Sickrole Compliance and Sickrole Deviance among Tuberculosis Patients on Treatment in Kanyama, a Zambian Shanty Compound

Abstract

Background: Kanyama compound has had a DOTS community based programme since 2012 where TB supporters in the community have been fostering the DOTS programme. Prior to this study, research had not been done using Parsonian sickrole behaviour concept to determine the pattern of deviance especially the sickrole behavioural responses on the part of people who were on TB treatment. Methods: This was an exploratory study and the study sample was drawn from a large mixed methods study (quan + QUAL) comprising of 457 men and women ≥15 years. Enrolees were disproportionately sampled using systematic sampling from a population of 1126 men and women who were on multi drug therapy over a two-year period. Categorical and numeric data from the tool was cleaned and analyzed by using SPSS version 21 (Inc., Chicago, USA). Statistical analysis was done using Pearson’s Chi square test and ANOVA. A p value of <0.05 was considered to be significant. Results: 18.5% of the enrolees honoured medical appointments when due whereas 81.5% did not. There was a significant association p < 0.05 with case type and marital status. 39.6% of the enrolees honoured the medical regimen by taking the prescribed drugs, 33.3% failed to honour and 27.1% were not sure. There was a significant association p < 0.05 between case type and marital status. Conclusions: Strengthening DOTS programs at community level through volunteers to enhance patient adherence to TB treatment and giving personalised attention to men and women who may be at risk of developing secondary tuberculosis, or risk for drug resistance and even dying is recommended. There is evidence to laud the great effort being expended by volunteer community based tuberculosis supporters in ensuring that what DOTS stands for is met.