.10 (95% CI 2.33 -35.63), P = 0.002] and the monthly family income [OR = 1.01(95% CI 1.00 -1.02), P =0.008] of the participants were found to be positively associated with clinic attendance. Conclusion: There was a high rate of clinic attendance default among the population of CHB patients we studied. Inadequate disease knowledge and financial incapability stood as two major factors needing attention in order to solve this problem.