Nasser Cherif Aidara
Country: Guinea
Background - Development Studies
Research Project: Directly Observed Treatment Short-Course Supervision: An investigation into the knowledge and practices of community DOTS providers in tuberculosis treatment in the prefecture of Telimele, Guinea
Background: TB is and has long been a major public health problem in Guinea. The recent introduction of community DOTS in the treatment of tuberculosis (TB) has made treatment available to many people living in remote areas in Telimele. However, problems such as defaulting, failure, multi-drug resistance TB (MDR), or death can occur for patients under community-based treatment methods, unless a qualitative investigation analysing CDPs awareness, knowledge and practice of DOTS is conducted and acted upon.
Methods: A qualitative approach using non-probability, purposive sampling method was used in conducting this study. A total number of thirty one participants were selected through a list provided by the Programme de Lutte Antituberculose in Conakry, and the Prefectural Health Department in Telimele. Participants were all interviewed using open-ended semi-structure interviews and data were analysed using a thematic content analysis.
Results: The results draw attention to CDPs’ insufficient knowledge and practice with regard to the WHO DOTS treatment guidelines, especially the direct observation component of it, which is a major cause of poor treatment adherence. The findings revealed that CDPs’ non-compliance to the WHO guidelines was associated to socio-cultural, economic, and political factors such as, poverty, lack of financial incentives, insufficient training, inadequate transportation means, and the remoteness of villages. However, it was evident that a comprehensive public policy with a cross-sectoral collaboration within different government department could contribute to TB control in Telimele.
Conclusions: Fighting TB in Guinea requires not only CDPs supervision but, more importantly, community education, and strong government leadership and commitment. This exploratory study provides the basis for further research in enhancing CDPs’ performance in TB treatment.
Key words: TB, DOTS, CDPs, Treatment, Adherence.