[What is needed to prevent defaulting from tuberculosis treatment?]

To investigate the factors relating to defaulting from tuberculosis treatment in Japan, and clarify what is needed to prevent defaulting.

Tuberculosis patients who were registered at public health centers (PHCs), and interrupted treatment for more than 2 months without the doctors' direction at the end of December 2005.

Investigation by questionaire sent by post-mail to all public health centers (608 PHCs) in Japan.

The valid answers was obtained from 89.0% (541/ 608) of PHCs. Tuberculosis patients who had interrupted treatment, but could be contacted by PHCs' staff were 137, and for those patients the factors relating to defaulting from treatment were analyzed. The factors were classified into 7 categories (there may be more than one factors in one patients); factors related to disbelief and/or prejudice for diagnosis and/or treatment (except factors related to drug adverse effects) were observed in 51.8%, factors related to economical problem in 24.1%, factors related to job or studies in 23.4%, factors related to drug adverse effects in 22.6%, factors related to visiting out-patients departments in 6.6%, psychiatric disease and/or drug abuse in 4.4%, others in 9.5%.

It is needed to prevent defaulting, first, to improve the quality of tuberculosis medical care and services including good and sufficient explanations on TB and how to cure it to patients, and proper managements for drug adverse effects, and then to expand public economical support for the costs of medicine and travel expenses to medical facilities and to make accessible time and place of the tuberculosis outpatient clinic more convenient and flexible for patients.