Positive impact of knowledge about tuberculosis and its treatment on treatment adherence among new smear-positive tuberculosis patients in ward E of Mumbai, Maharashtra, India

Abstract

Background: Treatment nonadherence is major challenge before tuberculosis (TB) control activities. Treatment adherence is the result of interactions of various factors related to the patient, provider, health setup, type of illness, and sociocultural factors. Aim: The aim was to assess baseline knowledge of new smear-positive TB patients about their disease and treatment and to find its impact on treatment adherence. Methods: New sputum-positive TB patients initiated directly observed treatment short-course in ward E of Mumbai district in first two-quarters of the calendar year were enrolled in the study. They were interviewed by trained interviewer as per pretested semi-structured interview schedules to collect sociodemographic information and to assess their knowledge after verbal consent. Treatment adherence was noted by screening treatment cards after any final outcome of the treatment as per Revised National Tuberculosis Control Program. Data were entered in Microsoft excel and analyzed using SPSS 15.0 software (developed by IBM, Chicago, USA in 2007). Results: Out of 157 patients enrolled, 150 could be interviewed. The majority were in reproductive age group and from class IV and V socioeconomic class. Good knowledge about infectiousness, reasons behind TB, its spread, curability, and treatment duration was found in 29.5%, 28.8%, 16%, 59%, and 22.3%, respectively. 72/150 were treatment adherent and good knowledge about all these aspects was significantly associated with treatment adherence. Most significant association was found with good knowledge about infectiousness of TB (odds ratio: 1.764, P < 0.001). Conclusions: Thorough knowledge regarding TB and its treatment should be given to the TB patients at the initiation of the treatment may help to improve treatment adherence.