International Journal of Community Health Nursing

FACTORS CONTRIBUTING TO NON-COMPLIANCE ON DOTS REGIMEN IN SELECTED URBAN DOTS CENTER IN BANGALORE.

S. Jenifer Helen Sathya , J. Violet Jayamani, Bai Jayanti Mishra

jeniferhelensathya@gmail.com

Tuberculosis, noncompliance, factors contributing, DOTS, Cat II sputum positive.

Introduction: Tuberculosis (TB) is a public health problem the world over, with a great part of its morbidity and mortality concentrated in developing countries. The therapeutic regimens as recommended by World Health Organization (WHO) have been shown to be highly effective for both preventing and treating tuberculosis but noncompliance to DOTS regimen is still a problem and is the most important cause of failure of initial therapy and relapse. Noncompliance to DOTS regimen has been cited as a major barrier to the control of TB. There are different factors responsible for the noncompliance of TB. Hence the present study intends to identify various factors contributing to noncompliance to treatment in patients on DOTS under RNTCP.Methods: Descriptive cross sectional research design was used in this study. The DOTS centers were selected by convenient sampling and 96 Cat II sputum positive defaulter patients were selected by purposive sampling technique. A semi structured interview schedule was used to obtain demographic data and factors contributing to noncompliance to DOTS regimen. The collected data was analyzed using descriptive and inferential statistics. Results: In the present study 62(64%) of the subjects with category II sputum positive defaulter were in age group of more than 35 years. Gender wise 82(85.4%) were males. The most common factor contributing to non-compliance 82(85.4%) were found to have habit of tobacco chewing in past, 10(10.4%) believed that alternative medicine cures TB, 13(13.5%) had fear of discrimination, 88(91.7%) had an improvement during initial treatment, 86(89.6) found hard to take too many pills at a time, 60(62.5%) experienced side effects like GI upset and 59(61.5%) fatigue. Regarding health care services 7(7.3%) waited for a prolonged period in the clinic and 6(6.3%) travelled long distance to clinic and 4(4.2%) felt hard to reach the clinic. Moreover, there were significant associations between selected demographic variables and alcohol consumption, health care services, area of residence and smoking of the defaulters.Conclusion: This study provided the reasons for defaulting from DOTS regimen and hence the need for guidance and counseling that will help to decrease the default rate and increase the cure rate