Ziemlé Clément Méda1, Yu-Ting Lin2, Issiaka Sombié3, Daouda Maré4, Donald E Morisky5, Yi-Ming Arthur Chen6. 1. Ministry of Health, Burkina Faso; International Health Program, Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; AIDS Prevention and Research Center, National Yang-Ming University, Taipei, Taiwan. 2. AIDS Prevention and Research Center, National Yang-Ming University, Taipei, Taiwan. 3. Research Office of West African Health Organization, Bobo, Dioulasso, Burkina Faso; National Institute of Health Sciences, Polytechnic University, Bobo Dioulasso, Burkina Faso. 4. Association Responsabilité-Espoir-Vie-Solidarité (REVS+), Bobo Dioulasso, Burkina Faso. 5. Department of Community Health Sciences, University of California at Los Angeles (UCLA), Fielding School of Public Health, Los Angeles, CA, USA. 6. International Health Program, Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; AIDS Prevention and Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Microbiology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: arthur@kmu.edu.tw.
Abstract
BACKGROUND: Adherence to treatment remains a key issue for tuberculosis (TB) and human immunodeficiency virus (HIV) programs. The study objective was to identify potential determinants of medication adherence (MA) among patients with TB, HIV, or both. METHODS: In this cross-sectional study, adult patients attending TB or HIV clinics were recruited in two main regions (Centre and Hauts-Bassins) of Burkina Faso from August to October 2010. Questionnaires were collected and simple and multiple step-wise linear regression models were used to identify predictors of MA. RESULTS: In total, 1043 patients (309 with TB, 553 with HIV, and 181 coinfected with both) participated in this study. For patients with TB, adjusted predictors of good MA were no alcohol use, ever been lost to follow-up, and awareness of disease transmission. For patients with HIV, adjusted predictors of good MA were less stigma, good knowledge about TB transmission, and awareness of disease transmission. For patients with dual infection, adjusted predictors of good MA was good attitude. Furthermore, adjusted predictors of poor MA for patients with TB or with dual infection were poor financial access to care and high number of persons sleeping in the household, respectively. CONCLUSION: This study provides information on MA in patients infected with TB, HIV, and those coinfected with TB and HIV. TB and HIV programs have to consider the environment of the patient and its characteristics, including stigma, attitude, status of loss to follow-up, TB knowledge, financial access to care, alcohol use, awareness of disease transmission, and number of persons sleeping in the household. These identified factors in this study need to be taken into account for a specific patient profile and during sensitization, project planning, and research stages.
BACKGROUND: Adherence to treatment remains a key issue for tuberculosis (TB) and human immunodeficiency virus (HIV) programs. The study objective was to identify potential determinants of medication adherence (MA) among patients with TB, HIV, or both. METHODS: In this cross-sectional study, adult patients attending TB or HIV clinics were recruited in two main regions (Centre and Hauts-Bassins) of Burkina Faso from August to October 2010. Questionnaires were collected and simple and multiple step-wise linear regression models were used to identify predictors of MA. RESULTS: In total, 1043 patients (309 with TB, 553 with HIV, and 181 coinfected with both) participated in this study. For patients with TB, adjusted predictors of good MA were no alcohol use, ever been lost to follow-up, and awareness of disease transmission. For patients with HIV, adjusted predictors of good MA were less stigma, good knowledge about TB transmission, and awareness of disease transmission. For patients with dual infection, adjusted predictors of good MA was good attitude. Furthermore, adjusted predictors of poor MA for patients with TB or with dual infection were poor financial access to care and high number of persons sleeping in the household, respectively. CONCLUSION: This study provides information on MA in patients infected with TB, HIV, and those coinfected with TB and HIV. TB and HIV programs have to consider the environment of the patient and its characteristics, including stigma, attitude, status of loss to follow-up, TB knowledge, financial access to care, alcohol use, awareness of disease transmission, and number of persons sleeping in the household. These identified factors in this study need to be taken into account for a specific patient profile and during sensitization, project planning, and research stages.
Authors: Jeremy C Kane; Melissa A Elafros; Sarah M Murray; Ellen M H Mitchell; Jura L Augustinavicius; Sara Causevic; Stefan D Baral Journal: BMC Med Date: 2019-02-15 Impact factor: 8.775