Evaluation of Non-adherence to Anti-tuberculosis Treatment at a DOTS Clinic in Malaysia

Adherence to tuberculosis treatment is vital to prevent and control the disease from further progression into multiple complications. However, due to many reasons the adherence level is very poor among the tuberculosis patients. This study was aimed to assess the knowledge and perception of tuberculosis patients on anti-tubercular therapy and determine the factors that involved in non-compliance to tuberculosis treatment. The study was carried out for a period of 4 months at the DOTS clinics, among the patients who availed anti-tuberculosis treatment for at-least 2 consecutive months. A structured, validated questionnaire was used to gather relevant information pertaining to the study objectives. Among the 171 respondents, most (39.8%) were between 21 to 39 years old, 55.6% were male, 81% with secondary level of education and 48% had diploma level of education. Majority of the respondents were Malay (40.9%), Chinese (23.4%), Indian (22.2%), and others (13.5%). The mean percentage score of respondents on knowledge, attitude, and perception on tuberculosis treatment were 58.9±19.3 and 44.2±9.4, respectively. There were no significant differences in the scores on knowledge, attitude, and perception on tuberculosis with respondents’ age, sex, education, ethnicity, marital and employment status. The knowledge, attitude, and perception towards TB treatment among the patients who regularly visit the DOTS clinics were moderate to good. However, there were many defaulters in the current TB therapy as many patients did not follow-up their treatment schedule and drop out in the early phase/month of the TB course due to lack of support from family and friends, and also the influence of social and community factors. These barriers need to be addressed in an emergency basis for the benefit of patient community.