Contributing factors to recurrent cases of smear positive Tuberculosis.

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Kamuzu University of Health Sciences
Tuberculosis is a leading cause of death among adults in Malawi and the single type that is giving many problems is smear positive Tuberculosis. This type of Tuberculosis needs adequate treatment with ant TB drugs for the required period. Many patients are readmitted into the hospital with recurrent smear positive Tuberculosis and this give problems to the health care system as it calls for retreatment. The purpose of this study was to assess and evaluate the contributing factors to recurrent cases of smear positive Tuberculosis. The study specifically aimed at exploring how supervision of patients is done at hospital, health center and guardian level, identifying problems that hinder effective treatment of smear positive Tuberculosis and exploring suggestions from health workers patients and guardians on how to improve treatment and supervision of patients with smear positive Tuberculosis. A descriptive research design was used and the study involved 30 subjects who consisted of health workers, patients and guardians. The study was conducted at Bottom hospital and area 25-health center. An interview guide was used to collect data from patients and health workers and a question guide was used for focus group discussions to collect data from guardians. Data was analysed manually to determine frequency distributions and responses from focus group discussions were categorized and subjected to descriptive statistics of content analysis. The study findings indicated lack of adequate knowledge by patients and guardians on TB disease and principles of treatment as one of the main contributing factor to recurrent cases of smear positive TB. The results also indicated lack of adequate supervision and adequate follow up of defaulters due to lack of human and material resources as other contributing factors. Poor social economic status of the patients and guardians, poor relationship between clients and health workers and long period of treatment featured as the other major contributing factors to recurrent cases of smear Positive Tuberculosis. If health planers and health workers do not address these areas, the hospitals will continue registering increased numbers of Smear Positive Tuberculosis.