Defaulting from Dots and its Determinants in Three Districts of Arsi Zone, Oromia Regional State, Ethiopia
No Thumbnail Available
Date
2000-12
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba Universty
Abstract
A case-control study, on defau lting From DOTS was performed in three districts of Arsi
Zone, Oramia Regional State, among patients registered during the period of July I, 1997
to December 31 , 1999 to determine the rate of defaulting and to identify factors associated
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 contro ls 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 overall defaulter rate and specific rate by month of defaulting, health
institutions, distri cts and distance from health 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 hW1dred sixty controls were included in the study.
The overall defaulting rate froID DOTS was calculated to be 11.3%. The rate of defaulting
in case of sputum smear positive pulmonatĀ·y tuberculosis was found to be 11 .6%. The rate
of defau lting was higher in Etheya clinic and Hitosa District. Highest (80%) rate of
VII
defaulting occurred during the continuation phase. Medication side effect was found to be
significantly associated with defaulting from DOTS (OR= 4.20 with 95% CI 1.51 to 11.66).
Adequate knowledge and family SUppOlt were found to be important poss ible protective
factors for defaulting (OR=0.04 with 95% CI 0.02 to 0.10 and OR=0.19 with 95% CI 0.08
to 0.46 respectively). Distance from hea lth units and drug intolerance were the major
reasons mentioned for defaulting. However, there is no significant difference between
cases and controls regarding distance, employment status, attitude to treatment center, level
of education and average monthly income.
The rate is slightly higher than tlle critical level of 10% set by WHO. The major factors
contributing to high rate of defaulting were lack of family SUppOlt, inadequate knowledge
about duration of treatment and presence of medication side effects. Health programme
that are intended to enhance family support and knnwledge about duration of DOTS
treatment and Drug tolerance should be strengthened.
Vlll
Description
Keywords
Defaulting from Dots and its Determinants in Three Districts