Determinants of adherence to tuberculosis treatment among clients with tuberculosis in Eswatini

Abstract

Introduction: Adherence to treatment is an important factor for effective therapy and limiting the emergence of drug resistant tuberculosis. However, the prevalence of TB continues to soar despite the available comprehensive treatment. The study investigated determinants of adherence to TB treatment and the strategies to enhance adherence to TB treatment were designed. Method: A quantitative descriptive design was used. Data were collected from TB clients in two (2) government hospitals in Eswatini. There were 123 participants in the study. Data were collected through individual interviews using an investigatordesigned structured questionnaire. The data were entered into the Statistical Package of the Social Sciences (SPSS, version 20.0), analysed using descriptive and inferential statistics. Results: The results revealed an association between educational level and adherence to TB treatment (r = 0.184, p = 0.042). Sixty seven percent (67.5%, n=83) preferred western treatment, and 32.5% (n=40) of the participants reported that they used other types of treatment for ailments. The data also revealed that illness grants were not distributed to all TB clients. A 76.4%, (n=94) of the participants did not get illness grants while on TB treatment, whereas, 23.6%, (n=29) received illness grants for being on TB treatment. The absence of illness grants is likely to impede adherence to TB treatment. Receiving health education before initiation on treatment enhanced adherence; where 88.6% (n=109) of the participants reported that they received counselling on adherence prior to initiation to TB treatment, and 11.4% (n=14) did not get any counselling on adherence. An 80.5% (n=99) participants reported that they

experienced side effects while on TB medication. There was a relationship between barriers and adherence to TB treatment (r = -0.416, p = 0.001). Conclusion: The data showed that TB clients had challenges with adherence to treatment. Key strategies were developed to enhance adherence to TB treatment; empower clients on effects and side effects of each TB drug; periodical evaluation of clients for side-effects; strengthening of incentive policy for TB clients; and introduction of a one stop centre for all TB clients.