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Management of pulmonary tuberculosis patients in an urban setting in Zambia: a patient’s perspective

Zambia continues to grapple with a high tuberculosis (TB) burden despite a long running Directly Observed Treatment Short course programme. Understanding issues that affect patient adherence to treatment programme is an important component in implementation of a successful TB control programme. We set out to investigate pulmonary TB patient’s attitudes to seek health care, assess the care received from government health care centres based on TB patients’ reports, and to seek associations with patient adherence to TB treatment programme. Methods: This was a cross-sectional study of 105 respondents who had been registered as pulmonary TB patients (new and retreatment cases) in Ndola District between January 2006 and. | Mulenga et al. BMC Public Health 2010 10 756 http www.biomedcentral.com 1471-2458 10 756 BMC Public Health RESEARCH ARTICLE Open Access Management of pulmonary tuberculosis patients in an urban setting in Zambia a patient s perspective 1.2 13 14 Chanda Mulenga 1 David Mwakazanga Kim Vereecken Shepherd Khondowe Nathan Kapata Isdore Chola Shamputa1 5 Herman Meulemans6 Leen Rigouts2 7 Abstract Background Zambia continues to grapple with a high tuberculosis TB burden despite a long running Directly Observed Treatment Short course programme. Understanding issues that affect patient adherence to treatment programme is an important component in implementation of a successful TB control programme. We set out to investigate pulmonary TB patient s attitudes to seek health care assess the care received from government health care centres based on TB patients reports and to seek associations with patient adherence to TB treatment programme. Methods This was a cross-sectional study of 105 respondents who had been registered as pulmonary TB patients new and retreatment cases in Ndola District between January 2006 and July 2007. We administered a structured questionnaire bearing questions to obtain individual data on socio-demographics health seeking behaviour knowledge on TB reported adherence to TB treatment and health centre care received during treatment to consenting respondents. Results We identified that respondents delayed to seek treatment 68 even when knowledge of TB symptoms was high 78 or when they suspected that they had TB 73 . Respondent adherence to taking medication was high 77 but low adherence to submitting follow-up sputum 47 was observed in this group. Similarly caregivers educate their patients more often on the treatment of the disease 98 and drug taking 100 than on submitting sputum during treatment 53 and its importance 54 . Respondent adherence to treatment was significantly associated with respondent s knowledge about the disease and its treatment p .