Factors at first diagnosis of tuberculosis associated with compliance with the Directly Observed Therapy (DOT) in the Limpopo Province, South Africa.

Abstract

The aim of this study is to compare and contrast health beliefs, demographic and socio-economic variables, causative beliefs, knowledge, health-seeking behaviour and health provider-patient interaction of compliant and non-compliant tuberculosis patients. The sample included 219 consecutive new sputum-smear and/or culture positive pulmonary tuberculosis patients registered between October 1999 and March 2000 in three hospitals in the Limpopo Province of South Africa. The patients were 144 (65.8%) men and 75 (34.2%) women in the age range of 18 to 79 years (M age 35.9 yr., SD = 12.6). The consultation at first diagnosis was observed and tape-recorded. Thereafter an interview was conducted and a questionnaire was face-to-face administered with the patient including knowledge, causative beliefs, health seeking, and Health Belief Model items. Discriminant analysis between compliant and non-compliant groups after six months follow-up showed that the quality of the health practitioner-patient interaction and causative belief were associated with compliance behaviour whereas knowledge, onset of TB, sociodemographic variables, health care seeking, and health beliefs were not associated.