Abstract
BackgroundNon-adherence to tuberculosis (TB) treatment threatens the success of treatment, increases the risk of TB spread, and leads to the development of drug resistance. The present study assessed non-adherence to anti-TB treatment among internal migrants with pulmonary TB living in Shenzhen, China, and examined risk factors for non-adherence in order to identify targets for intervention.MethodsA total of 794 internal migrants with TB treated at Bao’an Hospital for Chronic Disease Prevention and Cure, Shenzhen, were recruited. Structured questionnaires were used to collect data on these patients’ history and experiences with TB treatment. Ordinal logistic regression model were used to identify risk factors for non-adherence.ResultsThe proportion of patients who had missed one dose of medication within two weeks was 93/794 (11.71%), and those who missed at least two doses of medication within two weeks was 167/794 (21.03%), with a total of 33.74% of patients not adhering to TB treatment. Lack of knowledge about TB treatment and longer travel time to the nearest community health centers are significant predictors for non-adherence.ConclusionsThe present study shows that non-adherence is common among internal migrants with TB. Patients who lack knowledge about TB treatment or have to travel far to get treated are prone to miss one or more doses of medication. Interventions to improve health education and healthcare access are essential to reduce non-adherence to TB treatment among internal migrants.
Highlights
Non-adherence to tuberculosis (TB) treatment threatens the success of treatment, increases the risk of TB spread, and leads to the development of drug resistance
A standard anti-TB treatment requires the use of a number of medications regularly for a period of at least 6 months for a new patient and 8 months for a retreatment patient, which has been implemented in programs such as Directly Observed Therapy, Short-course (DOTS), promoted vigorously by World Health Organization (WHO) [3]
Patients with lower education level, single, employed, newly diagnosed, living farther away from community health centers (CHCs) had higher rates of non-adherence, and their lack of knowledge about anti-TB treatment was associated with higher non-adherence rates
Summary
Non-adherence to tuberculosis (TB) treatment threatens the success of treatment, increases the risk of TB spread, and leads to the development of drug resistance. According to the World Health Organization (WHO), there were 8.6 million new cases of TB and 1.3 million died from this disease worldwide in 2012 [1]. Data from the Fifth National TB Epidemiological Survey in 2010 showed that there were about 4.99 million TB patients in China, with a prevalence rate of Besides active surveillance and prevention, treatment adherence is of the greatest importance in TB control. Many factors from patient activation to care access can come into play and undermine the treatment adherence, threatening the success of treatment, increasing morbidity and mortality, Tang et al BMC Public Health (2015) 15:474 causing drug resistance, and increasing the risk of TB spread [4]
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