Selected Factors that Influence Nonadherence to Antituberculosis Drug Regimen among Tuberculosis Patients at Two (2) Rural Clinics in Guyana, South America

Abstract

Objectives: This study aimed to identify and compare the factors influencing non-adherence to antituberculosis drug regimens at two rural clinics in Guyana. Methods: A quantitative, cross-sectional design was employed to examine adherence barriers among tuberculosis (TB) patients at two rural clinics in Guyana. Data were collected using structured questionnaires administered to 46 non-adherent TB patients (15 from Clinic 1 and 31 from Clinic 2). Inclusion criteria and informed consent were adhered to, and a translator facilitated interviews in the Indigenous community served by Clinic 1. Descriptive and comparative statistical analyses were performed to interpret the data. Results: A total of 46 participants were identified as non-adherent to tuberculosis (TB) treatment protocols were included in the study, with a mean age of 43.7 years for Clinic 1 and 46.3 years for Clinic 2. Among the participants, 32% originated from Clinic 1 and 68% from Clinic 2. Statistical Analysis: Statistical analysis revealed significant factors influencing non-adherence to treatment. This included knowledge of TB transmission and the quality of patient-provider relationships (p = 0.049), frequency of chest clinic visits (p = 0.015), adherence to prescribed medication regimens (p = 0.001), depression among patients (p = 0.005), clinic attendance patterns, and instances of missed medication doses (p = 0.013). These findings underscore the multifactorial nature of non-adherence in the study population, highlighting both psychosocial and systemic influences. Conclusion: The findings highlight the interplay of psychological distress, clinic attendance, and patient-provider relationships in influencing TB treatment adherence. Despite high knowledge levels about TB transmission, adherence was limited. Integrated strategies, including mental health interventions, improved patient-provider communication, and logistical support, are essential to enhance adherence and treatment outcomes in rural populations.