Adherence to Pulmonary Tuberculosis Medication and Associated Factors Among Adults: A Cross-Sectional Study in the Metinaro and Becora Sub-Districts, Dili, Timor-Leste

Amentinho Fernandes, Sawanya Laohaprapanon, Truong Thanh Nam, Ercia Maria Da Conceicao Sequeira and Cua Ngoc Le ()
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Amentinho Fernandes: Environmental Safety Technology and Health Program, School of Public Health, Walailak University, Nakhon Si Thammarat 10860, Thailand
Sawanya Laohaprapanon: Environmental Safety Technology and Health Program, School of Public Health, Walailak University, Nakhon Si Thammarat 10860, Thailand
Truong Thanh Nam: Public Health Research Program, School of Public Health, Walailak University, Nakhon Si Thammarat 10860, Thailand
Ercia Maria Da Conceicao Sequeira: National Hospital Guido Valadares, Dili 670001, Timor-Leste
Cua Ngoc Le: Public Health Research Program, School of Public Health, Walailak University, Nakhon Si Thammarat 10860, Thailand

IJERPH, 2024, vol. 21, issue 12, 1-14

Abstract: Timor Leste is one of the top countries in Asia with a high incidence rate of pulmonary tuberculosis (TB). The success of TB treatment necessitated a more profound comprehension of adherence as a multifaceted behavioral issue, along with identifying the barriers that hinder and the factors that promote patient adherence. This study aimed to assess the rate of pulmonary TB medication adherence and identify its predictors among adults in Metinaro and Becora, Dili, Timor-Leste. A descriptive analytical cross-sectional study was conducted, and new patients with pulmonary TB aged 18 years and above were selected using a proportional sampling method. Quantitative data were collected from 398 patients with pulmonary tuberculosis. The medication adherence results were as follows: 73.6% low adherence, 18.3% moderate adherence, and only 8.1% high adherence. The study identified significant predictors of medication adherence, such as health service factors (OR = 14.024, 95% CI: 5.42–35.54, p = 0.001). Patients who perceived a high quality in the health service were 14 times more likely to exhibit higher medication adherence. Regarding individual behaviors, patients who consumed alcohol or occasionally engaged in physical exercise were significantly less likely to exhibit higher medication adherence (OR = 0.17, 95% CI: 0.091–0.312, p = 0.001). Similarly, patients experiencing high levels of stigma were less likely to achieve strong adherence (OR = 0.146, 95% CI: 0.058–0.326, p = 0.001).Both health service quality and individual factors, such as lifestyle behaviors and social stigma, were statistically significant predictors ofTB medication adherence. Enhancing the healthcare infrastructure, implementing multisectoral strategies for behavior change, and reducing stigma are crucial. Additionally, mobile health technologies, like SMS reminders and telehealth, might support real-time adherence improvements.

Keywords: pulmonary tuberculosis; medication adherence; influence factors; Timor-Leste (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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