Factors influencing default rates of tuberculosis patients in Ghana

Abstract

The purpose of this study was to describe factors contributing to the high default rate of tuberculosis (TB) patients participating in the Directly Observed Therapy Short Course (DOTS) programme in the Kwaebibirim district of Ghana. A quantitative, descriptive study was conducted to determine personal, health service, community and treatment factors contributing to the high default rate of DOTS implementation in the district. Structured interviews were used to collect the data. Purposive sampling was done and the sample comprised 130 TB patients who were on DOTS at the district chest clinic. The study highlighted TB patients' knowledge about TB, socio-economic characteristics, organisation of care as well as community perceptions about the disease. The findings revealed that patients defaulting on treatment is a complex behavioural issue involving multiple factors, including an interaction of personal, social and healthcare factors as well as side-effects of medication and duration of treatment. Recommendations include developing and implementing patient-centred interventions that encourage shared decisionmaking regarding treatment; providing ongoing training to healthcare staff members; strengthening patient support and community advocacy programmes aimed at eradicating the stigma attached to TB; and planning interventions to reduce the influence of poverty and gender on patients and their adherence to treatment.