Abstract
The purpose of this study was to investigate the difference between influence of health locus of control on medication adherence among outpatients undergoing directly observed treatment-short course (DOTS) and those receiving antiretroviral therapy (ART). Resurgence of tuberculosis (TB) infection following the spread of HIV epidemic has made treatment of TB and HIV co-infection a public healthcare priority in Nigeria. However, strict adherence to medications is critical for the treatment to be effective and to prevent death due to TB and rapid progression of HIV to full-blown AIDS. Locus of control perceptions of outpatients with TB and HIV infections should be assessed and determined for effective package of treatment that requires strict medication adherence. The participants were 100 outpatients receiving tuberculosis (n = 30) and HIV/AIDS (n = 70) services in seven selected treatment facilities across Edo State, Nigeria. The respondents were selected using a purposive sampling technique. All participants were individually administered with multidimensional health locus of control (MHLC) scale and Morisky (8-Item) medication adherence questionnaire (MMAQ). Percentage and inferential statistics (ANOVA) were used to analyse the data collected and were tested at p < 0.05. Heath locus of control presents similar influence on medication adherence among outpatients. There was an association between non-adherence (27%) and reported health complications (27%) by outpatients. The reasons cited for missing medications were travelling (48%), work schedule (14.8%), religion activities (14.8%), side effects of drug (11.1%), financial constraints (7.4%) and bereavement (3.7%). It was also observed that Internal-LOC [F = (23, 76) = 0.469, P<0.05], Powerful others-LOC [F = (26, 73) = 0.067, P<0.05] and Luck or chance-LOC [F = (27, 72) = 0.136, P<0.05] present similar influence on medication adherence among tuberculosis and HIV-positive outpatients undergoing treatments. The study revealed that LOC as a personality construct is not determined or influenced by TB or HIV/AIDS conditions. It was further shown that treatment methods such as DOTS for tuberculosis treatment whereby drugs use is directly administered and monitored by healthcare providers with support provided by family members ensured compliance influence of LOC beliefs, especially towards powerful others. Key words: Health, locus of control, medication, adherence, DOTS, tuberculosis, ART, HIV/AIDS
Highlights
Tuberculosis (TB) and Human immunodeficiency virus (HIV) have become major public health problems in many countries including Nigeria
The selected directly observed treatment-short course (DOTS)/ART centers were in two primary, two secondary, two tertiary/teaching and one private/mission health facilities (Table 1). 100 outpatients participated in the study that was held between February and March, 2013. 30 of the respondents were undergoing treatment for tuberculosis in DOTS centres while 70 were receiving antiretroviral therapy
The findings showed that Locus of Control present similar influence on medication adherence among tuberculosis and HIV-positive outpatients
Summary
Tuberculosis (TB) and HIV have become major public health problems in many countries including Nigeria. With an estimated 259,000 cases, has the sixth largest population of people with tuberculosis (TB) in the world. Before the HIV epidemic, the incidence rate of new cases of tuberculosis had been estimated at 2 per 1,000 (UNAID, 2005). Human immunodeficiency virus (HIV) greatly increases the risk for tuberculosis (TB), and the two epidemics continue to fuel one another (Suchindran et al, 2009). Olaitan (2004) observed that tuberculosis is recognized as a major complication of human immunodeficiency virus (HIV) infection (Raviglione et al, 1992; Murray et al, 1990). Many reports have shown high rates of HIV infection in patients with tuberculosis in countries with HIV epidemics (Kelly et al, 1990). The World Health Organization (WHO) estimates that 26% of patients with TB infection in Nigeria are HIV infected (WHO, 2010)
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