THE NON-COMPLIANCE TO TUBERCULOSIS TREATMENT AMONG PATIENTS SUFFERING TUBERCULOSIS

ABSTRACT

Tuberculosis is a problem of global importance among communicable diseases. It is second leading disease causing death worldwide killing nearly 2 million people each year in Nigeria. Non-compliance of patients on tuberculosis treatment in an irregular and unreliable way has greatly caused risk of treatment failure, relapse and the development of drug-resistance tuberculosis strains. There are varieties of reasons why patients fail to take their medications. The center for disease control (2008) states the following:

· The patients compliant are that medicines must be taken with empty stomach to facilitate absorption. This can be difficult for patients to follow especially waking up an hour earlier than usual everyday just to take medicine on empty stomach.

· Another complains is the size of tablet

· Side-effect of the drugs can lead to patients not complying to their treatment.

· Issues on denial, stigmatization, emotional distress, cultural and life-style factors make patients not to take their treatment.

· Poverty, transportation, religion and attitude of health workers contribute to non-compliance of patients on tuberculosis treatment.

Non-compliance of patient on tuberculosis treatment is a serious problem for national tuberculosis control programs (2007) states that this case tends   to have higher morbidity and mortality rate when compared to those who are not cured. They remain infectious for prolonged period of time; hence affected patient continues to transmit the disease in the community. World Health Organization (2009) has estimated that 2 billion people have latent tuberculosis disease which has killed 1.7 million people in Nigeria. In Nigeria, 81% patients are non-compliant to treatment for more than one month before presenting at chest clinics. The patients visit traditional healers and have low level of knowledge about the disease or due to high cost of treatment, transportation and poverty. World health organization (2013)reported worldwide that some countries like South Africa, Kenya, Nigeria, Malaysia, Ghana, China, United States of America and Canada were implementing the directly- observed treatment short-course strategy by the end of 2013. World health organization 2015) currently recommends a case detection rate of 70% and a treatment success rate of 85% for all tuberculosis cases.

CHAPTER ONE

1.0 INTRODUCTION

1.1 BACKGROUND OF STUDY

Tuberculosis is a problem of global importance among communicable diseases. It is second leading disease causing death worldwide killing nearly 2 million people each year in Nigeria.  Non-compliance of patients on tuberculosis treatment in an irregular and unreliable way has greatly caused risk of treatment failure, relapse and the development of drug-resistance tuberculosis strains. There are varieties of reasons why patients fail to take their medications. The center for disease control (2008) states the following:

· The patients compliant is that medicines  must be taken with empty stomach to facilitate absorption. This can be difficult for patients to follow especially waking  up an hour earlier than usual everyday just to take medicine  on empty stomach.

· Another complains is the size of tablet

· Side-effect of the drugs can lead to patients not complying to their treatment.

· Issues on denial, stigmatization, emotional distress, cultural and life-style factors make patients not to take their treatment.

· Poverty, transportation, religion and attitude of health workers contribute to non-compliance of patients on tuberculosis treatment.

Non-compliance of patient on tuberculosis treatment is a serious problem for national tuberculosis control programs (2007) states that this case tends   to have higher morbidity and mortality rate when compared to those who are not cured. They remain infectious for prolonged period of time, hence affected patient continues to transmit the disease in the community.

World Health Organization (2009) has estimated that 2 billion people have latent tuberculosis disease which has killed 1.7 million people in Nigeria. In Nigeria, 81% patients are non-compliant to treatment for more than one month before presenting at chest clinics. The patients visit traditional healers and have low level of knowledge about the disease or due to high cost of treatment, transportation and poverty. World health organization (2013)reported worldwide that some countries like South Africa, Kenya, Nigeria, Malaysia, Ghana, China, United States of America and Canada were implementing the directly- observed treatment short-course strategy by the end of 2013. World health organization 2015) currently recommends a case detection rate of 70% and a treatment success rate of 85% for all tuberculosis cases. It is believed that achieving these targets will lead to a reduction in tuberculosis prevalence, incidence, transmission and drug-resistance to tuberculosis treatment.

This study was conducted to determine the non-compliance of tuberculosis in Imo State University Teaching Hospital, Orlu L.G.A.

1.2 STATEMENT OF PROBLEM

Despite the global effort to reduce the incidence of tuberculosis worldwide through mass media, there is  still non-compliance to treatment which may be due to the bulkiness of the drugs and taking the  drugs on empty stomach. Noticing the incidence of tuberculosis on orthodox and other clinics motivates the researcher to carry out a research to determine the reasons for non-compliance of patients to tuberculosis treatment.

1.3 OBJECTIVE OF STUDY

The objectives of this study include:

· To ascertain the knowledge of people about tuberculosis, its  causes and its effects.

· To find the cause of patients not complying to their treatment.

· To identify the knowledge of patients based on the importance of complying to treatment.

· To identify strategies for improvement of patients’ acceptance of care and treatment of tuberculosis.

1.4 SIGNIFICANCE OF STUDY

To The Client:

· The study will help the individual to have the knowledge on health investigation and screening in order to indicate the early signs and symptoms

· It will also help the patient to know the importance of treatment given to them.

To the family

It will help the family members to have the knowledge on the cause & prevention of tuberculosis.

To the community

This will educate people on the importance of good personal and environmental hygiene and also avoid over-crowding.

To the country

It will reduce mortality and morbidity rate in the county.

To the health worker

It will help the health care provider to have adequate knowledge on the management and treatment of the patient.

1.5  RESEARCH QUESTION

· What are the knowledge levels of people about tuberculoses disease, its cause and its effects?

· What are the causes of patients not complying to their treatment?

· What are the people’s knowledge about the importance of complying to their treatment?

· What are the strategies for improvement of patients’ acceptance of care and treatment of tuberculosis?

1.6  SCOPE OF STUDY

This study is focused on patients suffering tuberculosis in Imo State University Teaching Hospital, Orlu, L.G.A.

OPERATIONAL DEFINITION  OF TERMS

· Tuberculosis: a communicable disease that is caused by mycobacterium tuberculosis.

· Investigation: finding or searching for more information.

· Infectious patients: people that harbor infections caused by micro- organisms.

· Infection: the presence and growth of a micro-organism that produce tissue –damage

Epidemic: this is the presence of a disease which affects a large number of populations in a definite territory