Defaulting from anti-tuberculosis treatment in a teaching hospital in Rio de Janeiro, Brazil
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Published on: September 5, 2017
C L G Salles1, M B Conde, C Hofer
1Unidade de Pesquisa em Tuberculose, Serviço de Pneumologia, Departamento de Clínica Médica, Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. csalles13@hotmail.com
Setting:
Few studies have investigated factors associated with defaulting from anti-tuberculosis (TB) therapy in hospital settings.
Objective:
To identify the factors associated with defaulting from treatment among TB in-patients in Rio de Janeiro city, Brazil.
Design:
Case-control study.
Methods:
All study participants initiated anti-tuberculosis treatment in a teaching hospital. A defaulting case was defined as a person who did not return for anti-tuberculosis medications after 60 days. Cases and controls were interviewed by a trained health care worker using a standardized form.
Results:
From 1 January to 31 December 1997, 228 TB cases were registered. After a review of the medical records, 39 were excluded. Household visits were performed in 189 patients; 46 subjects were identified as cases and 117 as controls. Defaulting from anti-tuberculosis treatment was observed in 66 cases (28.9%) before and in 46 (20.2%) after a home visit. After multivariate analysis, the strongest predictors of defaulting from treatment were: 1) returning card not provided (OR 0.099; 95%CI 0.008-1.2; P = 0.07), 2) not feeling comfortable with a doctor (OR 0.16; 95%CI 0.33-0.015; P = 0.001), and 3) blood pressure not measured (OR 0.072; 95%CI 0.036-0.79; P = 0.024).
Conclusions:
In this hospital, the factors associated with defaulting from anti-tuberculosis treatment highlight the necessity for a structured TB Control Program. It is expected that the implementation of such a program, pursuing specific approaches, should enhance completion of anti-tuberculosis treatment and cure.
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