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- Title
Factors affecting nonadherence to tuberculosis treatment in uMgungundlovu Health District in 2010.
- Authors
Ndwandwe, Z. S. I.; Mahomed, S.; Lutge, E.; Knight, S. E.
- Abstract
KwaZulu-Natal has a high burden of tuberculosis disease, and is currently not meeting national and international treatment outcome targets. The aim of this study was to investigate patient-related and socio-economic factors that affect treatment adherence in patients on tuberculosis treatment in uMgungundlovu Health District. A case-control study design was used. Three hundred cases (treatment interruption) and 300 controls (treatment completed) were interviewed by trained fieldworkers using a structured questionnaire. In bivariate analysis, lack of education, unemployment and other socio-economic indicators (low income, type of housing, sanitation and residential area) were associated with an increased risk of treatment interruption. Personal factors [smoking, drug and alcohol use, human immunodeficiency virus (HIV) co-infection and perceived severity of illness] were also risk factors for treatment interruption. In multivariate analysis, distance from the clinic was significantly associated with treatment interruption [adjusted odds ratio (OR) 1.3, 95% confidence interval (CI): 1.3-1.6, p-value < 0.005)], as well as residing in a rural area (adjusted OR 14, 95% CI: 1.1- 18, p-value < 0.005). Patients co-infected with HIV were twice as likely to interrupt treatment (adjusted OR 2.3, 95% CI: 1.1-4.7, p-value < 0.005), and feeling very or fairly ill during tuberculosis treatment was also significantly associated with treatment interruption (adjusted OR 5.0, 95% CI: 2.1-11.9, p-value < 0.005). The results highlight the complex interaction between personal and socio-economic risk factors for treatment interruption.
- Subjects
KWAZULU-Natal (South Africa); PATIENT compliance; TUBERCULOSIS treatment; SOCIOECONOMIC factors; PATIENT education; HIV infections
- Publication
Southern African Journal of Infectious Diseases, 2014, Vol 29, Issue 2, p56
- ISSN
2312-0053
- Publication type
Article
- DOI
10.1080/23120053.2014.11441570