Factors that contribute to high default rate of tuberculosis treatment in the Asunafo North District of the Brong-Ahafo Region, Ghana

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Tuberculosis kills approximately three million people per year worldwide. Of the estimated two billion people infected with tuberculosis, eight million develop the disease annually. The present global tuberculosis situation indicates that both the disease and default burdens are still very high especially in developing countries. Defaulting from treatment has been one of the major obstacles to treatment management and an important challenge for tuberculosis control. The main purpose of the study was to look for factors that contribute to high default rate of tuberculosis in the Asunafo North District in the Brong - Ahafo Region and to make recommendations. The study was a retrospective case- control of 72 patients registered for treatment from 1999- 2002. Default and cured patients were interviewed using structural interview and self- administered questionnaire were given to six selected health workers for data collection. Demographic, Service, Restrictive, Socio-economic, and Disease and treatment related factors were assessed to find whether there was an association between them and default. Majority of the patients interviewed were satisfied with the attitude of the health workers, opening and waiting times. Monitoring of patients to take their medication, level of income, length of treatment, stigmatization, drug side effects and number of drugs were some of the factors that had association with tuberculosis default in the District. It is recommended that, The District Health Directorate and the District Assembly should collaborate to train community members and cured patients as local DOTS workers to help reduced the tuberculosis default rate in the District. Areas for detailed and further research include private and public hospital partnership, nutritional status of TB patients in relation to treatment, and close supervision and counseling for tuberculosis treatment.
A dissertation presented to the Department of Community Health, School of Medical Sciences, College of Health Sciences Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirements for the award of MSc.degree in Health Services Planning and Management, 2005