Knowledge, attitudes and perceptions of TB non-adherent and adherent 2-3 years after their initial registration at Botšabelo clinic, Maseru, Lesotho

Magister Public Health - MPHBackground: Tuberculosis (TB) in the majority of cases is a curable disease requiring prolonged treatment of six months. The World Health Organisation (WHO) recommends the Direct Observation Treatment Short course (DOTS) strategy as the approach to control TB. Despite such interventions, defaulting from TB treatment is still a major problem among TB patients at Botšabelo Clinic in Maseru. This research aimed to describe knowledge, attitudes and perceptions to TB as a disease and its treatment among non-adherent and adherent at Botšabelo Clinic in the Maseru district of Lesotho, in order to identify contributing factors related to defaulting treatment. Study design: A cross-sectional descriptive study was conducted. Population and sampling: TB non-adherent and adherent registered at Botšabelo Clinic in 2007 were included in the study. Simple random sampling was used to select both non-adherent and adherent. Data collection: Data were collected by means of a structured questionnaire. Data analysis: Epi-Info Version 3.4.3 was used for data analysis. Descriptive statistics were calculated using frequencies, means and percentages for socio-demographic information, knowledge, attitudes and perceptions. A p-value of less than 0.05 was accepted as being statistically significant in all statistical tests. Results: The total number of respondents who were interviewed in this study was 283. 131(46%) were non-adherent and 152 (54%) were adherent. Non-adherent and adherent showed good knowledge of symptoms, prevention and transmission of TB. They were also knowledgeable about duration of treatment. 98% non-adherent and 100% adherent knew that TB is curable. 93% non-adherent and 93% adherent visited a health facility when TB symptoms occurred. Less than half of the respondents (47% non-adherent and 47% adherent) smoked. 47% non-adherent 43% adherent drank alcohol. Many non-adherent and adherent experienced support from the community. A large number mentioned that TB did not affect their marriage negatively. Conclusion: Non-adherent and adherent showed good knowledge of symptoms, prevention, disease transmission and definition of TB. Even though many could define TB, there were misconceptions that TB is caused by poison. Therefore, there is a need to strengthen health education on TB among communities. They were also knowledgeable that TB is curable and many could define DOT. Their attitudes and perceptions towards TB as a disease were positive. Many (93%) of those who were diagnosed with TB went to a health facility for treatment, while others sought it from traditional healers. Less than half of non-adherent and adherent delayed seeking treatment. A considerable number of non-adherent and adherent were heavy smokers. Alcohol intake was moderate among both groups. Media was reported as the main source of TB information in this study. Side effects to medication were the most reported deterrent to treatment among non-adherent. The side effect with the highest frequency was vomiting. It was followed by nausea and skin rash. Socio-economic factors that determined treatment were access to health services, long distance to the clinic, lack of transport and lack of funds and personal habits like smoking and alcohol abuse. Delay in seeking treatment was found to be a problem in this study. There was no difference found between knowledge attitude and perceptions of non-adherents and adherents

Antituberculosis Drug Resistance Survey in Lesotho, 2008-2009: Lessons Learned.

Drug resistance is an increasing threat to tuberculosis (TB) control worldwide. The World Health Organization advises monitoring for drug resistance, with either ongoing surveillance or periodic surveys.The antituberculosis drug resistance survey was conducted in Lesotho in 2008-2009. Basic demographic and TB history information was collected from individuals with positive sputum smear results at 17 diagnostic facilities. Additional sputum sample was sent to the national TB reference laboratory for culture and drug susceptibility testing.Among 3441 eligible smear-positive persons, 1121 (32.6%) were not requested to submit sputum for culture. Among 2320 persons submitted sputum, 1164 (50.2%) were not asked for clinical information or did not have valid sputum samples for testing. In addition, 445/2320 (19.2%) were excluded from analysis because of other laboratory or data management reasons. Among 984/3441 (28.6%) persons who had data available for analysis, MDR-TB was present in 24/773 (3.1%) of new and 25/195 (12.8%) of retreatment TB cases. Logistical, operational and data management challenges affected survey results.MDR-TB is prevalent in Lesotho, but limitations reduced the reliability of our findings. Multiple lessons learned during this survey can be applied to improve the next drug resistance survey in Lesotho and other resource constrained countries may learn how to avoid these bottlenecks

First-line drug susceptibility test results, Lesotho, 2008–2009 (N = 984).

<p>^†Missing results—new patients with missing isoniazid result = 13</p><p>^§Missing results—previously treated patients with missing isoniazid result = 3</p><p>First-line drug susceptibility test results, Lesotho, 2008–2009 (N = 984).</p

Map of Lesotho.

<p>Image source: <a href="https://www.cia.gov/library/publications/the-world-factbook/index.html" target="_blank">https://www.cia.gov/library/publications/the-world-factbook/index.html</a>.</p

Lesotho Drug Resistance Survey (DRS) Sampling Flow Diagram.

<p>Lesotho Drug Resistance Survey (DRS) Sampling Flow Diagram.</p