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A study on reasons for nonadherence to 99DOTS among HIV-tuberculosis coinfected patients in Davanagere district, Karnataka

Satish Ghatage, Anurupa M S, Swathi S Aithal, Shubha D B, Navinkumar Angadi.

Abstract
Background: Ensuring the patientís adherence is the critical challenge in tuberculosis (TB) treatment. To monitor the adherence to anti-TB drugs in HIV-TB coinfected patients, 99 directly observed treatment short (99DOTS) course has been introduced.

Objectives: The objectives of the study were to know the reasons for nonadherence to 99DOTS among HIV-TB coinfected patients.

Materials and Methods: A community-based cross-sectional study was conducted among 85 HIV-TB coinfected patients on 99DOTS in Davanagere district. A pretested semi-structured questionnaire was used to collect the data from October to December 2016. Data were analyzed using SPSS software v16.0. Descriptive statistics such as frequency and percentage were calculated.

Results: Of 85 study subjects, 81 (95%) of them were found to be nonadherent. Multiple factors were reasons for nonadherence, i.e. did not take TB medication (53%), not aware that they should call daily (35%), do not know how to use mobile phone (30%), network problem and mobile issues (20%), and used to call from any of the unregistered phone numbers (17%). Forgot to call after taking medication (6%) and registered phone number was of neighbors/relatives (5%). Reasons for not taking the medications were forgot to take medications (26%), discontinued because of too many pills (11%), avoid the side effects (9%), improvement in health (7%), alcohol intake (6%), due to other illness (6%), and stigma at home (3%).

Conclusions: HIV-TB coinfected patients on 99DOTS were found to be nonadherent because of multiple reasons. Orientation regarding the importance of adherence to drugs and calling daily after medication only from a registered number is required before initiation of treatment.

Key words: Nonadherence; 99Directly Observed Treatment Short, Tuberculosis; HIV-tuberculosis Coinfection



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