Volume 10, Issue 4 (2022)                   Health Educ Health Promot 2022, 10(4): 633-642 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Shahnavazi M, Rigi F, Heydarikhayat N. Treatment Adherence and Influencing Factors in Patients with Tuberculosis during the COVID-19 Pandemic: A Mixed Method Study. Health Educ Health Promot 2022; 10 (4) :633-642
URL: http://hehp.modares.ac.ir/article-5-60909-en.html
1- Department of Nursing, Medical School, Iranshahr University of Medical Sciences, Iranshahr, Iran
Abstract:   (1236 Views)
Aims: This study aimed to determine the adherence to treatment and affecting factors in tuberculosis patients during COVID-19 outbreaks.
Instrument & Methods: This is a mixed-method study with an explanatory sequential design. The first phase was a cross-sectional study on 108 tuberculosis patients. Data were collected with an adherence questionnaire in patients with chronic disease. Descriptive statistics and linear regression tests were used for quantitative data analysis. The second phase was a qualitative study with the conventional content analysis approach. Participants included 12 patients and healthcare providers involved in the directly observed treatment short course program for tuberculosis in related centers to Iranshahr University of Medical Sciences, Southeast of Iran.
Findings: The median scores of treatment adherence were 110.00±35.00, and 48 (44%) of subjects had poor to moderate scores. COVID-19 and non-COVID-19 factors have influenced the adherence to treatment in patients with tuberculosis patients.
Conclusion: A worldwide and unanticipated crisis can negatively affect the control of chronic diseases.  Anxiety and panic over the unknown nature, lack of definitive treatment, and mortality of COVID-19 led to the disruption of the directly observed therapies program by both tuberculosis patients and healthcare providers. Giving part of the tuberculosis management responsibility to the patient and family was not an effective solution during the COVID-19 crisis.
Full-Text [PDF 1365 kb]   (1468 Downloads) |   |   Full-Text (HTML)  (113 Views)  
Article Type: Descriptive & Survey | Subject: Health Education and Health Behavior
Received: 2022/04/16 | Accepted: 2022/07/12 | Published: 2022/09/10
* Corresponding Author Address: (n.hkhayat@gmail.com)

1. Zimmer AJ, Heitkamp P, Malar J, Dantas C, O'Brien K, Pandita A, et al. Facility-based directly observed therapy (DOT) for tuberculosis during COVID-19: a community perspective. J Clinl Tuberc Other Mycobact Dis. 2021;24:100248. [Link] [DOI:10.1016/j.jctube.2021.100248]
2. Kant S, Tyagi R. The impact of COVID-19 on tuberculosis: challenges and opportunities. Ther Adv Infect Dis. 2021;8. [Link] [DOI:10.1177/20499361211016973]
3. World Health Organization. Global tuberculosis report 2020: executive summary. Geneva: World Health Organization; 2020. [Link]
4. Chakaya J, Khan M, Ntoumi F, Aklillu E, Fatima R, Mwaba P, et al. Global tuberculosis report 2020-reflections on the global TB burden, treatment and prevention efforts. Int J Infect Dis. 2021;113 Suppl 1(Suppl 1):S7-12. [Link] [DOI:10.1016/j.ijid.2021.02.107]
5. Shirazinia R, Saadati D, Zeinali E, Mishkar AP. The incidence and epidemiology of tuberculosis in Sistan region: an update to past researches. Int J Basic Sci Med. 2017;2:189-93. [Link] [DOI:10.15171/ijbsm.2017.35]
6. Department of Tuberculosis and Leprosy Control. The incidence of tuberculosis in Iran [Internet]. Tehran: Ministry of Health and Medical Education; 2019 [Cited 2022 Jan 1]. Available from: https://tb-lep.behdasht.gov.ir/TB_Situation_in_Iran.aspx. [Persian] [Link]
7. Bialvaei AZ, Asgharzadeh M, Aghazadeh M, Nourazarian M, Kafil HS. Challenges of tuberculosis in Iran. Jundishapur J Microbiol. 2017;10(3):e37866. [Persian] [Link] [DOI:10.5812/jjm.37866]
8. Pradipta IS, Houtsma D, van Boven JF, Alffenaar JWC, Hak E. Interventions to improve medication adherence in tuberculosis patients: a systematic review of randomized controlled studies. NPJ Prim Care Respir Med. 2020;30:21. [Link] [DOI:10.1038/s41533-020-0179-x]
9. Genet C, Melese A, Worede A. Effectiveness of directly observed treatment short course (DOTS) on treatment of tuberculosis patients in public health facilities of Debre Tabor town, Ethiopia: retrospective study. BMC Res Notes. 2019;12:396. [Link] [DOI:10.1186/s13104-019-4424-8]
10. Tesfahuneygn G, Medhin G, Legesse M. Adherence to anti-tuberculosis treatment and treatment outcomes among tuberculosis patients in Alamata district, northeast Ethiopia. BMC Res Notes. 2015;8:503. [Link] [DOI:10.1186/s13104-015-1452-x]
11. Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020;55(5):2000547. [Link] [DOI:10.1183/13993003.00547-2020]
12. Chen Y, Wang Y, Fleming J, Yu Y, Gu Y, Liu C, et al. Active or latent tuberculosis increases susceptibility to COVID-19 and disease severity. MedRxiv. 2020 March. [Link] [DOI:10.1101/2020.03.10.20033795]
13. Udwadia ZF, Vora A, Tripathi AR, Malu KN, Lange C, Raju RS. COVID-19-tuberculosis interactions: when dark forces collide. Indian J Tuberc. 2020;67(4):S155-62. [Link] [DOI:10.1016/j.ijtb.2020.07.003]
14. Gebreweld FH, Kifle MM, Gebremicheal FE, Simel LL, Gezae MM, Ghebreyesus SS, et al. Factors influencing adherence to tuberculosis treatment in Asmara, Eritrea: a qualitative study. J Health Popul Nutr. 2018;37(1):1. [Link] [DOI:10.1186/s41043-017-0132-y]
15. Migliori GB, Thong PM, Akkerman O, Alffenaar JW, Álvarez-Navascués F, Assao-Neino MM, et al. Worldwide effects of coronavirus disease pandemic on tuberculosis services, January-April 2020. Emerg Infect Dis. 2020;26(11):2709-12. [Link] [DOI:10.3201/eid2611.203163]
16. Alene KA, Wangdi K, Clements ACA. Impact of the COVID-19 pandemic on tuberculosis control: an overview. Trop Med Infect Dis. 2020;5(3):123. [Link] [DOI:10.3390/tropicalmed5030123]
17. Caren GJ, Iskandar D, Pitaloka DA, Abdulah R, Suwantika AA. COVID-19 pandemic disruption on the management of tuberculosis treatment in Indonesia. J Multidiscip Healthc. 2022;15:175-83. [Link] [DOI:10.2147/JMDH.S341130]
18. McQuaid CF, Vassall A, Cohen T, Fiekert K, White RG. The impact of COVID-19 on TB: a review of the data. Int J Tuberc Lung Dis. 2021;25(6):436-46 [Link] [DOI:10.5588/ijtld.21.0148]
19. McQuaid EL, Landier W. Cultural issues in medication adherence: disparities and directions.J Gen Intern Med. 2018;33(2):200-6. [Link] [DOI:10.1007/s11606-017-4199-3]
20. Tavakoli A. Incidence and prevalence of tuberculosis in Iran and neighboring countries. Zahedan J Res Med Sci. 2017;19(7):e9238. [Persian] [Link] [DOI:10.5812/zjrms.9238]
21. Fei H, Yinyin X, Hui C, Ni W, Xin D, Wei C, et al. The impact of the COVID-19 epidemic on tuberculosis control in China. Lancet Reg Health West Pac. 2020;3:100032. [Link] [DOI:10.1016/j.lanwpc.2020.100032]
22. Seyed Fatemi N, Rafii F, Hajizadeh E, Modanloo M. Psychometric properties of the adherence questionnaire in patients with chronic disease: a mix method study. KOOMESH. 2018;20(2):179-91. [Persian] [Link]
23. Shava GN, Hleza S, Tlou F, Shonhiwa S, Mathonsi E. Qualitative content analysis utility, usability and processes in educational research. Int J Res Innov Soc Sci. 2021;V(VII). [Link]
24. Pazandeh F, Potrata B, Huss R, Hirst J, House A. Women's experiences of routine care during labour and childbirth and the influence of medicalisation: a qualitative study from Iran. Midwifery. 2017;53:63-70. [Link] [DOI:10.1016/j.midw.2017.07.001]
25. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurs Educ Today. 2004;24(2):105-12. [Link] [DOI:10.1016/j.nedt.2003.10.001]
26. Lincoln YS, Cannella GS. Dangerous discourses: methodological conservatism and governmental regimes of truth. Qual Inquiry. 2004;10(1):5-14. [Link] [DOI:10.1177/1077800403259717]
27. Jaiswal S, Sharma H, Joshi U, Agrawal M, Sheohare R. Non-adherence to anti-tubercular treatment during COVID-19 pandemic in Raipur district central India. Indian J Tuberc. 2021. [Link] [DOI:10.1016/j.ijtb.2021.08.033]
28. Syahridha S, Massi N, Ahmad A, Djaharuddin I. Associated factors of the results of pulmonary tuberculosis treatment during the COVID-19 pandemic in Makassar city. Open Access Maced J Med Sci. 2021;9:1001-5. [Link] [DOI:10.3889/oamjms.2021.6742]
29. Togun T, Kampmann B, Stoker NG, Lipman M. Anticipating the impact of the COVID-19 pandemic on TB patients and TB control programmes. Ann Clinl Microbiol Antimicrob. 2020;19:21. [Link] [DOI:10.1186/s12941-020-00363-1]
30. Aznar ML, Espinosa-Pereiro J, Saborit N, Jové N, Sánchez Martinez F, et al. Impact of the COVID-19 pandemic on tuberculosis management in Spain. Int J Infect Dis. 2021;108:300-5. [Link] [DOI:10.1016/j.ijid.2021.04.075]
31. Soko RN, Burke RM, Feasey HRA, Sibande W, Nliwasa M, Henrion MY, et al. Effects of coronavirus disease pandemic on tuberculosis notifications, Malawi. Emerg Infect Dis. 2021;27(7):1831-39. [Link] [DOI:10.3201/eid2707.210557]
32. Dwinantoaji H, Sumarni D. Human security, social stigma, and global health: the COVID-19 pandemic in Indonesia. J Med Sci. 2020;52(3):158-65. [Link] [DOI:10.19106/JMedSciSI005203202014]
33. Culqui DR, Munayco CV, Grijalva CG, Cayla JA, Horna-Campos O, Alva K, et al. Factors associated with the non-completion of conventional anti-tuberculosis treatment in Peru. Arch Bronconeumol. 2012;48(5):150-5. [Spanish] [Link] [DOI:10.1016/j.arbr.2011.12.005]
34. Nezenega ZS, Perimal-Lewis L, Maeder AJ. Factors influencing patient adherence to tuberculosis treatment in ethiopia: a literature review. Int J Environ Res Public Health. 2020;17(15):5626. [Link] [DOI:10.3390/ijerph17155626]
35. Álvarez JL, Kunst AE, Leinsalu M, Bopp M, Strand BH, Menvielle G, et al. Educational inequalities in tuberculosis mortality in sixteen European populations. Int J Tuberc Lung Dis. 2011;15(11):1461-7. [Link] [DOI:10.5588/ijtld.10.0252]
36. Mondal MNI, Nazrul HM, Chowdhury MRK, Howard J. Socio-demographic factors affecting knowledge level of tuberculosis patients in Rajshahi city, Bangladesh. Afr Health Sci. 2014;14(4):855-65. [Link] [DOI:10.4314/ahs.v14i4.13]
37. Ruru Y, Matasik M, Oktavian A, Senyorita R, Mirino Y, Tarigan LH, et al. Factors associated with non-adherence during tuberculosis treatment among patients treated with DOTS strategy in Jayapura, Papua province, Indonesia. Glob Health Action. 2018;11(1):1510592. [Link] [DOI:10.1080/16549716.2018.1510592]

Add your comments about this article : Your username or Email:

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.