Factors Affecting The Implementation of Directly Observed Therapy Short-Course(DOTS) in The Treatment of Tuberculosis in Osu-Klottey Sub-Metro.

ABSTRACT

Introduction: Currently, there is an annual decline in TB incidence rate of 1.5% globally which is lower than the expected 10%, according to the new End TB strategy which encourages innovation and improving tools that have been used to control TB to end it. A tool that has proven successful in the world is Directly Observed Therapy Short-course, which is one of the core principals of the stop TB strategy that ended in 2015. Even though there is a new strategy, the breakdown of high-quality DOTS would have an impact on the outcome of TB treatment and control. This study was conducted in Osu-klottey sub-metro in the Greater Accra Region on the factors affecting the implementation of DOTS in the treatment of TB. Methods: This study was a cross sectional study, using qualitative approach to collect data on TB patients and health workers (nurses and treatment supporters). Purposive sampling technique was used to select participants. In-depth and key informant interviews were conducted and analyzed using Nvivo11. Results: Health workers faced difficulties in implementing DOTS because of inadequate number of staff, staff attrition, and shortfalls of other facilities in addition to phasing out of treatment supporters. They expressed fear of contracting the disease even as they showed concern about reinfection of TB among drug abusers. Health seeking behavior of the TB patients showed their attitude towards TB and the DOTS accounting for their preference which affects accessibility of the strategy in the community. In describing the attitude of health workers towards them, TB patients expressed how they were made to feel like they were very important and loved in addition to being encouraged and comforted even as they were rejected by the community. Majority of the patients did not know about TB before they became ill. This study went ahead to discover that v patients who had physical manifestations for example becoming lean, viewed the disease as being serious compared to those who did not. Conclusion: DOTS strategy is still relevant in the treatment and elimination of TB and for its implementation to be improved, there is need for high-quality care and creation of more TB awareness.