Factors involved in patient compliance with anti-tuberculosis treatment in Jamaica

ABSTRACT

The worldwide resurgence of tuberculosis that took place in the 1990's did not unduly affect Jamaica's National Tuberculosis Programme. The case detection rate over the past ten years has remained steady, even in light of increase HIV/AIDS infection. The major problem affecting the National Tuberculosis Programme (NTP) is in the area of drug compliance, which has peaked at a cure/completion rate of 82 percent in 1998 (MOH, 1998). This rate is still 3 percent below the recommended WHO standards of 85 percent for NTP. The aim of study was to determine the factors relating to drug compliance within the Jamaican context. Data was collected using data extraction forms administered to a study population of 180 respondents. Qualitative data was collected from a focus group interview, which assisted in the design of questions for the data extraction forms. Some data was obtained from the national TB register and from records at the National Chest Hospital. 136 (75.5 percent) respondents of the 180 completed the extraction forms. The other 44 (24.5 percent) were not answered due to the deaths of some respondents and the inter-parish migration and emigration patterns of the others. The study found that the support given to family members during the period of illness definitely influenced the level of compliance. The gender and age distributions of respondents were similar to worldwide trends although it was found that males on the average were infected at an older age. The ability to procure medication is still an important component of drug compliance; 47 percent of completers were always able to purchase their drugs, which is 4 times greater than the defaulters. Respondents indicated their preference for treatment in hospital despite the relatively high cost of hospitalization although there was no stastically significant difference in compliance level. Most respondents had fair scores in response to the attitude questions. Except for gender (P<0.01), there was no significant relationship between attitude and demographic variables. The study also found that respondents' knowledge about DOTS was limited however those who knew about it, indicated, in their responses that it probably was the best method for treating TB cases.(Au)