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Risk factors and timing of default from treatment for non-multidrug-resistant tuberculosis in Moldova

H E Jenkins1, A Ciobanu, V Plesca

  • 1Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. jenkins.helen@gmail.com

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
|February 15, 2013
PubMed
Abstract

Insights

In Moldova, 14.7% of non-multidrug-resistant tuberculosis (MDR-TB) patients defaulted from treatment. Risk factors included social issues and HIV, with highest default risk after hospital or prison release.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Epidemiology

Background:

  • Republic of Moldova faces high rates of multidrug-resistant tuberculosis (MDR-TB).
  • Treatment default is linked to increased mortality and drug resistance amplification.
  • Understanding non-MDR-TB default is crucial for national TB control.

Purpose of the Study:

  • To identify risk factors for treatment default in non-MDR-TB patients.
  • To determine the timing of default from non-MDR-TB treatment.
  • To inform interventions for improving TB treatment adherence in Moldova.

Main Methods:

  • Retrospective analysis of routine surveillance data.
  • Inclusion of all reported non-MDR-TB patients from 2007 to 2010.
  • Statistical assessment of sociodemographic and health-related risk factors.

Main Results:

  • 14.7% of non-MDR-TB patients defaulted treatment.
  • Independent risk factors: homelessness, living alone, lower education, time abroad, HIV co-infection, lung pathology, and drug resistance.
  • Highest default risk observed post-hospitalization and post-incarceration.

Conclusions:

  • Targeted interventions are needed for high-risk patients to improve adherence.
  • Enhancing continuity of care from institutional to community settings is vital.
  • Reducing default can significantly lower MDR-TB rates in Moldova.

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