The problem of non-attendance at a paediatric tuberculosis outpatient clinic.

A total of 146 children receiving treatment for pulmonary tuberculosis at the University of Benin Teaching Hospital over a 5-year period were studied in order to determine the pattern of attendance, factors responsible for non-completion of treatment and the health status of non-attenders. There were 70 (48%) non-attenders and the mean duration of treatment before default was 20 weeks (range: 4-60). The factors mitigating against treatment completion included low maternal education level, disruptive family events and equating disappearance of the tuberculosis symptoms with cure of the disease. Of the non-attenders, 51 (72.9%) practised self-medication with the anti-tuberculosis drugs, often given intermittently and beyond the period otherwise allowable. Nineteen of the 70 patients who defaulted still had major health problems at the time of home visit. Of these, five were later hospitalized while the others were given fresh appointments. We conclude that supervision of treatment at home will minimize non-attendance but at the moment this service is not available at the study locale because of inadequate resources and the magnitude of the tuberculosis problem.