Assessment of factors affecting adherence to tuberculosis treatment in Northern Uganda : A case study of TB patients in Kitgum Hospital

Abstract

The study sought to Assess Factors Affecting Adherence to Tuberculosis Treatment in Northern Uganda, with the objective to: assess TB patients’ perceptions on adherence to treatment services; examine TB patients’ attitudes on care and treatment; identify challenges faced by TB patients while on treatment; identify possible solutions for improving adherence to TB treatment. A cross-sectional research design using both quantitative and qualitative research methods was used. A questionnaire was used to assess factors affecting adherence to tuberculosis treatment among 107 TB patients and 7 Key Informant Interviews. Observation was used for in-depth data collection. Quantitative data was edited, coded and analyzed using SPSS v 20.0. Qualitative data from key informants was transcribed and coded. Qualitative content analysis using the master sheet framework was used. Verbatim quotes were used during the analysis and report writing. The findings show that 98.1% of respondents were positive that they would comply with the instructions of TB treatment provided to them by health workers; know that TB can be cured; and have strong beliefs in the effectiveness of the TB regimen in curing TB disease. The majority of respondents were males with 66.4% and females were 33.6% respectively. In addition, 68.5% of the TB patients experienced side effects while on treatment. Long waiting time for service by 14.2% respondents as the greatest challenge faced by patients, while 13.3% the second biggest challenge faced by patients was inadequate/lack of food to take drugs. It was revealed that the major possible solution for improving adherence to tuberculosis treatment is food provision (23.5%). The majority of key informants pointed out this too. It was concluded that people have knowledge on TB transmission and prevention, that long waiting time for service was the greatest challenge towards TB treatment and that the major possible solution was food provision because medicines usually weaken the body of the patients. It was recommended that hospital management should provide food to both inpatients and outpatients; and need to track the lost to follow up patients. It was further, recommended that Ministry of Health should rehabilitate/renovate the TB ward; ensure constant supply of medicines for side effect management; recruit adequate staff; need to address the issue of stigma and discrimination; upgrade some HC IIs to HC IIIs; effective and constant supply of laboratory supplies and reagents; health workers should carryout continuous counseling and health education to TB patients and their care givers.