Factors influencing adherence to anti-tuberculosis treatment in Morocco: a cross-sectional study from the Béni Mellal-Khénifra region.

IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Osong Public Health and Research Perspectives Pub Date : 2025-09-19 DOI:10.24171/j.phrp.2025.0153

Mohamed Dellal, Sanae Batoui, Youness Aassem, Khalid Habbari

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Abstract

Objectives: Adherence to anti-tuberculosis treatment is essential for achieving successful outcomes and preventing the emergence of drug-resistant strains. This study aimed to evaluate adherence levels and identify factors associated with non-adherence among tuberculosis patients in the Béni Mellal-Khénifra region of Morocco. We hypothesized that sociodemographic, clinical, and behavioral factors influence adherence.

Methods: A facility-based cross-sectional study was conducted from January 2023 to December 2024 in 2 Tuberculosis and Respiratory Disease Diagnostic Centers in the Béni Mellal-Khénifra region. A total of 481 patients who had been on treatment for at least 2 months were recruited using convenience sampling. Data were collected through structured, pre-tested questionnaires administered in face-to-face interviews and verified against treatment cards and medical records. Adherence was defined as taking ≥90% of prescribed doses. Multivariable logistic regression was used to identify independent predictors of non-adherence.

Results: Among the 481 participants, 8.1% were non-adherent. Significant predictors of non-adherence included forgetfulness (adjusted odds ratio [AOR], 38.84; 95% confidence interval [CI], 11.35-132.88), adverse effects (AOR, 14.26; 95% CI, 3.17-64.13), male sex (AOR, 6.77; 95% CI, 1.45-31.60), rural residence (AOR, 4.42; 95% CI, 1.37-14.25), self-adjusted dosing (AOR, 5.83; 95% CI, 1.20-28.34), stopping treatment after symptom improvement (AOR, 6.56; 95% CI, 1.34-32.14), and missed follow-up visits (AOR, 6.74; 95% CI, 1.56-29.19).

Conclusion: Although overall adherence was high, 8.1% of patients were non-adherent. Strategies to improve adherence should focus on addressing forgetfulness, managing side effects, enhancing access in rural areas, and reinforcing patient education and follow-up systems to improve treatment outcomes in this and similar settings.

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影响摩洛哥坚持抗结核治疗的因素：一项来自bsamni mal - khsamnifra地区的横断面研究。

目标：坚持抗结核治疗对于取得成功结果和防止耐药菌株的出现至关重要。本研究旨在评估摩洛哥bsamni mal - khsamnifra地区结核病患者的依从性水平，并确定与不依从性相关的因素。我们假设社会人口学、临床和行为因素影响依从性。方法：从2023年1月至2024年12月，在bsamni mal - khsamnifra地区的2个结核病和呼吸疾病诊断中心进行了一项基于设施的横断面研究。采用方便抽样的方法，共招募了481例接受治疗至少2个月的患者。数据是通过结构化的、预先测试的问卷收集的，在面对面访谈中进行，并根据治疗卡和医疗记录进行核实。依从性定义为服用≥90%的处方剂量。使用多变量逻辑回归来确定不依从性的独立预测因素。结果：在481名参与者中，8.1%为非依从性。不依从性的显著预测因素包括健忘（调整优势比[AOR]， 38.84； 95%可信区间[CI]， 11.35-132.88）、不良反应（AOR, 14.26; 95% CI, 3.17-64.13）、男性（AOR, 6.77; 95% CI, 1.45-31.60）、农村居住（AOR, 4.42; 95% CI, 1.37-14.25）、自我调整给药（AOR, 5.83; 95% CI, 1.20-28.34）、症状改善后停止治疗（AOR, 6.56; 95% CI, 1.34-32.14）、错过随访（AOR, 6.74; 95% CI, 1.56-29.19）。结论：尽管总体依从性较高，但仍有8.1%的患者未依从。改善依从性的战略应侧重于解决健忘问题、管理副作用、加强农村地区的可及性，以及加强患者教育和随访系统，以改善这种情况和类似情况下的治疗结果。

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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