Assessment of patient preference in allocation and observation of anti-tuberculosis medication in three districts in Tanzania

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Authors: Saidi Egwaga, Nyagosya Range, Fred Lwilla, Abdallah Mkopi, Vivien Barongo, et al

Published Date February 2008 Volume 2008:2 Pages 1 - 6

DOI: http://dx.doi.org/10.2147/PPA.S

Saidi Egwaga¹, Nyagosya Range², Fred Lwilla¹, Abdallah Mkopi⁴, Vivien Barongo², Sally Mtenga³, Hassan Mshinda³, Frank Cobelens^4,5, Vera Haag⁶, Frank van Leth^4,5, Penny Grewal⁶

¹National Tuberculosis and Leprosy Programme, Ministry of Health and Social Welfare, Dar es Salaam,Tanzania; ²National Institute for Medical Research, Dar es Salaam,Tanzania; ³Ifakara Health Research and Development Centre, Ifakara, Tanzania; ⁴KNCV Tuberculosis Foundation, The Hague, The Netherlands; ⁵Center for Infection and Immunity, Academic Medical Center, University of Amsterdam, The Netherlands; ⁶Novartis Foundation for Sustainable  Development, Basle, Switzerland

Background: The new tuberculosis (TB) treatment in Tanzania contains rifampicin for six months. Direct observation of drug intake at the health facility for this period is not feasible.

Methods: Patients and health staff in three districts were interviewed to assess the burden of the current treatment strategy, and opinions on a proposed new strategy where patients are able to choose the place of treatment and the treatment supervisor, and receive treatment as a daily combination tablet.

Results: The study included 343 patients in 42 facilities. Daily collection of drugs was perceived as burdensome irrespective of distance needed to travel. Eighty percent of patients viewed medication taken at home or at a closer health facility as an improvement in TB-services. The proposed new treatment strategy was rated favorably by 85% of patients and 75% of health staff. Fifty-three percent of patients would opt for home-based treatment, and 75% would choose a family member or the spouse as treatment supporter.