Barriers and facilitators of adherence to anti-TB treatment in Western Indian population: A cross-sectional study.

INTRODUCTION

Achieving successful treatment outcomes for tuberculosis (TB) is essential in reaching the End TB goals. However, adherence to anti-TB treatment remains a significant challenge, leading to poor treatment outcomes, including drug resistance, relapse, and increased mortality. This study aimed to explore the barriers and facilitators influencing adherence to TB treatment in the western Indian population.

METHODS

A cross-sectional study design was undertaken in the Gandhinagar area of Gujarat, comprising people with tuberculosis on treatment. The data was collected through a quantitative questionnaire to investigate adherence prevalence and explore the association of factors affecting adherence behaviour. Descriptive and inferential statistics were utilized to identify key barriers to adherence among persons with TB.

RESULTS

The prevalence of non-adherence was 31.6 % among the study population. Bivariate and multivariate analyses revealed significant associations between adherence and several factors. Primary challenges to adherence comprised the occurrence of adverse drug reactions (ADR), as individuals reporting ADRs exhibited significantly lower adherence (p = 0.001). Tobacco consumption was another significant barrier, with tobacco users 1.35 times more likely to be non-adherent (AOR = 1.354, p = 0.001). Additionally, retreatment cases had higher odds of non-adherence compared to new cases (AOR = 1.171, p = 0.016). While facilitators of adherence included higher educational levels, with literate individuals showing better adherence (77.8 %) compared to illiterate individuals (61.7 %) (p = 0.037). Urban residents had better adherence (76.4 %) compared to those living in urban slums (55.0 %) (p = 0.003). These findings highlight the critical role of both individual and health system factors in influencing adherence to anti-TB treatment.

DISCUSSION: These findings underscore the need for targeted interventions to address the specific barriers and leverage facilitators to improve adherence rates and TB treatment outcomes. Strategies focusing on improving healthcare access, patient education, and social support systems to vulnerable populations could enhance treatment adherence and ultimately improve TB control efforts in the region.

CONCLUSION

This study provides insights into patient-related (demand side) and healthcare system-related (supply side) aspects affecting adherence. By addressing the identified challenges and utilizing the facilitators, public health interventions can be formulated to promote treatment adherence, resulting in enhanced TB control outcomes.