Reasons for noncompliance of treatment among sputum smear positive tuberculosis patients in Keshabpur Subdistrict hospital, Bangladesh

Abstract

Objectives of the study: To find out the proportion of sputum smear positive tuberculosis patients who did not comply the treatment and the factors associated with noncompliance of treatment among them who were treated against tuberculosis in Keshabpur Subdistrict hospital, Bangladesh between January 1997 to August 1999. Research Design: Descriptive Study. Research Methodology: 190 Sputum smear positive tuberculosis patients treated between January 1997 to August 1999 at Keshabpur Subdistrict hospital, Jessore, Bangladesh were interviewed by means of a questionnaire with previously fixed response options in order to identify which factors were responsible for having complied or not. Results: The study findings showed that 70.5% patients complied and 29. 5 % patients failed to comply treatment. Background characteristic results showed that the mean age of the patients was 38.97 years. Marital status was 82.1% married and 17.9% unmarried. Educational status was 37.9% illiterate and 62.1% literate. Median monthly family income of the patients was 6000.00 Takas. Statistical analysis demonstrated differences between compliers and non-compliers on several factors. Among different socioeconomic factors statistically significant association was found in cases of educational status and monthly family income with treatment outcome (p < 0.001). Other factors like home to hospital distance (p = 0.046), time took to visit hospital (p < 0.001), visit by the health worker (p = 0.002), missing of hospital appointment (p < 0.001), problem faced by the patients from hospital authority (p < 0.001), development of physical symptoms (p < 0.001), clinical improvement (p < 0.001), confidence on hospital treatment (p < 0.001), alternative treatment received by the patients (p < 0.001), moved residence during treatment (p < 0.001) and family support by the patients (p < 0.001) were found to have significant association on noncompliance of treatment. Multiple logistic regression analysis results indicated that the following independent variables were the major factors affecting the noncompliance of treatment among sputum smear positive tuberculosis patients: (1) time took to visit hospital from patients home (p < 0.001) , (2) buying drugs from outside during treatment (p < 0.001), (3) development of physical problems during treatment (p < 0.001), (4) moved residence during treatment (p = 0.022) and (5) family support by the patients (p < 0.001). Implication: The study findings will help the authorities concerned to produce a guideline for improving and strengthening the tuberculosis control program by removing the bottlenecks prevailing in the program and thereby reducing the rate of noncompliance among tuberculosis patients.