Adherence to Drug Medications amongst Tuberculosis Patients in a Tertiary Health Institution in South East Nigeria
Author(s)
Chika F. Ubajaka1*,
Emmanuel C. Azuike1,
John O. Ugoji2,
Onyema E. Nwibo3,
Obiorah C. Ejiofor4,
Ifeoma A. Modebe1,
Uche M. Umeh1
Affiliation(s)
1 Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. 2 Department of Pharmacy, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. 3 Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. 4 Department of Paediatrics, Anambra State University Teaching Hospital, Amaku, Nigeria.
1 Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. 2 Department of Pharmacy, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. 3 Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. 4 Department of Paediatrics, Anambra State University Teaching Hospital, Amaku, Nigeria.
ABSTRACT
Tuberculosis remains one of the major health problems in many tropical countries. An estimated eight to ten million people develop overt tuberculosis annually worldwide as a result of primary infection, endogenous reactivation or exogenous re-infection. About half of all patients with TB do not complete treatment and this contributes to prolonged infectiousness, drug resistance, relapse and death. This study is aimed at assessing the adherence of TB patients to anti-TB medications as well as the factors influencing drug adherence in a tertiary health care institution in South-Eastern Nigeria. A descriptive cross-sectional study was conducted among 217 TB patients in Nnamdi Azi-kiwe University Teaching Hospital, Nnewi. Information was obtained using a self-administered and interviewer administered semi-structured questionnaire. The mean age of the respondents is 36.1 ± 13.3 years. More of the respondents were females (58.1%), while 41.9% were males. It was observed that 74.2% had never failed to take their anti-TB drugs while 24.2% agreed they had failed to take their drugs. The major reasons for failure to take drugs were no money for transport to collect new drugs and forgetfulness by 32.7% of the respondents respectively. The factors which influenced drug adherence were educational qualification, average monthly income, ill-health as a financial burden and receiving HIV drugs (P < 0.05). Adherence towards anti-TB medications is good. However, efforts need to be intensified to educate and encourage TB patients to adhere strictly to their drugs as this will be of great value to them and the community at large.
Cite this paper
Ubajaka, C. , Azuike, E. , Ugoji, J. , Nwibo, O. , Ejiofor, O. , Modebe, I. and Umeh, U. (2015) Adherence to Drug Medications amongst Tuberculosis Patients in a Tertiary Health Institution in South East Nigeria. International Journal of Clinical Medicine, 6, 399-406. doi: 10.4236/ijcm.2015.66052.
Ubajaka, C. , Azuike, E. , Ugoji, J. , Nwibo, O. , Ejiofor, O. , Modebe, I. and Umeh, U. (2015) Adherence to Drug Medications amongst Tuberculosis Patients in a Tertiary Health Institution in South East Nigeria. International Journal of Clinical Medicine, 6, 399-406. doi: 10.4236/ijcm.2015.66052.
References
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[1] Giles, H.N. and Lucas, A.O. (2003) A Short Textbook of Public Medicine for the Tropics and Sub-Tropics. 4th Edition, Arnold, A Member of the Hodder Headline Group, London, 159-163. [2] Kumar, V., Abbas, A.K. and Fausto, N. (2004) Robbins and Cotrane Pathological Basis of Disease.7th Edition, Elsevier, A Division of Reed Elsevier India Private Limited, New Delhi, 381. [3] Nicholas, A.B., Nicki, R.C. and Brian, R.W. (2006) Davidson’s Principles and Practice of Medicine. 20th Edition, Elsevier Limited, Edinburgh, 675-696. [4] False, A.O. and Akinkugbe, O.O. (2002) A Compendium of Clinical Medicine. 2nd Edition, Spectrum Books Limited, Ibadan, 163-165. [5] The Guardian Newspaper (2009) The Race against Tuberculosis Burden. [6] Udoh, F. (2012) Nigeria: Burden of Tuberculous Disease in Nigeria.
http://allafrica.com/stories/201207020161.html [7] United States Embassy in Nigeria (2012) Nigeria Tuberculosis Fact Sheet 2012.
http://nigeria.usembassy.gov./ [8] Pawlowski, A., Jansson, M., Skold, M., Rottenberg, M.E. and Kallenius, G. (2012) Tuberculosis and HIV Co-Infection. PLOS Pathogens, 8, 1002464.
http://dx.doi.org/10.1371/journal.ppat.1002464 [9] Awofeso, N. (2008) A Study on Impact of Medication Side Effects on Treatment Adherence to Tuberculosis in Kyrgyzstan Prison. WHO Bulletin, 86, 161. [10] Munro, S.A., Lewin, S.A., Smith, H.J., Engel, M.E., Fretheim, A. and Volmink, J. (2007) Patient Adherence to Tuberculosis Treatment : A Systematic Review of Qualitative Research. PLOS Medicine, 4, e238.
http://dx.doi.org/10.1371/journal.pmed.0040238 [11] Kaona, F.A.D., Tuba, M., Siziya, S. and Sikaona, L. (2004) An Assessment of Factors Contributing to Treatment Adherence and Knowledge of Tuberculosis Transmission among Patients on Tuberculosis Treatment. BMC Public Health, 4, 68.
http://dx.doi.org/10.1186/1471-2458-4-68 [12] Araoye, M.O. (2003) Research Methodology with Statistics for Health and Social Sciences. Nathadex Publishers, Ilorin, 120. [13] Imam, T.S. and Oyeyi, T.I. (2008) A Retrospective Study of Pulmonary Tuberculosis (PTB) Prevalence amongst Patients Attending Infectious Diseases Hospital (IDH) in Kano, Nigeria. Bayero Journal of Pure and Applied Sciences, 1, 10-15. [14] Nwene, E. (2014) An Evaluation of Treatment Outcome in Tuberculosis Directly Observed Treatment Short Course (DOTS) Facilities in Anambra State (2004-2008). Unpublished Master’s Thesis, Nnamdi Azikiwe University, Awka.
http://naulibrary.org/dglibrary/admin/book_directory/Thesis/10363.pdf [15] Yao, S., Huang, W., Van den Hof, S., Yang, S., Wang, X., Chen, W., et al. (2011) Treatment Adherence among Sputum Smear-Positive Pulmonary Tuberculosis Patients in Mountainous Areas in China. BMC Health Services Research, 11, 341.
http://dx.doi.org/10.1186/1472-6963-11-341 [16] Mkopi, A., Range, N., Lwila, F., Egwaga, S., Schulze, A., Geubbels, E., et al. (2012) Adherence to Tuberculosis Therapy among Patients Receiving Home-Based Directly Observed Treatment: Evidence from the United Republic of Tanzania. Plos ONE, 7, e51828.
http://dx.doi.org/10.1371/journal.pone.0051828 [17] Amuha, M.G., Kutyabami, P., Kitutu, F.E., Odoi-Adome, R. and Kalyango, J.N. (2009) Non-Adherence to Anti Tuberculosis Drugs among TB/HIV Co-Infected Patients in Mbarara Hospital Uganda: Prevalence and Associated Factors. African Health Sciences, 9, 8-15. [18] Oluwadare, C. and Ibirinde, B. (2010) Health Seeking Behavior of Tuberculosis Patients in Ekiti State, Nigeria. EthnoMed, 4, 191-197. [19] Bagchi, S., Ambe, G. and Sathiakumar, N. (2010) Determinants of Poor Adherence to Anti-Tuberculosis Treatment in Mumbai India. International Journal of Preventive Medicine, 1, 223-232. [20] McDonnell, M., Turner, J. and Weaver, M.T. (2001) Antecedents of Adherence to Anti Tuberculosis Therapy. Public Health Nursing, 18, 392-400.
http://dx.doi.org/10.1046/j.1525-1446.2001.00392.x [21] Castlenuovo, B. (2010) A Review of Compliance to Anti Tuberculosis Treatment and Risk Factors for Defaulting Treatment in Sub-Saharan Africa. African Health Sciences, 10, 320-324. [22] Khalili, H., Dashti-khavidaki, S., Sajadi, S. and Hajiabolbaghi, M. (2008) Assessment of Adherence to Tuberculosis Drug Regimen. DARU, 16, 47-50. [23] Gad, A., Mandil, A.M., Sherif, A.A., Gad, Z.M. and Sallam, S. (1997) Compliance with Anti-Tuberculosis Drugs among Tuberculosis Patients in Alexandria, Egypt. La Revue de Santé Méditerrannée orientale, 3, 244-250. [24] Comolet, T.M., Rakotomalala, R. and Rajaonarioa, H. (1998) Factors Determining Compliance with Tuberculosis Treatment in an Urban Environment, Tamatave, Madagascar. The International Journal of Tuberculosis and Lung Disease, 2, 891-897. [25] Naing, N.N., D’Este, C., Isa, A.R., Salleh, R., Bakar, N. and Mahmod, M.R. (2001) Factors Contributing to Poor Compliance with Anti-Tuberculosis Treatment among Tuberculosis Patients. The Southeast Asian Journal of Tropical Medicine and Public Health, 32, 369-382. [26] Center for Disease Control (2010) HIV Testing and Treatment among Tuberculosis Patients in Kenya, 2006-2009. Morbidity and Mortality Weekly Report (MMWR), 59, 1514-1517.