Factors influencing non-adeherence to tuberculosis treatment in TB/HIV co-infected adults at the University Teaching Hospital,Lusaka,Zambia

Abstract

Zambia is a high TB/HIV prevalence country. The aim of this study was to explore barriers to TB treatment adherence and determine the prevalence of non-adherence in the Zambian capital of Lusaka. The factors under study were socio-economic and demographic, service-related and disease and treatment related factors. A cross-sectional study was conducted on 239 TB patients co-infected with HIV, using an interviewer-administered structured questionnaire. Chi-square test was used for bivariate analysis of the outcome and independent variables. Logistic regression was used to obtain the best model because the study had a binary outcome. The prevalence of non-adherence was found to be 8.4%. Factors that influenced adherence to TB treatment were response to treatment (p=0.038) and the affordability of transport costs (p<0.001) to the health-care facilities. The odds of a patient defaulting treatment due to their response to the TB drugs were up to 17 times higher for those with a poor response than those of a patient with an average response. This study found a low level of non-adherence to TB treatment. Economic constraints and treatment factors pose a threat of non-adherence to TB treatment. Social support and intensive counseling might help to mitigate this threat. Further studies addressing sensitization, intervention and their impact assessment are recommended. Keywords: Tuberculosis, HIV/AIDS, Non-adherence, co-infection