Socio economic factors contributing to default, relapse and development of resistance by TB patients in TB treatment

Abstract

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This thesis examines factors that contribute to tuberculosis (TB) patients who default, relapse and/or develop resistance toward TB treatment at Walvis Bay, Windhoek and Oshakati. The research hypothesis for this study was: "Socio- economic factors contribute to TB patients to default, relapse and develop resistance toward TB treatment. " The research question for this study was: "How do socio-economic factors contribute to TB patients to default, relapse and develop resistance toward TB treatment?" The thesis findings support the research hypothesis and answer the research question

The research populations consisted of health care workers and TB patients. The population of TB patients was divided into a sample of three: in- and outpatients as well as former in patients (30 each). Each research site was planned to consist of 90 patients, but Walvis Bay in-patients were only 14, bringing their total to 74 TB patients interviewed. The total of TB patients interviewed for all three sites was 254. In this research, the quantitative questionnaire research method was applied to TB patients; while, qualitative method focused on health care workers through an interviewing schedule. In addition, in-depth interviews were conducted with selected TB patients through an interviewing schedule. An opportunity sampling method was used to collect data from the above mentioned populations

The research findings concluded that a complex web of socio-economic factors contribute to TB patients defaulting, relapsing and developing resistance to TB treatment. These factors include: being single, a limited support, alcohol abuse, smoking, co-infection of TB and HIV/AIDS, limited knowledge regarding the clinical conditions of TB, stigmatisation and traveling. Economical factors that also contribute to problems in TB treatment include: a lack of or inadequate education that leads to poor communication between health care workers and TB patients, overcrowding and sub-standard housing, malnutrition, and unemployment. Personalistic factors include: deliberately missing treatments as well as the failure to fulfill in all DOTS aspects. In general, this thesis finds that TB patients who default, relapse or develop resistance to TB treatment lack emotional, physical and social support necessary for them to successfully complete treatment