Anti-TB treatment non-adherence predictors: A multi-center cross-sectional study in Kandahar, Afghanistan

Q3 Medicine

Indian Journal of Tuberculosis Pub Date : 2025-07-01 DOI:10.1016/j.ijtb.2024.05.005

Muhammad Haroon Stanikzai , Mohammad Hashim Wafa , Ahmad Haroon Baray , Ahmad Farshad Rahimi , Hadia Sayam

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引用次数: 0

Abstract

Background

Adherence to anti-TB treatment in low- and middle-income countries (LMICs), including Afghanistan, is critical for global TB control.

Objectives

We aimed to determine anti-TB treatment non-adherence prevalence and its predictors in Kandahar, Afghanistan.

Methods

We conducted a multi-center cross-sectional study of 579 TB patients in Kandahar, using a systematic random sampling method, and collected their data on sociodemographic attributes, clinical factors, and mental health. The eight-item Tuberculosis Medication Adherence Questionnaire (TBMAQ) was used for labeling TB patients as adherent or non-adherent. We assigned a score of ≤4 (the cut-off) as non-adherence. We performed the multivariable logistic regression to probe significant predictors of non-adherence.

Results

The non-adherence rate in this study was 66.8% (95% CI: 62.9–70.5). Being uneducated (AOR = 1.66, 95 % CI: 1.09–2.53), having a comorbid medical condition (AOR = 2.57, 95 % CI: 1.39–4.74), feeling stigmatized for having TB (AOR = 9.25, 95 % CI: 4.72–18.1), and having a comorbid depression (AOR = 1.77, 95 % CI: 1.16–2.71) were associated with non-adherence.

Conclusion

Anti-TB treatment adherence needs to be prioritized among TB patients overall, particularly in those with a low level of education, comorbidity, perceived TB-related stigma, and comorbid depression with consistent evidence of increased non-adherence.

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不坚持抗结核治疗的预测因素：阿富汗坎大哈多中心横断面研究

在包括阿富汗在内的低收入和中等收入国家坚持抗结核治疗对全球结核病控制至关重要。目的：我们旨在确定阿富汗坎大哈抗结核治疗不依从率及其预测因素。方法采用系统随机抽样的方法，对坎大哈579例结核病患者进行多中心横断面研究，收集患者的社会人口学特征、临床因素和心理健康数据。采用结核药物依从性问卷（TBMAQ）对结核患者进行依从性和非依从性标记。我们将评分≤4分（临界值）定为不依从。我们进行了多变量逻辑回归来探索不依从性的重要预测因素。结果本研究不依从率为66.8% （95% CI: 62.9 ~ 70.5）。未受教育（AOR = 1.66, 95% CI: 1.09-2.53）、有合并症（AOR = 2.57, 95% CI: 1.39-4.74）、因患有结核病而感到耻辱（AOR = 9.25, 95% CI: 4.72-18.1）、有合并症抑郁症（AOR = 1.77, 95% CI: 1.16-2.71）与不遵医道相关。结论：总体而言，结核病患者需要优先考虑抗结核治疗依从性，特别是那些受教育程度低、合并症、结核病相关耻辱感和合并症抑郁症的患者，并且有一致的证据表明不依从性增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian Journal of Tuberculosis Medicine-Infectious Diseases

CiteScore

2.80

自引率

0.00%

发文量

103

期刊介绍： Indian Journal of Tuberculosis (IJTB) is an international peer-reviewed journal devoted to the specialty of tuberculosis and lung diseases and is published quarterly. IJTB publishes research on clinical, epidemiological, public health and social aspects of tuberculosis. The journal accepts original research articles, viewpoints, review articles, success stories, interesting case series and case reports on patients suffering from pulmonary, extra-pulmonary tuberculosis as well as other respiratory diseases, Radiology Forum, Short Communications, Book Reviews, abstracts, letters to the editor, editorials on topics of current interest etc. The articles published in IJTB are a key source of information on research in tuberculosis. The journal is indexed in Medline