Medical Education Interventions on Non-Adherence toTuberculosis Treatment amongTb Patients in Kericho andNakuru Counties, Kenya.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 11
Abstract
Background:Tuberculosis (TB) continues to be a major cause of high morbidity and mortality in Kenya. Adherence to TB treatment is one of the interventions that lead to increase in cure rate thus reducing mortality and emergence of Multi drug resistant tuberculosis (MDR) and high cost of treatment. This study focused on TB patients in urban and rural areas of Kericho and Nakuru Counties of Kenya. Objective:The objective of the study was to identify medical education interventions that can reduce nonadherence to Tuberculosis Treatment among Tb patients in Kericho and Nakuru counties. Methods: A purposive sampling method was used to carry out a cross sectional descriptive survey with retrospective cohort of non-adherent TB patients. Target population was smear positive TB patients registered in the TB registers in the two counties, within the past six months (June-December 2015) at the commencement date of the study. Data was collected using developed interview schedules and questionnaires. Respondents were traced non-adherent smear positive TB patients (defaulters) and health care workers. Age, gender, inadequate knowledge, ignorance on need for treatment adherence, stigma, alcoholism, social and economic factors such as low income, lack of social support, low education, financial problems, drug side effects were analyzed using SPSS platform that generated graphs and tables. Results: Feeling well soon after medication initiation, drug side effects, stigma, alcoholism, low educational level, poor financial status, unemployment, shortage of Tb drugs including unavailability of pyridoxine which is essential in counteracting drug side effects were associated with defaulting. Healthcare workers were found to be poorly prepared to treat Tb patients.Existing training curricula in training institutions are deficient and wanting in components of management skills and devoid of soft skills applications. Conclusion: Socio-demographic and socio-cultural/economic factors associated with non-adherence to treatment included ignorance on need for treatment adherence, stigma, alcoholism, poverty, low income and inadequately prepared healthcare workers who seemed poor in treating Tb patients. Available training curricula in training institutions are inappropriate. Recommendations: A deliberate and sustained plan on patients’ health education regarding adherence to medication and stigma reduction must be emphasized. Staffs’ updates on Tb treatment must be regularly enhanced through continuing medical education forums.Existing training curricula in training institutions need to be revised and updated to include practical components that touch on patients’ management skills reinforced with mandatory hands on soft skills applications for all trainees.
Authors and Affiliations
Richard K. A. Sang, Simon Kange the, L. P. Ayiro, J. M. Changeiywo
Keywords
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- EP ID EP249825
- DOI 10.9790/0853-1611117683
- Views 71
- Downloads 0
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