TB patients not taking their medicine
By, Louise Flanagan, Independent Online, September 27, 2007
Tuberculosis patients in Limpopo - many of them elderly women - are not finishing their treatment.
"Most of them stop taking the drugs before they finish them," said nurse Catherine Tshishonga, who interviewed 200 TB patients for her postgraduate research through the University of Venda.
"They feel that the TB drugs are too much."
Patients can't cope with the number or size of the tablets and also suffer worse side effects if they take the drugs without food - a huge problem in poverty-stricken households, she found.
Tshishonga wanted to know why there was such a high rate of pulmonary TB in the Thohoyandou area in Limpopo. As part of her Masters degree in public health, awarded this month, she researched the patients' attitudes.
More than half she interviewed had negative attitudes towards TB drugs and believed that they could stop treatment once they felt better.
Most of those infected were elderly women.
The oldest patient was 86 and "most were older than 40".
Tshishonga said giving patients more information was crucial.
A Joburg doctor involved in TB research, who did not want to be named, said defaulting on treatment was the main reason for South Africa's low cure rate.
Failure to complete treatment may also result in drug-resistant TB strains.
Another Venda University student found that Limpopo clinics with the best TB cure rates had patients - not nurses - with a better knowledge of their illness.
Takalani Grace Tshitangano, who also received her Masters, looked at 13 clinics with cure rates of above 85 percent and nine with lower rates.
Using questionnaires, Tshitangano assessed nurses' knowledge of the national guidelines for TB control.
"They scored below 50 percent."
Tshitangano said the nurses had to deal with all illnesses, resulting in a "supermarket" approach.
"They are not specialists in anything and that is affecting the treatment."
Tshitangano also assessed patient knowledge and found that 82 percent of patients at better-performing clinics had good knowledge, compared to 58 percent of those at poorly-performing clinics.
The most knowledgeable patients were being treated for repeat infections.
Tuberculosis patients in Limpopo - many of them elderly women - are not finishing their treatment.
"Most of them stop taking the drugs before they finish them," said nurse Catherine Tshishonga, who interviewed 200 TB patients for her postgraduate research through the University of Venda.
"They feel that the TB drugs are too much."
Patients can't cope with the number or size of the tablets and also suffer worse side effects if they take the drugs without food - a huge problem in poverty-stricken households, she found.
Tshishonga wanted to know why there was such a high rate of pulmonary TB in the Thohoyandou area in Limpopo. As part of her Masters degree in public health, awarded this month, she researched the patients' attitudes.
More than half she interviewed had negative attitudes towards TB drugs and believed that they could stop treatment once they felt better.
Most of those infected were elderly women.
The oldest patient was 86 and "most were older than 40".
Tshishonga said giving patients more information was crucial.
A Joburg doctor involved in TB research, who did not want to be named, said defaulting on treatment was the main reason for South Africa's low cure rate.
Failure to complete treatment may also result in drug-resistant TB strains.
Another Venda University student found that Limpopo clinics with the best TB cure rates had patients - not nurses - with a better knowledge of their illness.
Takalani Grace Tshitangano, who also received her Masters, looked at 13 clinics with cure rates of above 85 percent and nine with lower rates.
Using questionnaires, Tshitangano assessed nurses' knowledge of the national guidelines for TB control.
"They scored below 50 percent."
Tshitangano said the nurses had to deal with all illnesses, resulting in a "supermarket" approach.
"They are not specialists in anything and that is affecting the treatment."
Tshitangano also assessed patient knowledge and found that 82 percent of patients at better-performing clinics had good knowledge, compared to 58 percent of those at poorly-performing clinics.
The most knowledgeable patients were being treated for repeat infections.
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