Level of Adherence To Tuberculosis Therapy In Adult Tuberculosis Patients At Chilenje Clinic In Lusaka

STUDY OBJECTIVE; to determine the level of adherence to TB therapy in TB patients on TB treatment at Chilenje clinic in Lusaka. METHOD; A cross section study was used. The study site wasChilenje clinic in Lusaka and the target population were all TB patients who were on TB therapy between the period from January 2013 to July 2015.The study sample of 321 TB patient’s files was selected using a simple random technique on excel version 13. Data collected from patient’s files was entered on the data sheet and SPSS version16 . 0 for analysis. DATA ANALYSIS; A descriptive analysis was carried out according to the characteristics of variables. Since the study was capturing nominal and categorical variables such as treatment defaulters, missed appointments, therapy completion etc. the percentages were obtained and cross tabulations were done to determine the Pearsons value and the graphical presentations such as the pie charts and bar charts were designed in excel version 13. RESULTS: the study found that 69% of patients completed TB treatment, 15defaulted and 16% died during therapy. The study did not find any significant association between patient’s age group, sex and category of treatment with patient adherence to TB treatment. The study however found a significant association between the patient’s HIV status and adherence to TB treatment. KEY WORDS; TB patients, Treatment adherence, Tuberculosis, Multi drug resistant 1.0 INTRODUCTION 1.1 BACKGROUND The emergence of drug resistant Tuberculosis (TB) has compounded the global challenges in the fight against TB (Zumla et al., 2012; Chian et al., 2013; Areias et al., 2014; Liu et al., 2014 and World Health Organization (WHO), 2014). For TB therapy to be successful, patients are required to adhere to TB therapy for not less than six months (Nyinyi et al., 2001). Treatment duration largely depends on the type of TB. The 2013, Zambian Standard Treatment Guidelines (STG) has categorized TB patients into two categories. Category I include all new smear positive, negative and extra-pulmonary TB patients while all smear positive retreatment cases, retreatment after treatment failure or defaulting and smear positive relapse cases are category II patients. Patient adherence to TB therapy is one of the most key factors in the control of TB and several authors have cited non patient adherence to TB therapy to be the major cause of Multi Drug Resistant TB (MDR-TB) (Nyinyi et al., 2001; Mishra et al., 2005; Maruza et al., 2011 and Muture et al., 2011). Drug resistant TB has further increased the challenges in the management and control of TB (Zignol et al., 2006; Naing et al., 2011; Zumla et al., 2012 and Bethesda, 2013). WHO (2004; 2013; 2014), reported an estimate of 9 million incidence of TB globally in 2013 of which 480 000 cases represented the Multi Drug Resistant (MDR-TB), an estimated death toll due to MDR-TB of 28% and a 48% rise in the MDR-TB cases from 210, 000 in 2004 to 480,000 in 2013. Africa accounts for 29% of the 2013 global incidence with South Africa recording highest drug resistant case rates in sub-Sahara Africa. Zambia in the year 2000 had an estimated proportion of 8.55 per 100,000 of MDR-TB and 1.85% cases among smear positive patients national wide while the chest disease laboratory in 2003 reported 1.8% MDR-TB for new and 2.3% retreated cases. The University Teaching Hospital (UTH) reported a proportion of 10.9% of MDR-TB among the TB culture positive patients between the year 2003 and 2008 (McNerney, 2008; Mukesela, 2011; STG, 2013). Several interventions such as the motivation of healthcare staff, health education, peer assistance and the Directly Observed Therapy (DOTS) have been put in place by the WHO, and most countries including the