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Tuberculosis treatment adherence and fatality in Spain
Joan A Caylà1, Teresa Rodrigo, Juan Ruiz-Manzano
1Programa Integrado de Investigación en Tuberculosis (PII TB) de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR), Spain. jcayla@aspb.es
Respiratory Research
|December 3, 2009
Summary
Tuberculosis treatment adherence is crucial for control. Factors like immigration status, living situation, and prior treatment impact adherence, while age, HIV infection, and drug use increase mortality risk, necessitating targeted interventions and closer monitoring.
Area of Science:
- Pulmonology
- Infectious Diseases
- Public Health
Background:
- Adherence to long tuberculosis (TB) treatment is vital for TB control.
- Patient dropout and mortality remain significant challenges in TB management.
- Identifying factors associated with treatment default and death is essential.
Purpose of the Study:
- To identify factors associated with defaulting from or dying during antituberculosis treatment.
- To analyze predictors of treatment completion and case fatality.
- To inform targeted interventions for improved TB treatment outcomes.
Main Methods:
- Prospective study of 1490 TB cases diagnosed between 2006-2007.
- Logistic regression analysis to determine predictive factors for treatment completion and fatality.
- Calculation of odds ratios (OR) and 95% confidence intervals (CI) for identified risk factors.
Main Results:
- Treatment completion rate was 93.5%.
- Poor adherence associated with immigration, living alone, institutional residency, prior treatment, injecting drug use (IDU), and comprehension difficulties.
- Case fatality rate was 1.8%, associated with older age, retirement, HIV infection, comprehension difficulties, IDU, and Directly Observed Therapy (DOT).
Conclusions:
- Immigrants, individuals living alone, institutional residents, previously treated patients, and IDUs require targeted Directly Observed Therapy (DOT) due to poor adherence.
- Stricter monitoring is needed for elderly patients, retired individuals, HIV-infected patients, IDUs, and those with comprehension difficulties to reduce fatality.
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