Pattern of tuberculosis infection and adherence to Directly Observed Treatment Strategy at a teaching hospital in Nigeria

Abstract

Background: Understanding the distribution pattern of tuberculosis infection as well as adherence to treatment guidelines could help to strengthen existing policy aimed at reducing morbidity associated with the disease. Aim: To assess the pattern of sputumsmear positive tuberculosis infection and adherence to Directly Observed Treatment Strategy (DOTS). Methods: This was a retrospective cohort study which utilized secondary data involving 210 sputum smear-positive tuberculosis patients with complete data out of 226 that underwent DOTS at LUTH from January 2008 to June 2011. Results: 66.2% of patients were HIV positive and 75.9% had pulmonary tuberculosis. The proximity of residence to the hospital was ≤25km for majority (65.7%) of the patients. 75.9% of the patients adhered to DOTS. Treatment outcomes included 72.5% cured, 8.6% dead and 12.4% defaulted. Median sputum conversion time was 67 (range: 63 ‐ 71) days. Patients who resided ≤25km to the hospital (65.7%) significantly adhered to treatment compared to those who lived >25km (31.6%). Also, patients who received family support significantly adhered to therapy (83.0%) com pared to those who did not (14.6%). Median conversion time was lower among those who adhered to treatment [58 (range: 54 ‐ 63) days] compared to those who did not [73 (range: 69 ‐ 77) days]. Conclusion: Majority of smear-positive tuberculosis infected pati ents were males and their level of adherence was high. Family support received was identified to influence adherence. Integration of family support with directly observed treatment strategy as well as location of treatment centers close to patients’ residence could enhance effectiveness of the strategy.