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Factors Influencing Patient Adherence to Tuberculosis Treatment in Ethiopia: A Literature Review.
International Journal of Environmental Research and Public Health Pub Date : 2020-08-04 , DOI: 10.3390/ijerph17155626
Zekariyas Sahile Nezenega 1, 2 , Lua Perimal-Lewis 3 , Anthony John Maeder 2
Affiliation  

Background: Tuberculosis (TB) is a major global public health problem and one of the leading causes of death among infectious diseases. Although TB can be cured with first-line antibiotics treatment of 6 months regimen, non-adherence to the treatment remains the main challenge for TB prevention and control. Interventions to promote adherence need to address multiple underlying factors linked to non-adherence, which requires a synthesis of studies to understand these factors in the local context. Our review accordingly examines these factors for TB treatment in Ethiopia. Methods: Articles were searched from PubMed and ScienceDirect databases, as well as manual searches through Google and Google Scholar search engines. Both quantitative and qualitative studies that showed factors associated with or reasons for non-adherence, default or loss to follow up from TB treatment were included. A total of 276 articles were screened, and 29 articles were ultimately included in the review. Findings: The extracted factors were synthesized thematically into seven dimensions of patient-centred, social, economic, health system, therapy, lifestyle, and geographic access factors. More than 20 distinct factors were identified under these headings. Some of these factors may also apply quite widely in other settings, with greater or lesser influence, but some are particularly applicable to the Ethiopian setting. Conclusion: Helping patients to achieve full adherence to TB medication is a complex problem as it is influenced by interplay between many factors. Healthcare managers, providers, and researchers need to consider and address multiple underlying factors when designing adherence interventions. This work provides a reference set of such factors for Ethiopian interventions.

中文翻译:

影响埃塞俄比亚患者对结核病治疗依从性的因素:文献综述。

背景:结核病 (TB) 是一个主要的全球公共卫生问题,也是传染病的主要死因之一。虽然结核病可以通过 6 个月的一线抗生素治疗治愈,但不坚持治疗仍然是结核病防控的主要挑战。促进依从性的干预措施需要解决与不依从性相关的多个潜在因素,这需要综合研究以了解当地背景下的这些因素。我们的审查相应地检查了埃塞俄比亚结核病治疗的这些因素。方法:从 PubMed 和 ScienceDirect 数据库中搜索文章,以及通过 Google 和 Google Scholar 搜索引擎手动搜索。显示与不依从性相关的因素或原因的定量和定性研究,TB 治疗的默认或失访被包括在内。共筛选了 276 篇文章,最终纳入了 29 篇综述。结果:提取的因素按主题综合为以患者为中心、社会、经济、卫生系统、治疗、生活方式和地理访问因素的七个维度。在这些标题下确定了 20 多个不同的因素。其中一些因素在其他环境中也可能相当广泛地适用,影响或大或小,但有些特别适用于埃塞俄比亚环境。结论:帮助患者实现对结核病药物的完全依从性是一个复杂的问题,因为它受到许多因素之间相互作用的影响。医疗保健管理者、提供者、研究人员在设计依从性干预措施时需要考虑并解决多种潜在因素。这项工作为埃塞俄比亚的干预措施提供了一组此类因素的参考。
更新日期:2020-08-04
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