Determinants of Poor Adherence to Anti-Tuberculosis Treatment in Mumbai, India

Suparna Bagchi; Guirish Ambe; Nalini Sathiakumar

<JournalTitle>International Journal of Preventive Medicine</JournalTitle>

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<ArticleTitle>Determinants of Poor Adherence to Anti-Tuberculosis Treatment in Mumbai, India</ArticleTitle>

<FirstName>Suparna</FirstName>

<LastName>Bagchi</LastName>

</Author>

<FirstName>Guirish</FirstName>

</Author>

<FirstName>Nalini</FirstName>

<LastName>Sathiakumar</LastName>

<Affiliation>MD, DrPH, University of Alabama at Birmingham, Birmingham.. nalini@uab.edu</Affiliation>

</Author>

</AuthorList>

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<Abstract>ABSTRACT Objectives: In this study, we investigated the determinants of poor adherence with anti-tuberculosis therapy among pulmonary tuberculosis (TB) patients in Mumbai, India, receiving Directly Observed Treatment Short Course (DOTS) therapy. Methods: A cross-sectional study on 538 patients receiving DOTS I and II regimen was conducted. Patients were interviewed and clinical and laboratory data were collected. Eighty seven patients were considered non-adherent. Multivariable logistic regression was used to determine risk factors associated with non-adherence. Results: Factors associated with non-adherence were found to be different among the newly-diagnosed patients and all the other residual groups. Smoking during treatment and travel-related cost factors were significantly associated with non-adherence in the newly-diagnosed patients, while alcohol consumption and shortage of drugs were significant in the residual groups. Conclusions: An approach, targeting easier access to drugs, an ensured drug supply, effective solutions for travel-related concerns and modification of smoking and alcohol related behaviors are essential for treatment adherence.Keywords: Tuberculosis, DOTS, Mumbai, Adherence, smoking, drug supply.</Abstract>

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