Impact of patient and program factors on default during treatment of multidrug-resistant tuberculosis
Published Date:May 07 2012
Source:Int J Tuberc Lung Dis. 16(7):955-960.
Aged, 80 And Over
Pubmed Central ID:PMC4616015
Funding:CC999999/Intramural CDC HHS/United States
In the Philippines, programmatic treatment of drug-resistant tuberculosis (TB) was initiated by the Tropical Disease Foundation in 1999 and transitioned to the National TB Program in 2006.
To determine patient and socio-demographic characteristics associated with default, and the impact of patient support measures on default.
Retrospective cohort analysis of 583 MDR-TB patients treated from 1999 to 2006.
A total of 88 (15%) patients defaulted from treatment. The median follow-up time for patients who defaulted was 289 days (range 1–846). In multivariate analysis adjusted for age, sex and previous TB treatment, receiving a greater number of treatment drugs (≥5 vs. 2–3 drugs, HR 7.2, 95%CI 3.3–16.0, P < 0.001) was significantly associated with an increased risk of default, while decentralization reduced the risk of default (HR 0.3, 95%CI 0.2–0.7, P < 0.001).
Improving access to treatment for MDR-TB through decentralization of care to centers near the patient’s residence reduced the risk of default. Further research is needed to evaluate the feasibility, impact and cost-effectiveness of decentralized care models for MDR-TB treatment.
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