Community Perception to Directly Observed Treatment Short Course among Tuberculosis Patients in Bahirdar, North Ethiopia (A Qualitative Study)

Abstract

Background: Tuberculosis rates in the world remain high, especially in low- and middle-income countries including Ethiopia. International tuberculosis policy generally recommends the use of directly observed treatment short course to ensure treatment adherence. Even though Ethiopia adopted directly observed treatment short course in the early nineties, its’ proper implementation is questionable. An understanding of perceptions of tuberculosis patients to this strategy, directly observed treatment short-course, is important to tuberculosis control programs. The aim of the study was to explore tuberculosis patients’ perceptions to directly observed treatment short course in Bahirdar, Ethiopia.Methods: The study was conducted in 2013 in Bahirdar town North Ethiopia. A qualitative approach was used. Interviews and focus group discussions were conducted with patients attending directly observed treatment short course, health providers and health manager who were involved in the delivery of directly observed treatment short course in the public sector in Bahirdar town.  Data were analyzed using open code software and qualitative content analysis.Results: The communities have both positive and negative perception towards DOTS; however the negative perception predominates due to reasons such as socioeconomic impact, its effect on patients work schedule, school attendance and lack of health staff support.Conclusions: These findings help to better understand the overwhelmingly negative perception of patients towards directly observed treatment short course.  TB control programs should be aware of this and devise alternative mechanisms or interventions tailored to local context.

Keywords: TB, DOTS, Community Perception