Defaulting From Dots and its Determinants in Three Districts of Arsi Zone, Oromia Regional State, Ethiopia

No Thumbnail Available



Journal Title

Journal ISSN

Volume Title


Addis Ababa University


A case-control study, on defaulting from DOTS was performed in three districts of Arsi Zone, Oramia Regional State, among patients registered during the period of July 1, 1997 to December 3 1, 1999 to determine the rate of defaulting and to identify factors assoc iated with it. A health record review of 1367 new tuberculosis patients put on DOTS during a period of 30 months (July 1997 to December 1999) was carried out in order to determine the rate of defaulting. All the study subjects were registered and put on DOTS after June 30, 1997 and completed treatment or declared cured before January 1,2000. The cases and controls were traced actively and interviewed by trained interviewers using a pre-tested structured questionnaire. The two groups were compared by social, demographic and health services variables. The overal l defaulter rate and specific rate by 1I10nth of defaulting, health in stitutions, di stricts and di stance from hea lth institutions were calculated. All defaulters and the non-defaulters were selected by paired matching of sex and age using the lottery method. Two controls were matched individually to each case. One hundred fifty five cases and one hundred sixty controls were included in the study. The overall defaulting rate from DOTS was calculated to be 11.3%. The rate of defaulting in case of sputum smear positive pulmonary tuberculosis was found to be 1 J .6%. The rate of defaulting was higher in Etheya clinic and Hitosa District. Highest (80%) rate of defaulting occurred during the continuation phase. Medication side effect was found to be signi fica ntly associated with defaulting from DOTS (OR= 4.20 with 95% CI 1.51 to I 1.66). Adequate knowledge and fa mily suppot1 were found to be impot1ant possible protective factors for defa ulting (OR=0.04 with 95% CI 0.02 to 0.10 and OR=0.J9 with 95% Cl 0.08 to 0.46 respectively). Distance from health units and drug intolerance were the major reasons mentioned for defaulting. However, there is no significant difference between cases and controls regarding distance, employment statu s, attitude to treatment center, level of education and average monthly income. The rate is slightly higher than the critical level of J 0% set by WHO. The major factors contributing to high rate of defaulting were lack offamily SUpp0l1, inadequate knowledge about duration of treatment and presence of medication side effects. Health prograt11l11e that are intended to enhance family suppOt1 and knowledge about duration of DOTS treatment and Drug tolerance should be strengthened.