Determinants of Treatment Defaulting among Tuberculosis Patients- Khartoum State, Sudan-2018

Abstract

Background: Persons who default from tuberculosis treatment are at risk for clinical deterioration and complications including worsening drug resistance and death. Although tuberculosis care is provided free of charge in Sudan, a high number of patients voluntarily discontinue their treatment before the end. Treatment Default is a major obstacle in the fight against the disease. The aim of the study: was to study the determinants of tuberculosis treatment default among defaulters in Khartoum (Sudan) State in order to improve treatment adherence among tuberculosis patients. Research methodology: the study was descriptive cross-sectional Facility-based study carried out on 204 defaulter patients in tuberculosis management units (Khartoum State (Sudan). A standardized administered questionnaire was used the data was collected by the researcher and three data collectors. Pre-test was canied out. The data were analyzed using statistical package for social sciences version 20. Results: In age between 20-40 years (58.8% of sample), Men (68.1%) were more likely to be non-adherent than women (31.9 %). Patients residing in urban areas constitute 74% of the sample. There was a statistically significant association between the Patients feelings of being stigmatized versus psychological family support (P value 0.000). There was a statistically significant association between patients feeling of being stigmatized and commitment to visits scheduled by the doctors (P-value 0.02). On the other hand, there was association (P value=.016) between commitment to visits scheduled versus the doctor and financial problems. Long duration of treatment was considered the reason of default among 64.2% of the defaulters. Period of discontinuation of treatment among patients was more common in the early months from the beginning of treatment 81.9%. 60.8% of participants had Knowledge about complication of non-treatment adherence and the rest were no. regard to Previous Knowledge of pts about complication of not adherence of TB treatment,29% spread of the disease to other, 62.9% the body resistance to treatment, 2.4% increasing the cost of treatment, 2.4% major side effects and 3.2% spread of the disease to others- the body resistance to treatment of participants Previous Knowledge about complication of defaulting TB treatment. Conclusion: two third of defaulters proximately In ages between 20-40 , men were more likely to be non-adherent than women .Patients residing in urban areas constitute. There was a statistically significant association between the patient feelings of being stigmatized by psychological family support (P value 0.000). There was a statistically significant association between patients feeling of being stigmatized versus commitment to visits scheduled by the doctors (P-value 0.02).. Period of discontinuation of treatment among patients was more common in the early months from the beginning of treatment . two third of participants had Knowledge about complication of non-treatment adherence and the rest were no. regard to Previous Knowledge of pts about complication of not adherence of TB treatment ,most of patients proximately mentions one complication. Recommendations: the necessity of early health education and counseling for patients, their families and all members of the community about the importance of taking the full dose of tuberculosis treatment and explaining the complications of defaulting treatment; we should also explain the modes of transmission to reduce the stigma and improve the economic status of patients in order to decrease the rate of default.