JTR  Vol.2 No.1 , March 2014
Assessment of Defaulting from Directly Observed Treatment Short Course (DOTS) and Its Determinants in Benin City, Nigeria
Abstract: Background: Defaulting from Directly Observed Treatment Short Course (DOTS) is a big challenge to the effective control of TB. There are no published data on defaulting from DOTS in Benin City which necessitated this study to determine the rate of defaulting and identify factors that significantly contribute to defaulting in Benin City, Nigeria. Methods: This was a case control study from August to December 2011 of 1253 TB patients placed on DOTS in Benin City. The two DOTS centres used for the study were situated in University of Benin Teaching Hospital (UBTH) and Egor local government secretariat, both in Egor local government area (LGA) in Benin City. Out of 1253 patients registered on DOTS in the two study centres, 722 patients comprising of 172 defaulters and 550 non- defaulters were selected for the study using the inclusion and exclusion criteria. Logistic regression analysis was performed to determine association between independent variables and defaulting. Results: The default rate was 23.8%. Defaulting was significantly associated with: male sex (OR 3.05; 95%CI 1.60 - 5.80), being married (OR 3.06; 95%CI 1.34 - 6.99), a history of travel (OR 6.87; 95%CI 3.19 - 14.80) and concomitant drug use with TB drugs (OR 1.95; 95%CI 1.02 - 3.73). Conclusion: The default rate from DOTS in Benin City and the factors significantly associated with defaulting have given us some information initially unavailable about defaulting from DOTS in Benin City. TB control programmes taking these factors into consideration need to be done to promote compliance to treatment.
Cite this paper: Inotu, A. and Abebe, F. (2014) Assessment of Defaulting from Directly Observed Treatment Short Course (DOTS) and Its Determinants in Benin City, Nigeria. Journal of Tuberculosis Research, 2, 30-39. doi: 10.4236/jtr.2014.21004.

[1]   Kendall, E.A., Theron, D., Frank, M.F., et al. (2013) Alcohol Hospital Discharge, and Economic Risk Factors for Default from Multidrug Resistant Tuberculosis Treatment in Rural South Africa: A Retrospective Study. PLoS ONE, 8, e83480.

[2]   Chisti, M.J., Ahmed, T., Pietroni M.A., et al. (2013) Pulmonary Tuberculosis in Severely Malnourished or HIV-Infected Children with Pneumonia: A Review. Journal of population Nutrition, 31, 308-313.

[3]   Hood, M.L. (2013) A Narrative Review of Recent Progress in Understanding the Relationship between Tuberculosis and Protein Energy Malnutriton. European Journal of Clinical Nutrition, 67, 1122-1128.

[4]   Millet, J.P., Moreno, A., Fina, L., et al. (2013) Factors That Influence Current Tuberculosis Epidemiology. European Spine Journal, 4, 539-548.

[5]   World Health Organization (2013) Global Tuberculosis Control. WHO Report 2013, Geneva.

[6]   Ukawaka, K.N., Alobu, I., Nweke, C.O. and Onyenwe, E.C. (2013) Health-Care Seeking Behavior, Treatment Delays and Its Determinants among Pulmonary Tuberculosis Patients in Rural Nigeria: A Cross-Sectional Study. BMC Health Services Research, 13, 25.

[7]   World Health Organization (2012) Global Tuberculosis Report 2012, Geneva.

[8]   Government Population Census of Nigeria, 2006

[9]   Cayla, J.A., Rodrigo, T., Ruiz-Manzano, J., Caminero, J.A., Vidal, R., Garcia, J.M., et al. (2009) Tuberculosis Treatment Adherence and Fatality in Spain. Respiratory Research, 10, 121.

[10]   Borgdoff, M.W., Veen, J., Kalisvaart, N.A., Broekmans, J.F. and Nagelkerke, N.D. (2000) Defaulting from Tuberculosis Treatment in the Netherlands: Rates, Risk Factors and Trend in the Period 1993-1997. European Respiratory Journal, 16, 209-213.

[11]   Salami, A.K. and Oluboyo, P.O. (2003) Management of Pulmonary Tuberculosis: A Nine Year Review in Ilorin, Nigeria. West Africa Journal of Medicine, 22, 114-119.

[12]   Erhabor, G.E., Adebayo, R.A., Omodara, J.A. and Famurewa, O.C. (2003) Ten Year Review of Patterns of Presentation and Outcome of Pulmonary Tuberculosis in OAUTHC, Ile Ife, Nigeria. Journal of health science, 3, 34-39.

[13]   Salami, T.A.T., Samuel, S. O., Eze, K.C. and Oziogbe, O.E. (2007) Tuberculosis in a Nigerian Teaching Hospital: Incidence and Pattern of Distribution. Tropical Journal of Health Science, 14, 26-30.

[14]   Elangovan, R. and Arulchevan, S. (2013). A Study on the Role of Mobile Phone Communication in Tuberculosis DOTS Treatment. Indian Journal of Community Medicine, 38, 229-233.

[15]   Kunawararak, P., Pongpanich, S., Chantawong S., Pokaew P., et al. (2013) Tuberculosis Treatment with Mobile-Phone Medication Reminders in Northern Thailand. South East Asian Journal of Tropical Medicine and Public Health, 24, 1444-1451.

[16]   Daniel, O.J., Oladapo, O.T. and Alausa, O.K. (2006) Default from Tuberculosis Treatment Programme in Sagamu, Nigeria. Nigerian Journal Medicine, 15, 63-67.

[17]   Tekle, B., Mariam, D.H. and Ali, A. (2002) Defaulting from DOTS and its determinants in three districts of Arsi Zone in Ethiopia. International Journal of Tuberculosis and Lung Disease, 6, 573-579.

[18]   Chee, C.B.E., Boudville, I.C., Chan, S.P., Zee, Y.K. and Wang, Y.T. (2000) Patients and disease characteristics and outcome of treatment defaulters from Singapore tuberculosis control unit: a one-year retrospective survey. International Journal of Tuberculosis and Lung Disease, 4, 496-503.

[19]   Muture, B.N., Keraka, M.N., Kimuu, P.K., Kabiru, E.W., Ombeka, V.O. and Oguya, F. (2011) Factors Associated with Default among Tuberculosis Patients in Nairobi Province, Kenya: A Case Control Study. BMC Public Health, 11, 696.

[20]   Chan-Yeung, M., Noertjojo, K., Leung, C.C., Chan, S.L. and Tam, C.M. (2003) Prevalence and Predictors of Default from Tuberculosis Treatment in Hong Kong. Hong Kong Journal of Medicine, 9, 263-268.

[21]   Oliveira, V.L., da Cunha, A.J. and Alves, R. (2006) Tuberculosis Treatment Default among Brazilian Children. International Journal of Tuberculosis and Lung Disease, 10, 864-869.

[22]   World Health Organization (1996) Group at Risk. WHO’s Report on the Tuberculosis Epidemics. WHO, Geneva, 42-55.

[23]   Fatiregun, A.A., Ojo, A.S. and Bamgboye, A.E. (2009) Treatment Outcomes among Pulmonary Tuberculosis Patients at Treatment Centres in Ibadan, Nigeria. Annals of African Medicine, 8, 100-104.

[24]   Chuah, S.Y. (1991) Factors Associated with Poor Patient Compliance with Anti-Tuberculosis Therapy in Northwest Perak, Malaysia. Journal of Tuberculosis, 72, 261-264.

[25]   Cormolet, T.M., Rakotomalala, R. and Rajaonarioa, H. (1998) Factors Determining Compliance with Tuberculosis Treatment in an Urban Environment, Tamatave, Madagascar. International Journal of Tuberculosis and Lung Disease, 2, 891-897.

[26]   Xu, W., Lu, W., Zhou, Y., Zhu, L., Shen, H. and Wang, J. (2009) Adherence to Anti-Tuberculosis Treatment among Pulmonary Tuberculosis Patients: A Qualitative Study. BMC Health Service Research, 9, 169.

[27]   Vijay, S., Balasangameswara, V, H., Jagannatha, P.S., Saroja, V.N. and Kumar, P. (2003) Defaults among Tuberculosis Patients Treated under DOTS in Bangalore City: A Search for Solution. Indian Journal of Tuberculosis, 50, 185-196.

[28]   Mishra, P., Hansen, E.H., Sabroe, S. and Kafle, K.K. (2005) Socio-Economic and Adherence to Tuberculosis Treatment: A Case Control Study in a District in Nepal. International Journal of Tuberculosis and Lung Disease, 9, 1134- 1139.

[29]   Shargie, E.B. and Lindtjørn, B. (2007) Determinants of Treatment Adherence among Smear Positive Pulmonary Tuberculosis Patients in Southern Ethiopia. PLOS Medicine, 4, 280-286.

[30]   Fry, R.S., Khoshnood, K., Vdovichenko, E., Granskaya, J., Sazhin, V., Shpakovskaya, L., et al. (2005) Barriers to Completion of Tuberculosis Treatment among Prisoners and Former Prisoners in St. Petersburg, Russia. International journal of Tuberculosis and Lung Disease, 9, 1027-1033.

[31]   Ayeh, C. (2011) Predictors of Tuberculosis Treatment Defaulting at Dangme West District, Accra, Ghana.