Abstract
BackgroundNon-adherence to tuberculosis (TB) treatment is an important barrier for TB prevention and control. Poor adherence may result in prolonged disease infectiousness, drug resistance, relapse and death. The aim of this study was to assess factors influencing adherence to tuberculosis treatment in selected health facilities in Asmara, Eritrea.MethodsA qualitative study which included in-depth interviews with 12 TB patients, three focus group discussions in selected health facilities in which one group comprised eight patients and key informant interviews with three health workers. Data analysis was done by translating and transcribing the verbatim of the interviews and focus group discussions. Transcribed data was then analysed using thematic framework procedure.ResultsThis study found that patients lacked knowledge about the cause, transmission and duration of treatment of TB. The most common reason mentioned for discontinuing treatment was the patient “felt cured”. Almost half of the respondents did not know the standard treatment duration and the consequences they face if they halt treatment. Patients reported losing their job when their diagnosis was known, were too ill to continue working or unable to find daily work due to time-consuming treatment arrangements. With few exceptions, the majority of patients reported that the short distance to the clinic encouraged them to attend regular treatment follow-up. Most of the respondents were unable to get enough food, leading to stress and feelings of hopelessness. Lack of social support for most of the patients was a critical factor for adherence as were stigma, medication side effects and long treatment duration. Recognized as an enabler to treatment adherence, health workers had good communication and positive attitude towards their patients.ConclusionLack of knowledge, loss of income, stigma and lack of social support, drug side effects and long treatment duration emerged as important barriers for treatment adherence. Short distances to health facilities, good communication and accepting attitude of health care providers emerged as enablers for treatment adherence. For better treatment adherence, comprehensive health education at treatment sites, patient’s family members and the community at large and strengthening of social support structures need to be addressed.
Highlights
Non-adherence to tuberculosis (TB) treatment is an important barrier for TB prevention and control
The TB case fatality rate varied widely—from under 5% in some countries to more than 20% in most countries in the WHO African Region. This highlights the persistence of large inequities in access to high-quality diagnostic and treatment services, widespread poverty, poor treatment adherence and lowered immunity in these countries [3, 4]. This is significant for the developing world because low- and middle-income countries share the largest burden of TB, worsened by the fact that about 75% of TB patients are in the youngest and economically most productive age groups (15–54 years) [3]
Study sites Six health facilities were designated as directly observed treatment schedule (DOTS) giving sites in Asmara by the Ministry of Health
Summary
Non-adherence to tuberculosis (TB) treatment is an important barrier for TB prevention and control. The TB case fatality rate varied widely—from under 5% in some countries to more than 20% in most countries in the WHO African Region This highlights the persistence of large inequities in access to high-quality diagnostic and treatment services, widespread poverty, poor treatment adherence and lowered immunity in these countries [3, 4]. This is significant for the developing world because low- and middle-income countries share the largest burden of TB, worsened by the fact that about 75% of TB patients are in the youngest and economically most productive age groups (15–54 years) [3]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call