The Implication of Non-Compliance with Tuberculosis
OBJECTIVE OF STUDY
The objectives of this study include:
- To ascertain the knowledge of people about tuberculosis, its causes and its effects.
- To find the cause of patients not complying to their treatment.
- To identify the knowledge of patients based on the importance of complying to treatment.
- To identify strategies for improvement of patients’ acceptance of care and treatment of tuberculosis.
Literature review deals with the review of related and relevant study under the following headings:
- Conceptual Framework:
- Concept of tuberculosis disease.
- Causes / sign and symptoms of tuberculosis disease.
- Treatment of tuberculosis disease.
- Non-compliance of patient to tuberculosis treatment.
- Prevention and control of tuberculosis disease.
- Theoretical framework.
- Empirical studies.
- Summary of literature review
CONCEPT OF TUBERCULOSES DISEASE
World health organization (2013) stated that tuberculosis disease is an air-bone infection which infects one-hird of the world’s population. It commonly manifests as an infection of the lungs usually with symptoms of coughing, weight loss. Center for disease control and prevention (2014) defined tuberculosis as a disease which is spread through the air from one person to the other. People who are not sick may still need treatment to prevent this disease form developing in the future.
Brian. D (2014) stated that tuberculosis disease is a bacterial infection which can live in the body without making a person sick. There, will be no symptoms and it cannot be spread to others unless if the tuberculosis bacterium becomes active in the body and multiply, the person will go from tuberculosis infection to being sick with tuberculosis disease.
Mc nully (2014) stated that tuberculosis disease is a chronic infectious disease that primarily attacks the lungs of other organs. The severity 0f the attack depends on whether the bacteria spreads from the lungs to other parts of the body. Tuberculosis infection in the blood, the meninges (membranes around the brain and spinal cord) and the kidney are the most infected. Mayo (2015) opined that tuberculosis diseases are potentially serious infectious diseases that affects the lungs. The bacteria of tuberculosis are spread from one person to another through tiny droplets released into the air via cough and sneeze. It is rare in developed countries but increases partly because of the emergence of H.I.V (the virus that cause AIDS). H.I.V weakens a person’s immune system so it can’t fight the tuberculosis germs. Bernstein (2015) states that tuberculosis is a bacterial infection that can spread through the lymph nodes and blood stream to any organ in your body. It is most often in the lungs. Most people who are exposed to tuberculosis never develop symptoms because the bacteria can live in an inactive form in the body for years but if the immune system becomes weak (such as in people with H.I.V or elderly adults), it becomes active and causes death of tissues in the organs they infect. Active tuberculosis disease can be fatal if left untreated.
National institute of allergy and infectious disease (2012) states that tuberculosis disease is contagious and caused by a bacterial infection which affects the lungs and other organs. It is usually treated with regimen of drugs taken for 6 months to 2 years depending on the type of infection. Web medical dictionary (2013) defined tuberculosis as a highly contagious infection caused by the bacteria called Mycobacterium Tuberculosis. Tubercles (tiny lumps) are characteristic findings in tuberculosis disease. Diagnosis may be by skin test which if positive should be followed by chest x-ray to determine the status (active or dormant) of the infection. Tuberculosis is more common in people with immune system problems such as AIDS than in the general population.
W.H.O (2007) states that tuberculosis is the largest single infectious cause of death among young people and adults today and accounts for more than one- quarter of all preventable adult deaths in developing countries. Every year, 2 to 3 million people die for tuberculosis disease and 8 million develop active infection. In sub –Saharan, 1.6 million of the cases occur in a year, 3 million occurs in south – East Asia and 2 million occur in Nigeria.
Center for disease control and prevention (2013) reported 14,874 cases in the United States or 5.1 cases per 100, 000 population. The actual number of tuberculosis infection however is estimated to be much higher. In 2012, there were 802 tuberculosis – related deaths. The District of Columbia had the highest rate of tuberculosis with 14 cases per 100,000 people in 2013.
CAUSES AND SIGNS AND SYMPTOMS OF TUBERCULOSIS DISEASE.
Mayo clinic (2015) states the causes and signs and Symptoms of tuberculosis disease;
Tuberculosis is caused by bacteria that spread from person to person through microscopic droplets released into the air. This can happen when someone with the untreated active from of tuberculosis coughs, sneezes, spits laughs or sighs.
This chapter deals with method & procedure the study. These include.
- Research design
- Target population
- Sampling technique
- Instrument for data collection.
- Validity /reliability of instrument
- Method of data collection
- Method of data analysis
- Ethnical consideration.
The survey designed was used in the study survey research is a method of collecting information or data as reported by individuals.
The study was carried out in Imo state university teaching hospital in Orlu. It is situated in Orlu L.G.,A
It is adequately serviced by professional doctors, nurses and other health workers.
This setting was chosen because it has the human and material resources suitable for the study
The population of study comprises of TB patients between 15-40 years of age in Imo State University Teaching Hospital, Orlu and they are 40 in number.
The researcher used snow ball sampling technique of non- probability sampling technique
This chapter analyzes the data collected on the study of non-compliance of tuberculosis treatment among patients suffering t tuberculosis in Imo state universi9ty teaching hospital, Orlu. The data was analyzed and presented in this chapter using tables and percentages.
Discussion of findings
This chapter is on the discussion of the findings, nursing implication, summary conclusions, limitations recommendations and suggestion for further studies the study assessed non-compliance to tuberculosis in Imo state university teaching hospital, Orlu, Imo state
RESEARCH QUESTON ONE: what are the knowledge levels of people about tuberculosis disease, its causes and effects?
From the study finding, 6o% of the respondents are aware of what tuberculosis disease is its causes and effects while 40% do not have an idea about the disease 75% think tuberculosis is an infectious disease, 7.5% think it is a spiritual attack, 12.5% think it is heredity disease while 5% believe it is a congenital disease. 17.5% think the disease is caused by plasmodium, 12.5% think it is caused by virus, 22.55 believe it is causes by mycobacterium tuberculosis. as for mode of transmission , touching of an infected person, 25% believe it can be transmitted by playing with an infected person, 37.5% think it can be contacted thorough inhalation of droplets from cough or sneeze of an infected person while 20% believe it can be contacted through the use of personal items belonging to an infected person
RESEARCH QESTION TWO: what are the causes of patients not complying to their tuberculosis treatment?
From the analysis data, the cause of non-compliance of patient to treatment could be seen in this manner 30% of the respondents adhere to treatment regimen while 70% do not adhere. As for the cause of non-compliance, 15% were not adhering to treatment due to the big size of tablets, 17.5% was due to less awareness that adherence to the therapy is very important for complete cure, 12.5% was as a result of side-effects of the drugs while 55% was due to the use of complementary and alternative medicine (natural). This is in line with centers for disease control and presentation (2008) which stated the reasons patients fail to take their medications as the above mentioned reasons.
RESEARCH QUESTION THREE: what are the peoples knowledge about the importance of complying to their treatment?
From the analyzed data, 25% (10) of the respondents think adherence to treatment is important while 75% I don’t think so. As well, 25% of the respondents think TB can damage body organs if not properly treated while 75% do not think so.
RESEARCH QUESTION FOUR: what are the strategies for improvement of patient’s acceptance of care and treatment of tuberculosis?
Based on the findings, 35(87.5%) of the respondents believe tuberculosis patients should receive instructions about the use and importance of the anti-Tb drugs from drugs providers while 12.5% do not think so. As well, 80% of the respondents think TB patients should receive comprehensive information about tuberculosis at the time of diagnosis through health education while 20% do not think so. 87.5% of respondents think showing patient those who are convalescing from the disease would help to improve compliance to treatment while 12.5% do not think so.
From the result of the study, it was shown that a large population of the respondent are aware of what tuberculosis is but they lack the thorough knowledge which affects their compliance to treatment. Therefore, the nurse and other health care workers should use the harmful effects of not complying t o treatment and as well as the use and importance of the anti- TB drugs, giving comprehensive information about tuberculosis at the time of diagnosis and showing TB patients whose who are convalescing from the disease.
This study was no the non-compliance to TB treatment among TB patients in Imo state university teaching hospital, Orlu L.G.A . A descriptive survey design method was used for the study. 40 questionnaires were formulated, distributed and data collected. The total populating constituted 40 patients. Table, and percentages, it was noticed that majority of the respondents understood what tuberculosis disease is but do not have in-depth knowledge about the importance of complying to treatment and dangers of non-compliance.
Based on the findings of the study, the researcher concluded that majority of the respondents had same knowledge about the respondents do not adhered to treatment due to certain personal reasons. However, all would definitely improve a great deal if more effort is put to properly educate and explain to patients on the need for strict adherence to treatment.
LIMITATION OF STUDY
- The following problems were encountered during the course of stud:
- Time interval to carry out this study was short.
- Lack of adequate literature for review, analysis and discussion
- Level of literacy of respondents was very poor making explanation of the topic and items in the questioner a difficult one.
- The researcher is a novice in research and this aided to the set back encountered.
In view of research findings, the following recommendations are made:
- There is need for hospitalization for actual diseases, specific treatment other than regimen.
- There should be implementation of a tuberculosis control program in general hospitals and provide supervised treatment at least for patients with parameters considered predictive for non-compliance.
- If the result of this study are confirmed by other studies of patients treated by general hospitals legislators responsible for public health policies should give priority to providing special treatment for tuberculosis patients (particularly in urban centers ), establishing out –patient and hospital –based tuberculosis control programs.
SUGGESTION FOR FUTHER STUDIES
The researcher suggested that a similar study should be carried out in other hospitals so that generalization would be made.
- world health organization.
- World Health Organization. Global tuberculosis control: a short update to the 2009 report. Geneva: world health organization; 2009.p. 39.
- World Health Organization. Tuberculosis: a global emergency. Case Notification update. Geneva: world health organization; 1994. P. 26.
- World Health Organization. WHO tuberculosis programmes: framework for effective tuberculosis control . Geneva: world health organization; 1994. P. 13. (WHO/TB/94.179).
- United Nations. The millennium development goals report 2010. New York, NY: united Nations; http:mdgs,un.org/unsd/mdg/resources/static/ Product/progress2010/MDG report 2010 en. Pdf, accessed on 25 august 2017.