Details:

Alternative Title:
Int J Tuberc Lung Dis
Personal Author:
Gler, M. T. ; Podewils, L. J. ; Munez, N. ; Galipot, M. ; Quelapio, M. I. D. ; ... More +
Gler, M. T. ; Podewils, L. J. ; Munez, N. ; Galipot, M. ; Quelapio, M. I. D. ; Tupasi, T. E. Less -
Description:
SETTING

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.

OBJECTIVE

To determine patient and socio-demographic characteristics associated with default, and the impact of patient support measures on default.

DESIGN

Retrospective cohort analysis of 583 MDR-TB patients treated from 1999 to 2006.

RESULTS

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).

CONCLUSION

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.


Subjects:
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Adolescent Adult Aged Aged, 80 And Over Antitubercular Agents Article Child Cohort Studies Drug-resistant Tuberculosis Female Humans Male Medication Adherence Middle Aged Motivation Patient Incentives Patients Philippines Program Interventions Retrospective Studies Risk Factors Socioeconomic Factors Treatment Adherence Treatment Refusal Tuberculosis, Multidrug-Resistant Tuberculosis, Pulmonary Young Adult
Source:
Int J Tuberc Lung Dis. 16(7):955-960
Pubmed ID:
22584124
Pubmed Central ID:
PMC4616015
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:d0744f33178155df8cf8e6cb315779e8d13ab57488cabb3492beb4c988ef5414
Download URL:
https://stacks.cdc.gov/view/cdc/35285/cdc_35285_DS1.pdf
File Type:

Supporting Files

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