IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861. Volume 4, Issue 3 (Jan.- Feb. 2013), PP 40-45 www.iosrjournals.org www.iosrjournals.org 40 | Page Challenges Linked With Adherence to Treatment by Adult TB Patients in Pakistan Fahmida Khatoon 1 , Atif Mahmood 2 , Mukkaram Ali 3 , Saima Ejaz 4 , Ghulam Ali 5 1 Department of Biochemistry 1 , United Medical and Dental College, Karachi. 2 Department of Physiology 2 , Shaheed Mohtarma Benazir Bhutto Medical College, Lyari, Karachi. 3 Department of Forensic Medicine 3 , Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan. 42 Department of Physiology, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan 5 Department of Forensic Medicine 4 , Sindh Medical College, Dow University of Health Sciences. Karachi, Pakistan. Abstract: To be aware of non compliant TB patients for drug loyalty and also investigating the dread for drugs in them. For public health community, tuberculosis (TB) has accessible confront in the developing countries although curative drugs exist, yet TB has remained the foremost killers among infectious diseases. The TB treatment regimen is long, intensive and fraught with potential side effects. For these reasons, only about 20% of people with TB successfully complete treatment. Cross sectional survey was conducted on a non-probability purposive sample of 349 TB patients attending JPMC Chest OPD, Malir Chest Clinic and Ojha Institute of Chest Diseases, Karachi in the month of June and July, 2007. All the patients who were administered Anti- tuberculous drugs (ATT) under Direct Observed Treatment Strategy (DOTS) in the above mentioned period were included in the study. The total response rate was 93%. Out of 349 TB patients observed, 43% [150] were males and 57% [199] were females. 94% of the patients were following DOTS i.e. they regularly came to the clinics, but 5% were those who did not follow it regularly and skipped the daily medicine. Only 13% have quit taking medication themselves. 60% of the patients experienced side effects of the anti-TB drugs whereas 40% didn’t experience any side effects. Proper counseling regarding the treatment options and side effects of the treatment can help reduce the challenges associated with adherence to the TB treatment. Keywords: DOTS therapy, Pakistan, Tuberculosis. I. Introduction: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis, and spreads by inhalation of infective droplets. Disease primarily affects lungs and impairs pulmonary functions but it can spread to almost any organ of the body. [1] TB is one of the 3 infectious diseases along with malaria and HIV that contributes to the major burden of communicable diseases. [2] Each year nearly 9 million people emerge as new cases of TB of which about 2 million die predominantly in developing countries. [3] Although TB is an ancient disease, it still contributes significantly to global human mortality and mortality. [4] Despite the fact that the disease is preventable and curable; the development of effective treatment for TB continues to be a challenge all over the world. [5] Following the same treatment strategy that was developed 50 years ago; TB patients have to take medication on daily basis for 6 to 8 months or more depending on the severity of disease. [6] The primary symptoms of the disease disappear in approximately 2-3 months which leads many patients to stop the treatment and non-compliance as interruption in taking the drugs prevents the complete cure and increases the risk of relapse and development of drug resistance. [7] Thus poor adherence to the medication remains the major contributor that leads to the deterioration of the disease. DOT is the strategy recommended by World Health Organization (WHO) to avoid such interruption of treatment. It has not only contributed in improving the TB control but has also helped in better understanding of factors that prevent patients from completing the course of medication which is required in order to improve the outcome of treatment. [3] Following are some of the factors identified: 1. Financial burdens of treatment [distance and fares of transportation] [4,7 -11] 2. Side effects of drugs [6, 12, 13] 3. Family, community and household influences a. Isolation of patient by family [7] b. Loss of job [8, 14 -16] c. Difficulty in marriage [17] 4. Personal behavior a. High dose of drugs