ABSTRACT
Introduction: Tuberculosis is a bacterial disease caused by the Mycobacterium tuberculosis. Regardless of many efforts made to control tuberculosis, the disease remains to be a major public health problem. Nonadherence to antituberculosis treatment poses a challenge to the disease treatment as it potentially increases the risk of drug resistance, mortality, relapse, and extended infectiousness. The North Shewa Zone had a poor performed on TB control status, so this study assessed the prevalence of antituberculosis drug nonadherence and its associated factors at governmental health institutions in Debre Berhan town, North Shewa Zone, Ethiopia, 2020. Methods: An institution-based cross-sectional study design was employed. A total of 180 tuberculosis patients were included in the study. The data was entered using EpiData version 3.1 and exported to SPSS version 20.0 for statistical analysis. Bivariable and multivariable logistic regression analyses were computed to determine factor associated with antituberculosis drug nonadherence. Result: Study finding shows that 26.0% respondents were nonadherent to their antituberculosis treatment. Respondents who were married were less likely to be nonadherent than who were single (AOR = 0.307; 95%CI = 0.120, 0.788). Respondents who have primary and secondary education were less likely to be nonadherent than those who had no formal education (AOR = 0.313; 95%CI = 0.100, 0.976). Respondents who experienced drug side effects were two times more likely to be nonadherent than those who did not experience drug side effects (AOR = 2.379; 95%CI = 1.008, 5.615). In addition, respondents who do not screen for HIV were four times more likely to be nonadherent than their counterparts (AOR = 4.620; 95%CI = 11.135, 18.802). Conclusion: The antituberculosis drug nonadherence is high. Marital status, educational status, drug side effects, HIV screening status of the patients, and availability of medication were the variables that influence drug nonadherence. There is a need to strengthen awareness creation and improve quality of the TB treatment services and anti-TB drug availability.
ABSTRACT
INTRODUCTION: The health insurance system has been proven to offer effective and efficient health care for the community, particularly community-based health insurance is expected to ensure health care access for people with low economic status and vulnerable groups. Despite the significance of evidence-based systems and implementation, there is a limited report about the magnitude of CBHI utilization. Therefore, this study was done to assess factors associated with community-based health insurance utilization in Basona Worena District, North Shewa Zone, Ethiopia. METHOD: A community-based cross-sectional study was employed. We have included 530 households from 6 randomly selected kebeles. The data was entered using Epi-Data V 3.1 and exported to SPSS version 20.0 for statistical analysis. Bi-variable and multivariable logistic regression analyses were computed to determine factors associated with community-based health insurance utilization. RESULT: The study finding shows that 58.6% of the respondents were members of community-based health insurance. Respondents who had primary and secondary education levels were 2 times more likely to be members than those who had no formal education. As compared to those who had awareness, respondents who had no awareness about CBHI were 0.27 times less likely to be insured. Respondents who did not experience illness were 0.27 times less likely to be members than respondents who experienced illness. CONCLUSION: Educational status, awareness about CBHI, perception of CBHI scheme and illness experience of family influence CBHI utilization. There is a need to strengthen awareness creation to improve the CBHI utilization.
