Michael Kifle W, Belachew Tefera, Jira Challi
Department of Epidemiology and Biostatistics, Public Health Faculty, Jimma University, P.O. Box 378, Jimma, Ethiopia.
Ethiop Med J. 2004 Oct;42(4):247-53.
A cross-sectional study was conducted among patients with tuberculosis on the DOTS regimen in the four teaching health centers of Jimma zone to determine rate of defaulting and factors associated with it. All tuberculosis patients registered and treated using DOTS regimen in the 4 teaching health centers (THC's) from the second half of 1999 to December 30, 2000 were included in the study. A sub-sample of one hundred and fourteen 114 (56.2%) defaulters were traced at their homes and interviewed to elicit their reasons for defaulting. The study showed that overall rate of defaulting was 6.7%. The default rate from the DOTS regimen was found to be quite low when compared to the rate of defaulting from the standard regimen in Jimma zone. Socio-economic factors including distance of patients' residence from the health institution, lack of money for paying transportation and poor awareness about the disease were the major reasons contributing to poor compliance and defaulting. Designing community based strategies for DOTS regimen in order to make the drug available within the vicinity of the grass root community and strong information education and communication activities need to be employed in order to reduce the defaulter rate and improve the quality of treatment of tuberculosis cases by the DOTS regimen.
在吉马地区的四个教学健康中心,对采用直接督导下的短程化疗(DOTS)方案治疗的结核病患者进行了一项横断面研究,以确定违约率及其相关因素。研究纳入了1999年下半年至2000年12月30日期间在这4个教学健康中心(THC's)登记并采用DOTS方案治疗的所有结核病患者。对114名(56.2%)违约者的子样本进行了家访并询问他们违约的原因。研究表明,总体违约率为6.7%。与吉马地区标准治疗方案的违约率相比,DOTS方案的违约率相当低。社会经济因素,包括患者居住地与医疗机构的距离、缺乏支付交通费用的资金以及对疾病的认识不足,是导致依从性差和违约的主要原因。需要制定基于社区的DOTS方案策略,以便在基层社区附近提供药物,并开展强有力的信息教育和宣传活动,以降低违约率,提高DOTS方案治疗结核病患者的质量。