MULTIDRUG RESISTANT TUBERCULOSIS TREATMENT NON- ADHERENCE AND ASSOCIATED FACTORS AMONG PATIENTS ATTENDING PUBLIC HOSPITALS IN SOUTHERN NATION NATIONALITIES AND PEOPLES REGION, ETHIOPIA

Abstract

ABSTRACT Background: One of the key elements of successful tuberculosis control programs is adherence to treatment, and this is a cornerstone of most international and national policies and guidelines. Few studies had investigated the survival status and factors associated with poor MDRTB treatment outcomes, but there is no published studies that assessed the magnitude and factors associated with MDRTB treatment non- adherence that determine outcomes in the study area. Therefore, the study will give insight on area of focus for program coordinators. Objective: To assess the level of non-adherence and associated factors among adult MDR-TB Patients attending public health institutions in South Nations Nationalities Peoples Region, Ethiopia Method: A facility based cross –sectional study design was conducted among adult MDRTB patients who are on follow-up and treatment in public hospitals in South Region from July 16 –August 15/2019. There were 160 MDRTB patients eligible and all were included in the study. Data was collected by trained data collectors using a structured and pre-tested questionnaire. Data was analyzed using SPSS- 25. Bivariate and multivariate logistic regression was fitted to identify predictors and control potential confounding variables. 95% confidence interval and p-value of < 0.05 was considered as cutoff. Result: Twenty seven (16.9%) of the patients were non-adherent in the last one month. Ten (37%) of patients missed drug doses due to drug adverse events. Distance from health facility (AOR=4.6; CI=1.5- 18); lack of adherence care and social support (AOR=5; 95% CI = 1.2 - 21); grade three or more adverse events (AOR=7.7; CI = 2-25); being on long term regimen (AOR=3.8; CI = 2 - 13) and co-morbidities including HIV/AIDS (AOR=4.5; CI= 1.5 - 20) were significantly associated with non-adherence. Conclusion: Non- adherence to MDRTB treatment was high among patients attending public hospitals in South Nations Nationalities Peoples Region. Non-flexible health delivery and insufficient support system, toxicities associated with drugs for MDRTB and comorbidities independently determine non-adherence. Interventions must be targeted to address these issues. Key words: Non- Adherence, MDRTB, SNNPR, Ethiopia