Factors associated with extreme nonadherence to tb treatment among adult defaulters attending Gqeberha clinic between 2018 and 2019
Date
2024
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
University of the Witwatersrand, Johannesburg
Abstract
Background
Tuberculosis remains a significant public health problem in sub-Saharan Africa leading to high morbidity, mortality, social and economic implications. Tuberculosis is a curable condition that can be eliminated. However, global efforts towards ending TB are under threat from patients’ nonadherence to effective TB treatment. This study aimed to determine the prevalence and factors associated with extreme nonadherence to TB treatment among adult defaulters attending Gqeberha clinic in South Africa.
Methods
The study is a secondary data analysis of a cross sectional study on TB defaulters attending Gqeberha clinic. The analysis included 144 participants with minimum age of 18 years who had defaulted treatment between April 2018 and September 2019. TB nonadherence and study characteristics were described using frequencies and percentages. Extreme nonadherence was defined by an aggregate score of at least 4 based on the Morisky Medication Adherence 8-item
scale (MMA8). The prevalence of extreme nonadherence was estimated using percentage frequencies while univariable and multivariable logistic regression modelling were performed to identify the factors associated with extreme nonadherence.
Results
There were 18(12.9%) TB defaulters who had extreme nonadherence. The majority of TB defaulters 65.2% (n=90) were men. All participants involved had a minimum age of 18 years. 73.4% (n =102) of the study participants stayed in formal dwellings, 79.1% (n =110) were unemployed, 68.8% (n =95) had not attained matric level qualification and 78.4% (n =109) were either single, divorced or separated. A larger proportion of participants, 79.9% (n =111) stayed within 5km radius of Gqeberha clinic, 65.5% (n =91) experienced shorter waiting times and 84.2% (n =117) acknowledged constant availability of medicines at the health facility. However, 69.1% (n =96) did not have a family member who encouraged them to attend clinic visits, 64% (n =89) lacked adequate food whilst taking medication, and 80.6% (n=112) had inadequate income to cover their basic needs whilst on treatment. After adjusting for covariates, those who took other medication besides TB treatment had 0.33 times odds (95% CI: 0.11-0.97) of extreme nonadherence compared to their contrasting peers. All the other factors were not significant in
the adjusted model.
Conclusion
The prevalence of extreme nonadherence to TB treatment among adult defaulters was low. The participants involved in the study were from low-income families with the majority being unemployed, having low educational attainment and lacking adequate food during treatment course. The use of multiple drugs was significantly associated with lower odds of extreme nonadherence. There is need to intensify programs aimed at improving adherence to treatment if the end TB by 2035 goal is to be realized.
Description
Research report submitted for the degree of MSc in Epidemiology, Field of Implementation Sciences, to the Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, 2024
Keywords
Tuberculosis (TB), Extreme nonadherence, Defaulter, UCTD
Citation
Chipise, Elisha. (2024). Factors associated with extreme nonadherence to tb treatment among adult defaulters attending Gqeberha clinic between 2018 and 2019 [Master’s dissertation, University of the Witwatersrand, Johannesburg]. WireDSpace.