Medication nonadherence and associated factors in patients with tuberculosis in Wau, South Sudan: a cross- sectional study using the world health organization multidimensional adherence model.

Autor: Marin PM; Department of Public Health, University of Bahr El Ghazal (UBG), Wau, South Sudan. pmarin999@gmail.com.; Department of Biosecurity, Ecosystem and Veterinary Public Health, Makerere University, Kampala, Uganda. pmarin999@gmail.com., Munyeme M; Department of Disease Control, University of Zambia, Lusaka, Zambia., Kankya C; Department of Biosecurity, Ecosystem and Veterinary Public Health, Makerere University, Kampala, Uganda., Jubara AS; Department of Clinical Studies, University of Bahr El Ghazal (UBG), Wau, South Sudan., Matovu E; Department of Bimolecular Resources and Biolab Sciences, Makerere University, Kampala, Uganda., Waiswa P; Department of Biosecurity, Ecosystem and Veterinary Public Health, Makerere University, Kampala, Uganda., Romano JS; Department of Medical Biology, UiT-The Arctic University of Norway (UiT), Tromsø, Norway., Mutebi F; Department of Pharmacy, Clinical and Comparative Medicine, Makerere University, Kampala, Uganda., Onafruo D; Department of Biosecurity, Ecosystem and Veterinary Public Health, Makerere University, Kampala, Uganda.; Department of Clinical Studies, University of Bahr El Ghazal (UBG), Wau, South Sudan., Kitale E; Department of Biosecurity, Ecosystem and Veterinary Public Health, Makerere University, Kampala, Uganda.; Department of Clinical Studies, University of Bahr El Ghazal (UBG), Wau, South Sudan., Benard O; Clinical Epidemiology Unit, Makerere University, Kampala, Uganda., Buhler KJ; Department of Forestry & Wildlife Management, Inland Norway University of Applied Sciences (INN), Evenstad, Norway., Tryland M; Department of Forestry & Wildlife Management, Inland Norway University of Applied Sciences (INN), Evenstad, Norway.; Department of Arctic & Marine Biology, UiT - The Arctic University of Norway (UiT), Tromsø, Norway.
Jazyk: angličtina
Zdroj: Archives of public health = Archives belges de sante publique [Arch Public Health] 2024 Jul 15; Vol. 82 (1), pp. 107. Date of Electronic Publication: 2024 Jul 15.
DOI: 10.1186/s13690-024-01339-9
Abstrakt: Background: Tuberculosis medication nonadherence is a multi-dimensional public health problem with serious consequences worldwide. There is little information available for medication nonadherence in South Sudan. This study assessed the proportion, reasons, and associated factors for nonadherence among patients with TB in Wau Municipality, South Sudan.
Methods: A health facility based cross-sectional study was conducted among 234 tuberculosis (TB) patients receiving first line anti-TB regimen in Wau Municipality. Urine isoniazid metabolite testing (IsoScreen ® ) was used to determine nonadherence (visualized by negative test results) and a questionnaire was used to describe the reasons for nonadherence. Modified poisson regression with robust standard errors was performed since the proportion of nonadherence was < 10%, to identify nonadherence associated factors using the WHO Multidimensional adherence model.
Results: Out of 234 participants, 24.8% (95% CI, 19.2 - 30.3) were nonadherent to the TB treatment regimen. At multivariate analysis, nonadherence was significantly associated with: relief of symptoms (APR 1.93, 95% CI 1.12 - 3.34, p = 0.018), alcohol use (APR 2.12, 95% CI 1.33 - 3.96, p = 0.019) and waiting time to receive drugs (APR 1.77, 95% CI 1.11 - 2.83, p = 0.017).
Conclusion: Tuberculosis medication nonadherence was high, and it's associated with patients' relived of symptoms, alcohol use, and prolonged waiting time at health facility. Hence, addressing these barriers and the use of multifaceted interventions e.g. counseling, health education and improve appointments are crucial to reduce nonadherence among patients with TB in South Sudan.
(© 2024. The Author(s).)
Databáze: MEDLINE
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