Compliance to Directly Observed Treatment Short Course (DOTS) Chemotherapy among the Patient of Pulmonary Tuberculosis in Banke District of Nepal

Abstract

Tubercular infection is still a pervasive public health problem in Nepal despite the massive efforts of National Health Service stakeholders. High bacterial infectivity, transmissibility, increasing drug resistance and non compliance to the therapy have been adding up challenges to prevention and control of tuberculosis. This study was conducted to observe the treatment compliance pattern among new pulmonary sputum smear positive cases of tuberculosis. A cross sectional study was carried out in the year 2009. The 114 new smear positive pulmonary tuberculosis patients registered in the six selected DOTS centres of the Banke Disrtict were randomly selected. Participants were selected from each DOTS centre by probability proportionate sampling methods. Data were analyzed by SPSS (11.0 Version) and P< 0.05 was considered as significant. Overall compliance to DOTS was 86.80 percent; of these, 57.00 percent showed excellent and regular compliance followed by nearly 30 percent good compliance. And 13.20 percent participants were non complaint to DOTS therapy. Positive Family behaviors were positively associated with compliance while alcohol consumption was found to be negatively associated with compliance however; age, sex and income were found to be non significant factors for compliance. Feeling of getting cure even before the course of DOTS therapy (feeling better after 2-3 months regular treatment) and drinking habits were found to be the major causes of non compliance. Supportive family behaviors and avoidance of alcohol consumption may promote the compliance. Excellent treatment compliance in the face of many odds is highly encouraging and the pattern can be useful in treatment despite little non compliances; furthermore compliance can be enhanced by acting on these causes of non compliances.

Key words: Pulmonary, Tuberculosis, DOTS, Banke, Nepal