Format

Send to

Choose Destination
Int J Tuberc Lung Dis. 2006 Jun;10(6):649-55.

Risk factors associated with default from multidrug-resistant tuberculosis treatment, South Africa, 1999-2001.

Author information

1
International Research and Programs Branch, Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. tholtz@cdc.gov

Abstract

SETTING:

Multidrug-resistant tuberculosis (MDR-TB) treatment centers in five provinces, South Africa.

OBJECTIVES:

To estimate the mortality and evaluate risk factors associated with default from MDR-TB treatment.

DESIGN:

Using registries and a standardized questionnaire, we conducted a case-control study among patients diagnosed and treated for MDR-TB. Cases were defined as patients who began MDR-TB treatment between 1 October 1999 and 30 September 2001 and defaulted from treatment for more than 2 months; controls were defined as patients who began MDR-TB treatment during the same time and were cured, completed or failed.

RESULTS:

After initial identification and reclassification, 269 cases and 401 controls were confirmed eligible for interview. Further investigation revealed that 74 (27%) cases and 44 (10%) controls had died. Among 96 cases located who consented and were interviewed, 70% had defaulted after receiving at least 6 months of treatment. In a multivariate model, the strongest individual risk factors for default included reporting smoking marijuana or mandrax during treatment, and having an unsatisfactory opinion about the attitude of health care workers.

CONCLUSION:

Mortality among MDR-TB defaulters was high. Interventions to reduce default from MDR-TB treatment should center on substance abuse treatment, patient education and support and improving provider-patient relationships.

PMID:
16776452
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Ingenta plc
Loading ...
Support Center