{
  "abstract": "Introduction Global efforts to eliminate tuberculosis (TB) must address the unique barriers that children and adolescents face in adhering to treatment for TB infection and disease. Factors influencing adherence are multifaceted, encompassing socioeconomic, psychological and healthcare-related elements. Understanding these factors can help improve treatment outcomes and reduce the burden of disease. This study aims to determine the social factors predicting treatment adherence among children and adolescents with TB.Methods This study was conducted among patients with TB diagnosed at three public-sector hospitals in Punjab. It included Gene Xpert-confirmed TB cases registered from March to August 2024. Sociodemographic, behavioural and environmental factors were recorded to identify predictors of treatment default and patients were followed throughout the treatment period. Default cases were defined as those whose treatment was interrupted for more than 8 weeks and efforts were made to trace and encourage them to resume treatment.Results The logistic regression analysis identified significant predictors of treatment adherence. Age (β=−0.218, p=0.010) and material need insecurity (β=−1.634, p=0.001) were negatively associated with adherence, with adjusted OR (aOR) of 0.804 (95% CI 0.681 to 0.949) and 0.195 (95% CI 0.072 to 0.529), respectively. Older age and financial hardship were linked to lower treatment adherence. Specifically, as age increased, adherence decreased slightly, and children/families facing material insecurity were much less likely to adhere to treatment. On the other hand, family support (β=1.781, p<0.001) was positively associated with adherence, with an adjusted OR of 5.934 (95% CI 2.273 to 15.488). Family support was associated with better adherence, with those receiving it almost six times more likely to follow treatment properly.Conclusion The findings emphasise the need for targeted interventions to address socioeconomic challenges, particularly material need insecurity, and the importance of promoting family involvement in treatment adherence.",
  "authors": [
    {
      "affiliations": [
        "Pediatrics, Ameer-ud-Din Medical College of PGMI, Lahore, Punjab, Pakistan"
      ],
      "name": "Muhammad Faheem"
    },
    {
      "affiliations": [
        "Public Health, Green International University, Lahore, Punjab, Pakistan"
      ],
      "name": "Javeria Saleem"
    },
    {
      "affiliations": [
        "Post Graduated Resident, Department of Pediatrics, Ameer-ud-Din Medical College of PGMI, Lahore, Punjab, Pakistan"
      ],
      "name": "Zarmina Fatima"
    },
    {
      "affiliations": [
        "Public Health, The University of Lahore—Raiwind Road Campus, Lahore, Punjab, Pakistan"
      ],
      "name": "Asif Hanif"
    },
    {
      "affiliations": [
        "Jinnah Hospital, Lahore, Punjab, Pakistan"
      ],
      "name": "Afia zafar"
    },
    {
      "affiliations": [
        "Public Health, The University of Lahore—Raiwind Road Campus, Lahore, Punjab, Pakistan"
      ],
      "name": "Muhammad Yaqoob"
    }
  ],
  "title": "Determinants of treatment adherence in children and adolescents for tuberculosis: a study from Pakistan",
  "uid": "c86c7ab9-c8be-5af6-874e-a2b867179cac"
}