Presentation is loading. Please wait.

Presentation is loading. Please wait.

Factors Associated with Interruption of Treatment Among Pulmonary Tuberculosis Patients in Plateau State, Nigeria, 2011 Luka M. Ibrahim 1, P. Nguku 1,

Published byRobert Bryan Modified over 9 years ago

Similar presentations

Presentation on theme: "Factors Associated with Interruption of Treatment Among Pulmonary Tuberculosis Patients in Plateau State, Nigeria, 2011 Luka M. Ibrahim 1, P. Nguku 1,"— Presentation transcript:

1 Factors Associated with Interruption of Treatment Among Pulmonary Tuberculosis Patients in Plateau State, Nigeria, 2011 Luka M. Ibrahim 1, P. Nguku 1, H. Akpan 2, S. H. Idris 3 1.Nigeria Field Epidemiology and Laboratory Training Programme 2.Epidemiology Division, Federal Ministry of Health, Abuja, Nigeria 3.Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria

2 Introduction Tuberculosis (TB) is a global health problem –One third of world population is infected –1.1 million deaths in 2010 –95% of deaths in low and middle income countries 22 countries account for 80% of the TB burden Nigeria ranks fifth among the 22 countries –Incidence of 311 /100,000 (World TB report 2010) 2

3 TB treatment strategy Directly observed treatment short course (DOTS) –Direct observation of patients in the intensive phase of treatment –Reduces morbidity and mortality –Prevents multi-drug resistant TB (MDR-TB) Caused by inadequate or incomplete treatment –Adopted in Nigeria in 1996 3

4 Outcomes of TB treatment in Plateau state 2001-2010 4

5 5 63.5% (≥85%) 6.5% (3%)

6 Objectives To determine the proportion of TB patients with interrupted treatment To identify the factors associated with interruption of TB treatment 6

7 7 Nigeria Plateau state Study site

8 Methods Study design: Cross-sectional study Study period: June - July, 2011 Respondents: Pulmonary TB (PTB) patients Eligibility for enrolment –Age ≥ 15 years –In the eighth month of treatment TB treatment interruption –Intensive phase – 2 days –Continuation phase – 14 days 8

9 Recruitment of respondents 9 438 TB patients in eighth month of treatment 422 (96%) with pulmonary TB patients ≥ 15 years 378 (90%) identified interviewed with questionnaire

10 Data collection technique Quantitative –Checklist –Structured questionnaire Qualitative –Focus group discussion (FGD) –Homogenous groups of male and female 10

11 Data collection Quantitative data by –Trained research assistants Qualitative data Note taker Moderator FGD guide Tape recorder 11

12 Data analysis Data analyzed with Epi Info version 3.5.1 –Descriptive analysis –Bivariate analysis –Multivariate analysis Analysis of FGD –Transcription –Translation from local language to English –Report 12

13 Ethical considerations Ethical clearance obtained from the Plateau State Ethical Review Committee Informed consent obtained from all study participants 13

14 Results 14

15 Age and sex distribution of respondents (n=378) 15 Mean age 37.6 (±13.5) years, 61% male

16 Age and sex distribution of respondents (n=378) 16 Mean age 37.6 (±13.5) years, 61% male 61%

17 Clinical and socio-behavioral characteristics of respondents (n=378) Factors n (%) Category classification 2 34 (9.0) Married 271 (71.7) < Secondary level education 189 (50.0) Unemployed 85 (22.5) Smoke cigarettes70 (18.5) Alcohol use 167 (44.2) Bread winner of the family 180 (47.6) Living > 5 km from tx site 72 (19.0) 17

18 Knowledge of respondents on duration of TB treatment 18

19 Knowledge of respondents on duration of TB treatment 19 15.3%

20 Interruption of treatment Total number of PTB respondents 378 – Number that interrupted TB treatment 71 (19%) Interruption by TB treatment phase – Intensive phase 25 (35%) – Continuation phase 46 (65%) 20

21 21 Reasons for interrupting treatment among respondents

22 22 Reasons for interrupting treatment among respondents

23 Factors associated with interruption of treatment among respondents 1/2 23 Factors Interrupted treatment OR (95% CI) Yes (%)No (%) Unemployed 22 (31) 63 (21) 1.7 (0.9-3.2) Age > 35 years 35 (49) 141 (45)1.1 (0.7-2.0) Male 44 (62) 185 (60) 1.1 (0.6-1.9) < Secondary Education 36 (51) 153 (50) 1.0 (0.6-1.7) Bread winner in family 32 (45) 148 (48) 0.9 (0.5-1.5) Married 48 (68) 223 (73) 0.4 (0.4-1.4) OR : Odds Ratio, CI: Confidence Interval

24 Factors associated with interruption of treatment among respondents 2/2 24 Factors Interrupted treatment OR (95% CI) YesNo Living > 5km from treatment site 38 (54%) 34 (11%)9.3 (4.9-17.4) Don’t know duration of treatment 23 (32%) 35 (11%)3.7 (1.9-7.2) Smoke cigarettes20 (28%) 50 (16%)2.0 (1.1-3.7) Category classification 2 8 (11%) 26 (8%)1.4 (0.5-3.4) Alcohol use28 (39%) 139 (45%)0.8 (0.5-1.4)

25 Factors associated with interruption of treatment among respondents 2/2 25 Factors Interrupted treatment OR (95% CI) YesNo Living > 5km from treatment site 38 (54%) 34 (11%)9.3 (4.9-17.4) Don’t know duration of treatment 23 (32%) 35 (11%)3.7 (1.9-7.2) Smoke cigarettes20 (28%) 50 (16%)2.0 (1.1-3.7) Category classification 2 8 (11%) 26 (8%)1.4 (0.5-3.4) Alcohol use28 (39%) 139 (45%)0.8 (0.5-1.4)

26 Factors associated with interruption of treatment among respondents 2/2 26 Factors Interrupted treatment OR (95% CI) YesNo Living > 5km from treatment site 38 (54%) 34 (11%)9.3 (4.9-17.4) Don’t know duration of treatment 23 (32%) 35 (11%)3.7 (1.9-7.2) Smoke cigarettes20 (28%) 50 (16%)2.0 (1.1-3.7) Category classification 2 8 (11%) 26 (8%)1.4 (0.5-3.4) Alcohol use28 (39%) 139 (45%)0.8 (0.5-1.4)

27 Unconditional logistic regression of factors associated with interruption of treatment among PTB patients 27 FactorsAOR95% C.I. Sex (Male)1.90.7 - 5.2 Age > 35 years0.80.3 - 1.9 Clinical class (Cat 2)1.90.5 - 7.1 Living > 5km from treatment site14.15.5 - 35.8 Don’t know duration of treatment 5.32.0 - 14.2 Smoked cigarettes3.61.2 - 10.2 Alcohol use0.60.2 - 1.4 AOR; Adjusted odds ratio

28 Result of focus group discussion Majority knew the duration for treatment Few had interrupted their treatment –‘I take the drugs to get well so as to get back to my work (female participant)’ Factors responsible for interruption of treatment –Cost of transport to clinic –Unfriendly attitude of health care workers 28

29 Discussion 1/2 Proportion of TB patients with interruption of treatment is 19% Factors associated with interruption of treatment –Living far from and cost of transportation to treatment sites 29

30 Discussion 2/2 –Inadequate knowledge on duration of treatment Supported by (Gupta et al, 2010) –Unfriendly attitude of health care workers might cause interruption of treatment Supported by Jaiswal et al (2004) 30

31 Limitations We could not trace all the PTB patients that were eligible for the study 31

32 Conclusion Interruption of TB treatment in Plateau state associated with –Long distance of patients from treatment sites and transport cost –Poor knowledge of duration of TB treatment –Unfriendly attitude of health care workers towards patients 32

33 Public health actions Supportive supervision with training of health care workers on –Patient education on duration of treatment To ensure accessibility of services to patient –Decentralization of TB treatment sites –Use of treatment supporters for TB patients 33

34 Recommendation The Government of Plateau state –To support and sustain the decentralization process –To support the implementation of community TB care 34

35 35 Acknowledgements Nigeria FELTP Nigeria TB Control Program Federal Ministry of Health, Nigeria CDC Nigeria

36 36 Thank you for your attention

37 Distribution of patient by their occupation Occupation Frequency N (%) Farming 134 (35.4) Business 75 (19.8) Civil servants 64 (16.9) Applicant 45 (11.9) Schooling 38 (10.1) Artesan 20 (5.3) Others 2 (0.5) Total 378 37

38 TB Patients roles in the family Patients role in the family Frequency N(%) Main Bread winner 180 (47.6) Not bread winner but supports family 58 (15.3) Dependant 60 (15.9) House wife 80 (21.2) Total 378 38

39 Highest educational levels of respondents Highest educational level Frequency N(%) None 69 (18.3) Qur’ anic 27 (7.1) Primary 93 (24.6) Secondary 121 (32) Post secondary 68 (18) Total 378 39

40 Marital status of patients Marital status Frequency N (%) Single 81 (21.4) Married 271 (71.7) Separated 11 (2.6) Divorced 10 (2.9) Widow 5 (1.3) Total 378 40

41 Association of alcohol use with cigarette smoking among PTB patients (n=378) Alcohol use Cigarette smoking Total Yes No Yes 51 116167 No 19 192211 Total 70 308378 41 Odds ratio 4.4, 95% Confidence interval 2.4 – 8.2

42 HIV status of the patients HIV status Frequenc y % Screened for HIV (N=378) Yes 246 65.1 No 132 34.9 HIV positive (N=246) Yes 85 34.6 No 161 65.4 42

43 Patients’ knowledge (n=378) Frequency % TB is curable Yes362 95.8 No1 0.3 Don’t know15 3.9 Anti-TB drugs cures TB disease Yes364 96.3 No1 0.3 Don’t know13 3.4 Duration of treatment < 8 months21 5.6 8 months320 84.7 > 8 months6 1.5 Don’t know31 8.2 Patients’ knowledge

44 Exposure factorsInterrupted treatment OR (95% CI) Yes No HIV +ve 8 (11%) 77 (25%)0.5 (0.2 – 1.1) Interruption of treatment

45 Age and sex distribution of respondents 45 Age group in years Sex Total N(% Female N(%) Male N(%) 15-19 2 (1.3) 10 (4.4) 12 (3.2) 20-24 19 (12.8) 17 (7.4) 36 (9.5) 25-29 28 (18.8) 32 (14.0) 60 (15.9) 30-34 32 (21.5) 45 (19.7) 77 (20.4) 34-39 18 (12.1) 31 (13.5) 49 (13.0) 40-44 21 (14.1) 23 (10.0) 44 (11.6) 44-49 6 (4.0) 20 (8.7) 26 (6.9) 50-54 7 (4.7) 20 (8.7) 27 (7.1) > 54 16 (10.7) 31 (13.5) 47 (12.4) Total 149 (39.4) 229 (60.6) 378 (100) Male (61%), Mean age 37.6 ± 13.5 (female: 35.8, male: 38.7). Median 35 yrs 60.8% between 25 to 44 years.

46 DOTS coverage in Plateau state 168 facilities offering TB services for 3.7M –1 TB treatment sites (DOTS site) per 22,000 people –Expected target is 1 DOTS site for 10,000 – 15,000 people 46

47 Distance of respondents from TB treatment sites (n=378) 47

48 Interruption of treatment among the respondents 48

49 Interruption of treatment by phase of TB treatment 49

Download ppt "Factors Associated with Interruption of Treatment Among Pulmonary Tuberculosis Patients in Plateau State, Nigeria, 2011 Luka M. Ibrahim 1, P. Nguku 1,"

Similar presentations

From study objectives to analysis plan Helen Maguire.

From study objectives to analysis plan Helen Maguire.
“Concepts in evaluation of vaccination programs in low income countries Jagrati Jani Section for International Health Department of Community Medicine.

“Concepts in evaluation of vaccination programs in low income countries" Jagrati Jani Section for International Health Department of Community Medicine.
FACTORS AFFECTING UPTAKE OF CERVICAL CANCER SCREENING AMONG WOMEN IN NAKASONGOLA DISTRICT, UGANDA AFENET Scientific Conference Authors: John Kamulegeya,

FACTORS AFFECTING UPTAKE OF CERVICAL CANCER SCREENING AMONG WOMEN IN NAKASONGOLA DISTRICT, UGANDA AFENET Scientific Conference Authors: John Kamulegeya,
Josephat Nyagero, Moses Mwangi, Elijah Mbiti, Bob Akach, Jacqueline Kung’u, Stewart Kabaka, Christopher Wanyoike, John Nduba Safari Park Hotel, Nairobi.

Josephat Nyagero, Moses Mwangi, Elijah Mbiti, Bob Akach, Jacqueline Kung’u, Stewart Kabaka, Christopher Wanyoike, John Nduba Safari Park Hotel, Nairobi.
Delay from Testing HIV Positive until First HIV Care for Drug Users: Adverse Consequences and Possible Solutions Barbara J Turner MD, MSEd* John Fleishman.

Delay from Testing HIV Positive until First HIV Care for Drug Users: Adverse Consequences and Possible Solutions Barbara J Turner MD, MSEd* John Fleishman.
《 Promotion of Capability and Effectiveness for Tobacco Control Program among Rural Residents* 》 --Report On The Baseline Survey (Tobacco use status among.

《 Promotion of Capability and Effectiveness for Tobacco Control Program among Rural Residents* 》 --Report On The Baseline Survey (Tobacco use status among.
FACTORS HINDERING ATTITUDE TO TREATMENT AMONG PATIENTS WITH TYPE-2 DIABETES MELLITUS IN THE NIGER DELTA, NIGERIA by AGOFURE OTOVWE and OYEWOLE OYEDIRAN.

FACTORS HINDERING ATTITUDE TO TREATMENT AMONG PATIENTS WITH TYPE-2 DIABETES MELLITUS IN THE NIGER DELTA, NIGERIA by AGOFURE OTOVWE and OYEWOLE OYEDIRAN.
Socioeconomic Position and Adherence to Tuberculosis Treatment: A case-control Study Mishra P, 1 Hansen EH, 1 Sabroe S 2 1 Dept of Social Pharmacy, Danish.

Socioeconomic Position and Adherence to Tuberculosis Treatment: A case-control Study Mishra P, 1 Hansen EH, 1 Sabroe S 2 1 Dept of Social Pharmacy, Danish.
Access to health care and mortality of children under 5 years of age in the Gambia: a case–control study Rutherford ME et al Bull of the World Health Organ.

Access to health care and mortality of children under 5 years of age in the Gambia: a case–control study Rutherford ME et al Bull of the World Health Organ.
Dr R.Reesaul Chest Physician Chest Clinic P. D`or Hospital

Dr R.Reesaul Chest Physician Chest Clinic P. D`or Hospital
Introduction Hypothesis Conclusions Specific Aims In-home Intervention Improves Outcomes of Tuberculosis Patients in Zimbabwe, Africa Olga Kishek, Tess.

Introduction Hypothesis Conclusions Specific Aims In-home Intervention Improves Outcomes of Tuberculosis Patients in Zimbabwe, Africa Olga Kishek, Tess.
Monitoring and Evaluation: A Review of Terms. Goals To provide better treatment for people with tuberculosis in Country X To achieve a treatment success.

Monitoring and Evaluation: A Review of Terms. Goals To provide better treatment for people with tuberculosis in Country X To achieve a treatment success.
Amref Health Africa International Conference 24-26 November, 2014 Nairobi, Kenya 7/2/20151.

Amref Health Africa International Conference November, 2014 Nairobi, Kenya 7/2/20151.
Predictors of Multidrug Resistant Tuberculosis Among Adult Tuberculosis Patients in Saint Peter Hospital, Addis Ababa, Ethiopia: Case control study.

Predictors of Multidrug Resistant Tuberculosis Among Adult Tuberculosis Patients in Saint Peter Hospital, Addis Ababa, Ethiopia: Case control study.
ANNE MURUGI1,2 1.Amref Health Africa 2.University of Nairobi

ANNE MURUGI1,2 1.Amref Health Africa 2.University of Nairobi
IS MENTAL DEPRESSION A SERIOUS ISSUE AMONG FEMALE SEX WORKERS? EVIDENCE FROM SOUTHERN INDIA Sangram Kishor Patel 1, Niranjan Saggurti 1, Saroj Pachauri.

IS MENTAL DEPRESSION A SERIOUS ISSUE AMONG FEMALE SEX WORKERS? EVIDENCE FROM SOUTHERN INDIA Sangram Kishor Patel 1, Niranjan Saggurti 1, Saroj Pachauri.
Roger Shapiro Poloko Kebaabetswe Shahin Lockman Serara Mogwe

Roger Shapiro Poloko Kebaabetswe Shahin Lockman Serara Mogwe
Pakistan.

Pakistan.
Culture Conversion and Self- Administered Therapy in Privately Managed Tuberculosis Patients Melissa Ehman MPH, Jennifer Flood MD MPH, Pennan Barry MD.

Culture Conversion and Self- Administered Therapy in Privately Managed Tuberculosis Patients Melissa Ehman MPH, Jennifer Flood MD MPH, Pennan Barry MD.
Social Economic Determinants of Cervical Cancer among Women Attending Referral Hospitals in Dar Es Salaam, Tanzania 2012-13 Karugira Rweyemamu 1,3, Janneth.

Social Economic Determinants of Cervical Cancer among Women Attending Referral Hospitals in Dar Es Salaam, Tanzania Karugira Rweyemamu 1,3, Janneth.

Similar presentations

Ads by Google