Background: Non-adherence to treatment remains a major obstacle to
efficient tuberculosis control in developing countries. The dual
infection of Tuberculosis and HIV presents further adherence problems
because of high pill burden and adverse effects. This poses a risk of
increased multi-drug resistant TB. However, the prevalence of
non-adherence and its associated factors have not been studied in these
patients in Uganda. Objectives: To determine the prevalence and
factors associated with non-adherence to anti-TB drugs among TB/HIV
co-infected patients in Mbarara hospital. Methods: A cross-sectional
study with qualitative and quantitative data collection methods was
conducted among TB/HIV co-infected adults in Mbarara hospital from
January to March 2008. Consecutive sampling was used to select 140
participants. Adherence was assessed over a 5-day period prior to the
interview using patients self-reports. Data was collected using an
interviewer administered questionnaire. Qualitative data was collected
through key informant interviews using a topic guide and was analyzed
manually. Quantitative data was analyzed using STATA version 8.
Logistic regression was used to determine factors associated with
non-adherence. Results: The prevalence of non-adherence was 25% (95%
CI=17.8-32%). Being on continuous phase of the TB regimen was
significantly associated with non-adherence (OR=6.24, p<0.001).
Alcohol consumption, being on antiretroviral therapy and smoking
confounded the relationship between stage of the TB regimen and
non-adherence. Conclusion: The prevalence of non-adherence was high.
Patients that are on continuous phase of TB treatment should be
supported to continue taking their drugs. In addition, patients that
drink alcohol; smoke and those not on ART should be targeted with
interventions to improve adherence