studies show that, Poor adherence to treatment is one of the major challenges affecting tuberculosis control and account for the major obstacles to treatment management . Uganda had a TB default rate of 11% with a treatment success rate of only 70% among smear positive patients (WHO, 2010), compared with national accepted adherence level of 95% of as per the WHO guidelines. It is on record that, Masaka District has high prevalence of TB known to be associated with HIV/AIDs (NTRL 2016). an institutional based survey established among other factors that, inadequate and irregular supplies of TB drugs, long travel distance by patients, stigma, discrimination and suspension of transport as COVID 19 prevention guideline have contributed to poor adherence of TB patients in Masaka.

1. Ministry of Health
Republic of Uganda
CoPresenter: Dr Mathias Tumwebaze tel: 0772916618
emai:;mathiastumwebaze@gmail.com
Bishop Stuart University-Mbarara
The 8th National Quality Improvement Conference
At SPEKE RESORT MUNYONYO
Factors associated with adherence of patients on
Tuberculosis treatment following COVID-19 pandemic at
Health facilities of Masaka City.-Uganda
PRESENTER(PI) : PATRICK OGWOK (MPH)
TEL NO. : +256777775530
EMAIL: ogwokpatricko@gmail.com

2. Purpose of the study
To examine factors associated with adherence of patients on Tuberculosis
treatment following COVID-19 pandemic at Health facilities of Masaka
City.
Specific objectives;
 To establish the current level of adherence of patients on TB treatment.
 To explore the patient knowledge on adherence of TB treatment
 To identify socio-economic factors affecting adherence on TB treatment.
 To identify Health facility factors affecting adherence on TB treatment

3. Introduction
 Tuberculosis (TB) is an infectious disease caused by the Bacillus
Mycobacterium tuberculosis, other spp M. bovis and M.avium
 The prevalence of TB is known to be associated with HIV/AIDS
infection. COVID 19 affected adherence of TB patients on treatment
 TB prevalence in 2019/20 was 200/100,000 population in Uganda and
cases notified were at 65,897 (WHO,2020), mortality rate was at
35/100,000 population
 Masaka district reported a default rate of 18% ((URC-USAID 2018/19)

4. METHODOLOGY
 Study adopted A cross-sectional research design applying both quantitative and
qualitative Approaches of data collection.
 110 patients on Tuberculosis drug were selected from 10 Health facilities and 15
Health workers from TB clinics included were intervied in the study
 Structured questionnaires and interviews guide was used to obtained information
 The study obtained REC approval from TASO Uganda,
 informed consent was sought from TB patients

5. RESULTS
More than half of TB patients 58(55%)
had excellent adherence to TB drugs,
17(16%) person had average adherence.
15(14%) had poor adherence, 10(10%) of
patient had fair adherence to
The prevalence of adherence was at 86%

6. Level of knowledge on
TB Adherence
Majority TB patients 65(61.9%) had
adequate knowledge on adherence on
tuberculosis drug,
A quarter 27(25.71%) had average
knowledge on Tuberculosis,
while 13(12.38%) had fair knowledge
on adherence to TB drugs

7. Results cont.…..
Multiple logistic regression showing association between patients’
adherence and factors affecting adherence at multivariate analysis
Characteristic of
Variable
Odd Ratio Std. Err T P>|T| [95% Conf. Interval]
Taking Medicine With
lack water and food 1
Water 1.513941 1.142562 0.55 0.583 .3449149 6.645165
Food -5.43319 2.67234 -2.03 0.045 -10.7350 -.131335
Turn Back From Refill
Yes .3430429 .4228959 0.75 0.451 .314678 13.51039
No 5.84393 3.42894 1.70 0.091 -.958997 12.6468
Received Freq.
Counselling
not counselled 1
On The First Visit 5.221684 3.322339 2.60 0.09 1.500468 18.17165
At Each Visit 15.5073 5.93346 2.61 0.010 3.73553 27.2791
Once In Awhile 2.277243 1.71609 1.09 0.275 .5199469 9.97378
Conduct Of Health
Worker
Fair 1
Good 7.0566 2.15751 3.27 0.001 2.77620 11.3371
Bad .4460711 .4601572 -0.78 0.434 .0590641 3.368875

8. Description, Cont.……..
Results show statistically significant association frequent counselling at each visit
and adherence to TB drugs. (OR=15.5073; [95% Cl: 3.73553- 27.27917]; p=0.010).
TB patients who received frequent counselling were 15.5 times more likely to adhere
to TB treatment than their counter part who were not counselled.
A strong relationship was also found between patients’ adherence and the good
conduct of health workers .
(OR=7.0566; [95%Cl: 2.77620- 11.3371]; P=0.001).
Good conduct of Health worker was 7.1 times more likely to contribute to adherence
of TB patients than their counter part who did not

9. CONCLUSION.
 Patient adherence to Tb drugs was suboptimal at 86% against MOH Uganda set
standard of 95%,
 Factors affecting adherence included stigma, discrimination and suspension of
transport as COVID 19 prevention guideline by MOH which contributed to
isolation and neglect by the community
 Noted also was limited medical supplies and TB drugs in private facilities.

10. RECOMMENDATIONS
 Each TB patient be assigned family member and a VHT as treatment supporters to
help support the clients.
 Reinforce counseling by health care workers at each visit using the local language
 District Health Team Strengthen referral system within facilities both private and
public facilities
 Health Facilities to include TB survivors in advocacy services and to increase,
create demand for missing opportunities within communities
 District Health department to ensure Private clinics are included in treatment of
TB and have access to Genexpert sites.

11. LESION LEARNT.
 Pre TB treatment counselling on adherence increases patients
ability to take medication consistently leading to good TB
treatment outcomes
 Not involving and supporting Private clinics to provide TB
services is a very big missed opportunity by the health sector.
Most patients first visit private clinics before coming to health
Centres.

12. Acknowledgement
MOH FOR ORGANISING THIS CONFERENCE
MASAKA POLICE HEALTH CENTRE and ALL TB
PATIENTS FOR participation n
EVERY BODY PRESENT FOR LISTENING