Challenges of DOTS implementation strategy in the treatment of tuberculosis in a tertiary health institution, Ilorin, Nigeria
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Date
2010-04
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Academic Journal
Abstract
Despite the fact that Directly Observed Treatment Strategy (DOTS) short course has recorded
significant improvement in the tuberculosis (TB) disease detection, treatment and control in Nigeria,
neither the set target for the TB detection rate nor the cure rate has been achieved nationwide, as
several challenges detract its effective implementation. The objective of this study was to examine the
challenges of DOTS implementation strategies in the treatment of TB patients with the view to
determine factors militating against its effective implementation. Majority (75.3%) of the patients were
within the age bracket of 16 - 45 years, while half (52.8%) of the patients that received proper counseling
on medication at the hospital did not adhere to anti-TB drug dosage regimen. However, dark urine
features prominently (72.1%) as side effects of anti-TB drugs among the patients followed by nausea
and vomiting (25.4%), impaired vision (1.8%) and yellowish eyes (0.7%). There is a positive effect of
finance on the TB patients and only very few patients could afford to purchase anti-TB drugs during
stock-out due to financial constraints. Patients’ defaulted rates were 22.3 and 14% among the males
and females respectively. Low treatment failure rates of 7.2 and 7.9% were also recorded in both men
and women respectively. For effective DOTS strategy in eliminating TB nationwide, there is dire need
for holistic approach in reaching all the patients with high-quality health care services even in the
remote areas. Also, literacy level and social economic status of Nigerian citizens should be improved to
enhance effective DOTS implementation
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Keywords
Tuberculosis treatment, DOTs strategy, Nigeria