| Risk factors associated with default, failure and death among tuberculosis patients treated in a DOTS programme in Tiruvallur District, South India, 2000. | |
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MedLine Citation:
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PMID: 12234133 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To identify risk factors associated with default, failure and death among tuberculosis patients treated in a newly implemented DOTS programme in South India. DESIGN: Analysis of all patients registered from May 1999 through April 2000. A community survey for active tuberculosis was underway in the area; patients identified in the community survey were also treated in this programme. RESULTS: In all, 676 patients were registered during the period of the study. Among new smear-positive patients (n = 295), 74% were cured, 17% defaulted, 5% died and 4% failed treatment. In multivariate analysis (n = 676), higher default rates were associated with irregular treatment (adjusted odds ratio [AOR] 4.3; 95%CI 2.5-7.4), being male (AOR 3.4; 95%CI 1.5-8.2), history of previous treatment (AOR 2.8; 95%CI 1.6-4.9), alcoholism (AOR 2.2; 95%CI 1.3-3.6), and diagnosis by community survey (AOR 2.1; 95%CI 1.2-3.6). Patients with multidrug-resistant tuberculosis (MDR-TB) were more likely to fail treatment (33% vs. 3%; P < 0.001). More than half of the patients receiving Category II treatment who remained sputum-positive after 3 or 4 months of treatment had MDR-TB, and a large proportion of these patients failed treatment. Higher death rates were independently associated with weight <35 kg (AOR 3.8; 95%CI 1.9-7.8) and history of previous treatment (AOR 3.3; 95%CI 1.5-7.0). CONCLUSIONS: During this first year of DOTS implementation with sub-optimal performance, high rates of default and death were responsible for low cure rates. Male patients and those with alcoholism were at increased risk of default, as were patients identified by community survey. To prevent default, directly observed treatment should be made more convenient for patients. To reduce mortality, the possible role of nutritional interventions should be explored among underweight patients. |
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Authors:
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T Santha; R Garg; T R Frieden; V Chandrasekaran; R Subramani; P G Gopi; N Selvakumar; S Ganapathy; N Charles; J Rajamma; P R Narayanan |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
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Title: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease Volume: 6 ISSN: 1027-3719 ISO Abbreviation: Int. J. Tuberc. Lung Dis. Publication Date: 2002 Sep |
Date Detail:
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Created Date: 2002-09-17 Completed Date: 2002-11-19 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9706389 Medline TA: Int J Tuberc Lung Dis Country: France |
Other Details:
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Languages: eng Pagination: 780-8 Citation Subset: IM |
Affiliation:
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Tuberculosis Research Centre, Chetput, Chennai, India. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Factors Antitubercular Agents / therapeutic use Directly Observed Therapy / statistics & numerical data* Drug Resistance, Bacterial Female Humans India / epidemiology Male Middle Aged Risk Factors Sex Factors Socioeconomic Factors Treatment Failure Treatment Refusal / statistics & numerical data Tuberculosis / drug therapy*, epidemiology, mortality* |
| Chemical | |
Reg. No./Substance:
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0/Antitubercular Agents |
| Comments/Corrections | |
Comment In:
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Int J Tuberc Lung Dis. 2003 Feb;7(2):200-1
[PMID:
12588027
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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