Treatment adherence among tuberculosis patients in Nelson Mandela District, Eastern Cape Province
- Authors: Sohuma, Ntombifikile
- Date: 2019-09
- Subjects: Patient compliance , Tuberculosis -- Patients , Tuberculosis -- Mortality
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/22957 , vital:53254
- Description: Tuberculosis (TB) morbidity and mortality rates remain high globally and are even higher in Africa. The key factor that continues to drive the burden of disease is poor compliance / adherence to treatment regimens. This study aimed to identify determinants that continue to drive poor treatment adherence among low-income communities in South Africa. Methods A cross-sectional survey was conducted, drawing on TB patients who were defaulting on treatment. An assessment tool with several socio-economic and disease-related determinants was administered to participants. Data was entered into MS Excel and analysed in SPSS version 24. Results Regarding health services factors generally, all participants agreed that health service delivery was conducted in a conducive environment and that facilities were reasonably close to their places of residence. Participants demonstrated that health workers do not provide adequate information regarding medications that patients receive. Of patients cited, 11percent indicated that they stopped medications owing to health services. When questioned, participants reported that health workers shouted at them for coming late (e.g. after lunch) and that waiting times were very long. Approximately 85percent of the study participants were more likely to adhere poorly to TB medication owing to various factors such as comorbidities and personal perceptions of wellbeing / health status. Comorbidities are high among patients, with 58percent taking other medication while on TB treatment. Self-prognosis on wellbeing is significantly high, and 44percent reported a tendency to stop medication when they were seemingly in recovery. The unemployment rate among respondents was 78percent, with limited education: 69percent had below matric. Of the respondents, 40percent showed an unsatisfactory perception of their social and economic life, 55percent were somewhat satisfied and only 5percent were very satisfied. These indicators constitute a highly vulnerable community that depends heavily on subsidised healthcare from the state. Adherence to TB treatment is mainly influenced by poverty, the health service provider–patient relationship and perceived stigma. Limited family support was noted towards the treatment of patients. , Thesis (MPH) -- Faculty of Health Sciences, 2019
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- Date Issued: 2019-09
Factors contributing to non-adherence in HIV positive patients on antiretroviral treatment in primary health care facilities, East London, Eastern Cape
- Authors: Petse, Siphokazi
- Date: 2018
- Subjects: Antiretroviral therapy -- Eastern Cape -- South Africa , Patient compliance , HIV-positive persons -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/9734 , vital:34905
- Description: Aim: South Africa is faced with the major challenge of ensuring and sustaining the quality of services, including preventing and managing side- effects, and improving drug adherence, which are all critical, for the success of a comprehensive HIV programme. The aim of this study was to examine the underlying contributing factors to antiretroviral treatment adherence among HIV positive patients attending primary health care facilities in East London. Methods: This was a descriptive cross-sectional study involving 371 HIV positive patients on antiretroviral treatment in xx primary health care facilities in East London, South Africa. The study utilized a self- designed structured questionnaire with both open- ended and closed ended questions, divided into socio-demographic, socio- economic, level of understanding and knowledge on HIV, quality of care and waiting times. Results: About 64 percent of the participants had a good knowledge of HIV, 25 percent had an average knowledge with few participants having poor knowledge of HIV (11 percent). Majority (92.2 percent) were counselled before starting ARVs treatment. Majority of participants (70.7 percent) do have money for transport to come to the clinic, while 53.1 percent experienced side effects. The majority (70 percent) of the participants were non-adherents. Concerning viral load distribution, 52 percent were undetectable, 26 percent unsuppressed and 22 percent suppressed. Marital status (married) (p=0.005), having no formal education (p=0.035), being Christian (p=0.007), alcohol consumption (p= 0.021) and viral load suppression had significant association with non-adherence to ARV treatment among participants. After adjusting for confounders, only non-Christians and unsuppressed viral loads were the independent predictors of non-adherence. Conclusion: The main contributing factors to ART non-adherence among participants on ARVs were marital status, level of education, religion, and Christians were more adherent to the treatment than non-Christians. Alcohol consumption also contributed to non-adherence and viral load. Adherence counseling should be done on each and every visit to remind the participants on the importance of taking their treatment. These factors need to be addressed to improve adherence to the treatment, decrease the virus in the blood (viral load) and improve their health in general.
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- Date Issued: 2018