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[Treatment abandonment and tuberculosis recurrence: aspects of previous episodes, Brazil, 1993-1994]
H B Oliveira1, D C Moreira Filho
1Departamento de Medicina Preventiva e Social, Universidade Estadual de Campinas, Campinas, SP, Brasil. helenice@obelix.unicamp.br
Objective:
Recurrent patients due to treatment dropout or disease relapse have been congesting health centers and impeding treatment routines and services. The purpose is to study aspects of previous treatment and irregularities concerning the patient, medication and service organization and to evaluate the outcome of retreatment.
Methods:
A descriptive study of patient's personal characteristics, previous treatment and retreatment was carried out at Campinas, São Paulo State, in 1993 and 1994. Statistics analyses were performed using 95% confidence interval with Yates correction, exact Fisher test and Mantel Haenszel qui-square for stratification.
Results:
Retreatment sequence corroborated with the default rates (63%) that were lower, but still high among relapsed cases (28.4%). Only 34.1% of relapsed cases did not present irregularities at previous treatment.
Conclusions:
High proportions of retreatment and inadequate previous treatment are favouring drug resistance. Efforts should be taken to improving tuberculosis services efficiency because many irregularities are due to "failures" in health services routine.