Defaulting from tuberculosis treatment at the Addis Abeba Tuberculosis Centre and factors associated with it

A case control study among patients registered at the Addis Abeba Tuberculosis Centre was carried out from 1 September 1989 to 31 August 1990 to determine the rate of defaulting from treatment and to identify factors associated with it. The medical records of 1,206 new tuberculosis patients registered over the 12 month period were reviewed. A high rate of defaulting, 82%, was found. The rates of defaulting were higher in males, in the older age groups and in those living near to the TB centre. Most of the defaulting occurred in the third and fourth months of treatment. Social problems and feeling of improvement were the top two reasons for patients to default. A sample of the defaulters (cases) and the non-defaulters (controls) were then traced and interviewed. The two groups were compared by social, demographic and health variables. Inadequate knowledge, low educational level, nearer distance and negative attitude toward the TB Centre were found to be statistically significant predictors for defaulting p < 0.0001, p < 0.001, p < 0.001, and p < 0.05 respectively). These high rates of defaulting suggest important programme inadequacies and an urgent need for change. Therefore the introduction of an alternative national tuberculosis control programme with new strategies is recommended.