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Agaro Town, Jimma Zone, Oromia Region, Ethiopia ) Correspondence To: Eliyas Kadi (Msc., RPH., B

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Agaro Town, Jimma Zone, Oromia Region, Ethiopia ) Correspondence To: Eliyas Kadi (Msc., RPH., B UDK: 616-002.5-08(63) medicinska revija 614.2(63) medical review COBISS.SR-ID 220637964 Balche A. et al n MD-Medical Data 2015 ;7(4) : 263-270 Originalni ~lanci/ ADHERENCE TO ANTI-TUBERCULOSIS Original articles TREATMENT AMONG TUBERCULOSIS PATIENTS AT AGARO HOSPITAL AND ITS HEALTH CENTER (Agaro Town, Jimma Zone, Oromia Region, Ethiopia ) Correspondence to: Eliyas Kadi (MSc., RPH., B. Pharm) PRIDRŽAVANJE ANTITUBERKULOZNOG Lecturer Medicinal Chemistry Major Leader, Pharmaceutical Chemistry Course LEČENJA BOLESNIKA SA TUBERKULOZOM Team School of Pharmacy U BOLNICI I ZDRAVSTVENOM CENTRU College of Health Sciences Jimma University, Jimma, Ethiopia AGARO (Agaro Town, Jimma Zone, Oromia Region, Ethiopia ) Cell phone: +251912052022 [email protected] 1 1 P.O. Box. 5114 (Private) Asnake Balche , Eliyas Kadi and Ramya Krishna Jimma University Seelam 1 Jimma, Ethiopia Skype address; eliyaskadi 1 [email protected] Department of Pharmacy, College of Health Sciences, Jimma University, Jimma Ethiopia Abstract Key words Background: Tuberculosis is an important re-emerging disease with increased morbidity and mortality. Tuberculosis control is hindered by patient non-adherence with treatment TB, adherence, treatment, Agaro regimens. The poor adherence to anti-tuberculosis treatment among patients with tubercu - Hospital, Ethiopia losis is a major problem in Ethiopia. The purpose of this study was, therefore, to assess level of adherence to anti-tuberculosis treatment at Agaro hospital and its health center. Klju~ne re~i Method: Cross sectional study design was conducted to determine the level of adherence TB, pridržavanje, lečenje, Agaro bolnica, to anti-tuberculosis treatment among tuberculosis patients at Agaro hospital and its health Etiopija center, using structured questioner, from February 9 up to 20, 2015. Data was collected, compiled and analyzed to determine the level of adherence Result: Total of 137 patients included in this study. Among them 68 (49.6%) are females and 69 (50.4%) are males. Fifty three (38.7%) were in the age group of 25-46 and only 17(12.4%) were on age above 66. Total of interviewed patients, 79 (57.6%) were from urban area. The overall proportion of adherent patients was 91.2%. The main reasons for being non- adherent were forgetting to take medication (58.3%), being away from home (33.3%), and failure to go to the health facilities (8.3%) on their right appointment. Conclusion: The level of adherence (91.2%) observed in this study is relatively high. The main reasons for being non-adherent were forgetting to take medication, being away from home, failure to go to the health facilities on their right appointment. Health education on TB treatment and control must be continued in strengthened manner. Special emphasis should be made with regard to TB patients who are HIV positive to improve adherence to TB treatment by the health care provider of the health center. INTRODUCTION M. caprae, M. Canettiand M. pednpenii) (2) . The emergence of drug resistant strains of TB is considered a global threat Tuberculosis (TB) continues to be an important public to the control of the disease (3) . In spite of the fact that TB is health problem worldwide, in terms of both mortality and preventable, treatable and curable; it is estimated that one- (1) morbidity among the adult population . The appearance of third of the world’s population is infected with latent TB micro epidemics of the tuberculosis has been increased in (LTB), about eight million new cases arise each year and many parts of the world. As a result, the world health organi - about two million people die from TB each year (3) . (2) zation in (1993) declared tuberculosis as an emergency . It The World Health Organization (WHO) estimates that is a highly infectious disease which is caused by acid-fast almost 9 million new patients develop TB each year, and that bacilli (AFB), belonging to the Mycobacterium tuberculosis 1.8 million people died from TB globally in 2008. TB has a complex (Tuberculosis, M.bovis, M.africanum, M. microti, huge impact on patients, families and their communities Balche A. et al n MD-Medical Data 2015 ;7(4) : 263-270 264 MD MEDICAL DATA / Vol .7 NO 4 / Decembar - Decembre 2015. through spending on diagnosis, treatment, transport to and to anti-TB treatment. Non-adherence to anti- TB treatment from the health facilities and time lost from work. However, may result in prolonged infectiousness, drug resistance, if TB is detected early and fully treated, people with the dis - relapse and death. Treatment interruption thus poses a seri - ease quickly become non-infectious and are eventually ous risk both for the individual and the community (19) . cured (4) . The WHO, in its global plan to stop TB, reports In many countries globally, the adoption of Directly that poor treatment has resulted in evolution of mycobacteri - Observed Treatment (DOT) has been associated with um TB strains that do not respond to treatment with standard reduced rate of treatment failure, relapse and drug resist - first line combination of anti-tuberculosis medicines, result - ance. However, its impact in reducing TB incidence has ing in the emergence of multi-drug resistance tuberculosis been limited by non-adherence to DOT, which occurs when (MDR-TB) in almost every country of the world (5) . Without patients do not turn up for treatment at the health facility or the implementation of proper control measures, WHO esti - community DOT point. In countries where DOT has had lit - mates that between 2000 and 2020, nearly one billion peo - tle impact on TB control, poor or non-adherence to self- ple will be newly affected, 200 million will get sick and 35 administered TB treatment is common and has been identi - million will die from TB (5) . fied as an important cause of failure of initial treatment, The disease affects the lungs in approximately two thirds leading to relapse (20) . of cases, but almost all other organs can be the site of TB One of the main barriers to adherence to TB treatment infection. Its clinical presentation, therefore, depends on the programme is the limited social and economic resources that site of infection, the organ affected and its severity (6, 7) . The TB patients endure (21) . According to a study conducted to main source of infection is untreated smear-positive pul - illustrate health care practitioner’s responses to TB patient’s monary TB (SPPTB) patient discharging the bacilli. TB understanding, many of the focus group members often mainly spreads by airborne route when the infectious patient report that they are not able to meet their basic needs for expels droplets containing the bacilli. It is also transmitted food and adequate shelter (22) . Inadequate knowledge about by consumption of raw milk containing M. bovis (8, 9) . The the illness, also, has a negative impact on adherence (22) . risk of infection depends on the susceptibility of the host, the Several studies have been done on the factors associated extent of the exposure and the degree of infectiousness of with, compliance and adherence issues for anti-TB treatment the index case (10) . (23-34) . A complex interaction exists between TB and HIV infec - Once the factors are identified then targeted strategies to tion (11) . HIV increases the risk of infection, as it reactivates address them can be designed. The study should benefit the LTB and increases the progression to active disease (12) . TB- TB patients as the findings may be used to develop strategies HIV co-infection has fatal consequences as TB becomes the to improve the quality of care. The objective of this study leading cause of death in HIV infected individuals and was to assess the level of adherence to anti-TB treatment patients with AIDS (12) . HIV weakens the immune systems; among TB patients at Agaro hospital and its health center it increases vulnerability to TB (12) . The highest rates of TB Agaro town, Jimma zone, Oromia region, Ethiopia. cases are found in countries where poverty, crowding and insufficient health care programs are common problems. 1. METHODS AND MATERIALS Ethiopia is among the 22 high burden countries (HBCs), in 1.1 Study design (13) the world . According to hospital statistics data, TB is the A cross-sectional descriptive study was conducted on leading cause of morbidity, the third cause of hospital admis - (14) patients following tuberculosis follow up clinic at Agaro sion and the second cause of death in Ethiopia . Efforts to hospital and its health center, Agaro town, Jimma zone, control the tuberculosis epidemic depend largely on patient’s (14) Oromia region, Ethiopia, from February 9 up to 20,2015. adherence to tuberculosis treatment . The required sample size for study was calculated by using Although, the correct treatment of TB aims at curing the the simple population proportion formula. Sample size was patient, poor treatment outcomes are the main challenges in determined to estimate level of adherence to anti-TB treat - TB control in many regions of the world resulting in ment with reasonable degree of accuracy (i.e. margin of increased risk of morbidity, drug resistance and transmission error will be taken as 5% with 95% confidence) assuming (15) . According to WHO report on the topic emphasizes 90% for the level of adherence of the patient to anti- TB adherence is simultaneously influenced by several factors treatment. Based on a previous study conducted in northern such as individual patient characteristics, socio-economic (23) factors, the structure and nature of health care services part of Ethiopia, the adherence prevalence rate was 78% , offered, the quality of patient- provider communication and with confidence interval of 95% and taking a margin of error the nature of social support that patients receive (16) . Patient- of 5%. This prevalence rate is with the assumption that 90% related factors including socio-demographic factors, knowl - of the interviewed patients will adhere to their medication.
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