Patient compliance with tuberculosis treatment in Ghana: factors influencing adherence to therapy in a rural service programme

• Published in: Tubercle Vol. 71; no. 4; pp. 247 - 252
• Main Authors: Van Der Werf, T.S., Dade, G.K., Van Der Mark, T.W.
• Format: Journal Article
• Language: English
• Published: Harlow Elsevier Ltd 01.12.1990; Livingstone
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Ambulatory Care; Antitubercular Agents - therapeutic use; Bacterial diseases; Bacterial diseases of the respiratory system; Biological and medical sciences; Female; Ghana; Health Services Accessibility; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Patient Compliance; Patient Dropouts; Rural Population; Sex Factors; Tuberculosis, Pulmonary - drug therapy; Ghana; Human; Rural environment; Respiratory disease; Lung; Africa; Ghana; Mycobacterial infection; Epidemiology; Statistical study; Infection; Drug compliance; Chemotherapy; Treatment; Tuberculosis; Follow up study; Bacteriosis; Public health
• ISSN: 0041-3879
• DOI: 10.1016/0041-3879(90)90036-8

In Agogo Hospital in the hills of Ashanti, Ghana, default and cure rates among 569 consecutive sputum-smear positive pulmonary tuberculosis (PTB) patients registered between 1984 and 1987 in a rural ambulatory non-supervised service program were analysed. Female gender, shorter home-to-clinic distances and younger age were significantly associated with higher cure and lower default rates. Within the district where liaison health workers paid home visits to PTB patients, the home-to-clinic distance effect on default was overruled by the effect of follow-up. Data from two surveys held in 1985 and 1987, among 68 and 49 PTB patients respectively, revealed that many patients visited healing churches but few admitted to having consulted traditional healers; that financial expenses for transport outweighed hospital charges; that lower educational levels were not associated with poorer compliance to therapy and that health education had improved significantly over the 2-year-period. It is concluded that intervention with liaison health workers and simple health education results in improved outcome in rural service tuberculosis programme.