Open Access Peer-reviewed

Socioeconomic, Disease, and Biochemical Factors in Adherence to Anti Tuberculosis Treatment Regime in Benin City, Nigeria: A Comparative Study

A. O. Iyamu1, Onyeneke E. C2, J. E. Ugheoke3, W. A. Adisa4,, N. Akpede5, O. Aigbe1, G. Oko-Oboh6

1Department of Medical Biochemistry, College of medicine, Ambrose Alli University, Ekpoma, Nigeria

2Department of biochemistry, University of Benin, Benin City, Nigeria

3Department of Internal Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria

4Department of Human Physiology, College of Medicine, Ambrose Alli University, Ekpoma, Nigeria

5Department of Community Health, Irrua Specialist Teaching Hospital, Irrua, Nigeria

6Department of Community Health, University of Benin Teaching Hospital, Benin City, Nigeria

American Journal of Biomedical Research. 2013, 1(4), 80-85. DOI: 10.12691/ajbr-1-4-3
Published online: August 25, 2017


Tuberculosis is a re-emergent disease of great epidemiological concern with the directly observed treatment short course (DOTS) recommended by the World Health Organization falling short of targeted expectations. The aim was to compare the impact of socioeconomic, disease, and biochemical factors on the decision of patients to return to (comply with) the six-month treatment schedule. Effects of education, age, occupational and marital (socioeconomic) and biochemical (drug side effects and values of biochemical indices of liver function) factors were compared between 52 SLR and 49 SNR patients. The results suggest that socioeconomic factors play a more prominent role than factors related to drug side effects in determining whether a patient returns to treatment after initial stoppage. A more integrated multi-disciplinary approach to DOTS administration with professional and social inputs is recommended


adherence, tuberculosis, regime, socioeconomic, liver enzymes
[1]  Global Tuberculosis Report WHO (2012).
[2]  Dohn PJ, Raviglone MC, Koch; A Global Tuberculosis Incidence And Mortality During 1999-2000. Bull world health organ, 72(2): 212-220. 1994.
[3]  Maher D, Hauster HP, Ravighone MC. Tuberculosis Care In Community Care Organizations In Sub-Sahara Africa: Practice and Potential. International Journal of Tuberculosis Lung Disease,1(3): 276-283. 1997. PubMed
[4]  Kironde S, Tuberculosis. In: Ntuli A, Crisp N, Clarke E, Baron P, Editors, South African Health Review 2000. Durban: Health Systems Trust pp 335-349.
[5]  Teckle B, Mariam DH, and Ali A. Defaulting from DOTS and its determinant in three districts of Arizona in EthopiaInterational Journal of Tuberculosis Lung Disease, 6:574-579. 2002.
[6]  Fox W. Compliance of Patients and Physicians. Experience and Lessons from Tuberculosis. BAAJ, 287:33-37.1983.
[7]  Burke and Parnell. Minimal Pulmonary Tuberculosis; Canadian Medical Association Journal, 59:348. 1948. PubMed
[8]  Awofeso N. Antituberculosis medication side effects constitute a major factor for poor adherence for tuberculosis treatment. Bull World Health Organization (2008).View Article  PubMed
[9]  William BG. What is the limit of case detection under the DOTS strategy for tuberculosis control? Tuberculosis, 83 (1-3):35-43. 2003.View Article
[10]  Forget EJ, and Menzes D. Adverse reaction to first line antituberculosis drugs. Expert Opinion on Drug Safety, 5(2)231-249. 2006.View Article  PubMed
[11]  Rosenstock IM. Why People Use Health Services. Millbank Memorial Fund Quarterly, 44(3): 94-127. 1966.View Article  PubMed
[12]  Schaberg T, Rebham KM, and Lode H. Risk factors for side effects of isonazids, rifampicine, pyrazinamide, in patients hospitalized for pulmonary tuberculosis. European Respect Journal, 9: 2026-2030. 1996.View Article
[13]  Kumar V, Abbas AK, Fausto W and Mitchell RM. Robbins Basic Pathology. (8th Ed.) Saundsers Elsevier,Pp 516-522. 2007.
[14]  Gornall AG, Bardawill CJ and David MM. Determination of Serum Proteins by means of the Biuret Reaction. Journal of Biological Chemistry, 177:751. 1949. PubMed
[15]  Corcaran RM and Durnan SM: Albumin determination by a modified bronicresol green method. Clinical Chemistry, 23(4):765-766. 1977.
[16]  Reitman S, Frankel S. A Calorimetric method for the determination of serum glutamic oxaloacetate and glutamic pyruvic transaminases. American Journal of Clinical Pathology, 28:53-56. 1988.
[17]  Lathe, GH and Ruthven LRT. Factors affecting the rate of coupling of bilirubin and conjugated bilrubin in the Van den Bergh reaction. J Clin pathol 71:155,1958View Article
[18]  International Labour Organization. International Standard Classification of Occupation (2011).
[19]  Garner P, Smith H, Munro S, Volmink J. Promoting adherence to tuberculosis treatment. Bull World Health Organ, 85:404 – 6. 2007.View Article  PubMed
[20]  Conrad P. The meaning of medication: another look at compliance. Soc Sci Med., 20: 29-37. 1985.View Article
[21]  Building on and enhancing DOTS to meet the TB-related Millennium Development Goals. Geneva: WHO: 2006. /tb/ publications /2006/ who htmtb 2006 386.
[22]  Self – Study Modules on tuberculosis: Patient adherence to tuberculosis treatment Washington DC: National Centre for HIV, STD and TB Prevention, US Department of Health and Human Services; 1999. http://www.cdc.ov/tb/pubs/ssmodules/pdfs/9.pdf.
[23]  Elzinga G, Rarighone MC, Maher D. “Scale up: Meeting targets in global tuberculosis control”. Lancet, 63 (9411): 814-19. 2004.View Article