A study on factors associated with treatment interruption among resistered tuberculosis patients in HoniaraCity Solomon Islands: 2006–June 2010.
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Background: Interruption of TB treatment is a major challenge faced in tuberculosis control programs and is the leading cause of default and multi-drug resistant-tuberculosis. Efforts to avoid the interruption of treatment require knowledge and understanding of the complex socio-economic, cultural and behavioral issues associated with interruption among patients and service providers.Study objectives: The overall objective of this study is to assess and identify socio-economic and demographic factors and how they influence the decision of patients registered and treated for TB in Honiara City.Methods: This study was carried out in Honiara City, in the Solomon Islands. Patients who had a history of interruption for at least one day and were of the age of 15 years and over were selected to participate in the study. Seventy-nine TB patients registered during the period of 2006 to June 2010 were interviewed using structured questions covering socio-economic, cultural, and demographic factors and 77 (97.5%) were accepted for analysis after data cleaning was conducted. Four steps of data analysis were conducted using SPSS software version 18. First, single tabulation analysis to assess the proportions of variables was conducted. Variables that were deemed significant in the single tabulation were analyzed to assess for their associations using the cross-tabulation method of the chi-square test. ANONA was used to assess the differences among variables that had significant association in the chi-square test, and was followed by a multiple regression analysis for factors found significant in the ANOVA test.Results: Of the 77 respondents, 46 (59.7%) were male and 31 (40.3%) were female. Ages ranged from 15-67 years, with a mean of 31.8 years. Frequency of interruption of treatment ranged from 1-11 times with a mean of 3.8. Duration ranged from 2-64 days with a mean of 22 days. The main factors identified in this study associated with treatment interruption were a lack of family support (91.8%), feeling better (90.0%), not knowing the risks of interruption (87.5%), not knowing one had TB (86.6%), concomitant diseases (85.7%), a lack of understanding of the English instructions used on the treatment label (81.8%), work commitments (79.5%), communication barriers (76.9%), drinking alcohol during the treatment period (67.6%), transportation costs (67.3%), stigma (65.9%), and drug side-effects (54.5%). Eleven (14.3%) of the respondents have reached a duration of interrupted treatment of over 56 days. The duration of treatment is the outcome variable for the study. The study found that age, educational attainment, and marital status were the associated factors for the interruption of treatment, while level of income was seen as an associated factor for transportation costs.Conclusion: Effective health education programs should be given to groups vulnerable to the interruption of treatment, such as the elderly, people with a lower level of education, and low income earners. TB education needs to pay attention to patientrelated factors, such as knowledge of TB, social support from family, and issues related to the stigma. The establishment of counseling programs for both patients and family members during the intensive phase of treatment is the recommended intervention for improvement. Continuous training for health workers is also essential.
- 2011-10-00