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Patient attitudes towards community-based tuberculosis DOT and adherence to treatment in an urban setting; Kampala, Uganda.

Abstract High Tuberculosis treatment default rate (17%) and sub-optimal treatment completion rates (45%) has burdened Kampala. Nevertheless, there are observable increase in the number of patients on TB DOT; from 6% to 29% in two consecutive annual reports. The main objective was to determine the association of TB patient attitudes towards community-based observers on the TB drug adherence on directly observed treatment for TB in Kampala.
PMID
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Authors

Mayor MeshTerms
Keywords

Tuberculosis

community-based

pulmonary tuberculosis

treatment supporters

tuberculosis directly observed treatment

Journal Title the pan african medical journal
Publication Year Start




PMID- 28748003
OWN - NLM
STAT- MEDLINE
DA  - 20170727
DCOM- 20170804
LR  - 20170804
IS  - 1937-8688 (Electronic)
VI  - 27
DP  - 2017
TI  - Patient attitudes towards community-based tuberculosis DOT and adherence to
      treatment in an urban setting; Kampala, Uganda.
PG  - 1
LID - 10.11604/pamj.2017.27.1.11119 [doi]
AB  - INTRODUCTION: High Tuberculosis treatment default rate (17%) and sub-optimal
      treatment completion rates (45%) has burdened Kampala. Nevertheless, there are
      observable increase in the number of patients on TB DOT; from 6% to 29% in two
      consecutive annual reports. The main objective was to determine the association
      of TB patient attitudes towards community-based observers on the TB drug
      adherence on directly observed treatment for TB in Kampala. METHODS: A
      cross-sectional study was carried out in Lubaga division, Kampala. A total of 201
      patients in continuation phase of treatment for Pulmonary TB (i.e. 8 to 20 weeks 
      of TB treatment) were included in the study. Patient attitudes were measured
      using a 4-point Likert scale aggregated into a binary outcome with ''agree'' and 
      ''disagree'' responses. Poisson regression model using a forward fitting approach
      in STATA v12 was used to determine the association between patient attitude
      towards CB-DOTs observers and adherence to TB treatment. RESULTS: Among the 201
      patients, 66% reported their treatment was being observed by someone. Relatives
      were the commonest (82%) treatment observers, 26% were non adherent to their TB
      treatment. Perceiving ''no need for a treatment observer'' and ''people rejecting
      TB patients'' were predictors of non-adherence to TB treatment (IRR=1.6,95%CI
      1.00-2.57;p=0.048) and (IRR=0.6, 95%CI 0.35-0.95; p=0.019) respectively.
      CONCLUSION: Patient's perceived attitude and stigma towards treatment observers
      contribute to non-adherence on TB treatment. For improved local TB control, more 
      emphasis is needed to build a friendly environment between treatment supporters
      and patients during the course of TB treatment.
FAU - Hassard, Sempeera
AU  - Hassard S
AD  - School of Public Health, Makerere University, Kampala, Uganda.
AD  - International Health Sciences University.
FAU - Ronald, Anguzu
AU  - Ronald A
AD  - School of Public Health, Makerere University, Kampala, Uganda.
FAU - Angella, Kawooya
AU  - Angella K
AD  - International Health Sciences University.
LA  - eng
PT  - Journal Article
DEP - 20170501
PL  - Uganda
TA  - Pan Afr Med J
JT  - The Pan African medical journal
JID - 101517926
RN  - 0 (Antitubercular Agents)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Antitubercular Agents/*administration & dosage
MH  - Attitude to Health
MH  - Community Health Services/methods
MH  - Cross-Sectional Studies
MH  - Directly Observed Therapy/*psychology
MH  - Female
MH  - Humans
MH  - Male
MH  - Medication Adherence/*psychology
MH  - Middle Aged
MH  - Poisson Distribution
MH  - Social Stigma
MH  - Tuberculosis, Pulmonary/*drug therapy
MH  - Uganda
MH  - Urban Population
MH  - Young Adult
PMC - PMC5511727
OTO - NOTNLM
OT  - Tuberculosis
OT  - community-based
OT  - pulmonary tuberculosis
OT  - treatment supporters
OT  - tuberculosis directly observed treatment
EDAT- 2017/07/28 06:00
MHDA- 2017/08/05 06:00
CRDT- 2017/07/28 06:00
PHST- 2016/11/08 [received]
PHST- 2017/04/22 [accepted]
AID - 10.11604/pamj.2017.27.1.11119 [doi]
AID - PAMJ-27-1 [pii]
PST - epublish
SO  - Pan Afr Med J. 2017 May 1;27:1. doi: 10.11604/pamj.2017.27.1.11119. eCollection
      2017.