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Updated: May 22, 2026

The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
Published on: August 11, 2008
Impact of patient and program factors on default during treatment of multidrug-resistant tuberculosis
M T Gler1, L J Podewils, N Munez
1Tropical Disease Foundation, Manila, The Philippines.
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.
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