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Determinants of default from pulmonary tuberculosis treatment in Kuwait
Qing Zhang1, Mohamed Gaafer2, Ibrahim El Bayoumy3
1Tuberculosis Diagnosis and Treatment Center, Shanghai, Pulmonary Hospital, School of Medicine, Tongji University, 507 Zheng Min Road, Shanghai 200433, China.
Objectives:
To determine the prevalence and risk factors of default from pulmonary tuberculosis treatment in Kuwait.
Design:
Retrospective study.
Patients And Methods:
We studied all patients who were registered for pulmonary tuberculosis treatment between January 1, 2010, and December 31, 2012, and admitted into TB wards in El Rashid Center or treated in the outpatient clinic in TB Control Unit.
Results:
There were 110 (11.5%) patients who defaulted from treatment. Fifty-six percent of those who defaulted did so in the first 2 months of treatment and 86.4% of them were still bacteriologically positive at the time of default. Key risk factors associated with noncompliance were male sex, low educational level, non-Kuwaiti nations, history of default, and history of concomitant diabetes mellitus, liver disease, or lung cancer. Multiple drug resistance was also associated with default from treatment.
Conclusion:
Default from treatment may be partially responsible for the persistent relatively high rates of tuberculosis in Kuwait. Health professionals and policy makers should ensure that all barriers to treatment are removed and that incentives are used to encourage treatment compliance.
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