Adherence to tuberculosis therapy among patients receiving home-based directly observed treatment: evidence from the United Republic of Tanzania

Non-adherence to tuberculosis (TB) treatment is the leading contributor to the selection of drug-resistant strains of Mycobacterium tuberculosis and subsequent treatment failure. Tanzania introduced a TB Patient Centred Treatment (PCT) approach which gives new TB patients the choice between home-bas...

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Bibliographic Details
Published in:PloS one 2012-12, Vol.7 (12), p.e51828-e51828
Main Authors: Mkopi, Abdallah, Range, Nyagosya, Lwilla, Fred, Egwaga, Saidi, Schulze, Alexander, Geubbels, Eveline, van Leth, Frank
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Adhesion
Adolescent
Adult
AIDS
Analysis
Antiretroviral drugs
Antitubercular agents
Antitubercular Agents - therapeutic use
Care and treatment
Cross-Sectional Studies
Directly Observed Therapy
Drug resistance
Drugs
Female
Health care facilities
Health centres
Health facilities
HIV
Human immunodeficiency virus
Humans
Isoniazid
Leprosy
Male
Medical research
Medication Adherence - statistics & numerical data
Medicine
Middle Aged
Mycobacterium tuberculosis - drug effects
Patient compliance
Patient Compliance - statistics & numerical data
Patients
Regression analysis
Self Administration - statistics & numerical data
Tanzania
Therapy
Treatment Outcome
Tuberculosis
Tuberculosis - drug therapy
Urine
Young Adult
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Summary:Non-adherence to tuberculosis (TB) treatment is the leading contributor to the selection of drug-resistant strains of Mycobacterium tuberculosis and subsequent treatment failure. Tanzania introduced a TB Patient Centred Treatment (PCT) approach which gives new TB patients the choice between home-based treatment supervised by a treatment supporter of their own choice, and health facility-based treatment observed by a medical professional. The aim of this study was to assess the extent and determinants of adherence to anti-TB therapy in patients opting for home-based treatment under the novel PCT approach. In this cross-sectional study, the primary outcome was the percentage of patients adherent to TB therapy as detected by the presence of isoniazid in urine (IsoScreen assay). The primary analysis followed a non-inferiority approach in which adherence could not be lower than 75%. Logistic regression was used to examine the influence of potentially predictive factors. A total of 651 new TB patients were included. Of these, 645 (99.1%) provided urine for testing and 617 patients (95.7%; 90%CI 94.3-96.9) showed a positive result. This result was statistically non-inferior to the postulated adherence level of 75% (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0051828