Factors associated with default in TB treatment outcomes in the Bole District of Ghana: A cross-sectional study

Abstract

Tuberculosis (TB) is of great public health concern affecting one-third of the world’s population regardless of all the interventions put in place to control it. Non-adherence to TB treatment is a major barrier to effective TB control because incomplete treatment may lead to antibiotic resistance, which has the effect of keeping patients infectious for a longer period, relapsing, and dying as a result. The aim of this study was to determine the factors that affect default in TB treatment in the Bole District in the Savannah Region of Ghana. A cross-sectional study was conducted with 95 TB patients in Bole District Health TB Center, Savannah Region, Ghana from January to December 2014. A semi-structured questionnaire was used to collect data from the study participants to evaluate the patient and health-related factors associated with default in TB treatment. Default in TB treatment was defined as any interruption of treatment for at least 2 months following treatment initiation. Data analysis was done using SPSS (Version 20). For the determination of factors associated with default, binary logistic regression was used and p<0.05 was considered statistically significant. The default rate was 21%; while patient-related factors such as age (aOR [95%CI] 7.61 [1.85 – 31.40], p = 0.005), sex (aOR [95%CI], 4.39 [1.10 – 17.62], p = 0.037) and experiencing side effects from the drug (aOR [95%CI], 8.51 [2.17 – 33.36], p=0.002), and health systems related factors of not given enough information about TB on diagnosis (aOR [95%CI], 7.22 [1.40 – 37.27], p = 0.018) predicted default in treatment. Avoidance, backbiting, and isolation by family and community members were some of the negative attitudes that caused TB patients to default in treatment. In conclusion, treatment of TB among patients in the district is largely influenced by age, sex, side effect of drug, and whether patients have enough information about TB on diagnosis. To curb default in TB treatment enough education must be given on TB diagnosis and the focus must be on females and older ones.