Reasons for defaulting from drug-resistant tuberculosis treatment in Armenia: a quantitative and qualitative study.
Int J Tuberc Lung Dis
; 18(2): 160-7, 2014 Feb.
Article
em En
| MEDLINE
| ID: mdl-24429307
ABSTRACT
SETTING:
Armenia, a country with a high prevalence of drug-resistant tuberculosis (DR-TB).OBJECTIVE:
To identify factors related to default from DR-TB treatment in Yerevan.DESIGN:
Using a retrospective cohort design, we compared defaulters with patients who were cured, completed or failed treatment. Patients who initiated DR-TB treatment from 2005 to 2011 were included in the study. A qualitative survey was conducted including semi-structured interviews with defaulters and focus group discussions with care providers.RESULTS:
Of 381 patients, 193 had achieved treatment success, 24 had died, 51 had failed treatment and 97 had defaulted. The number of drugs to which the patient was resistant at admission (aRR 1.16, 95%CI 1.05-1.27), the rate of treatment interruption based on patient's decision (aRR 1.03, 95%CI 1.02-1.05), the rate of side effects (aRR 1.18, 95%CI 1.09-1.27), and absence of culture conversion during the intensive phase (aRR 0.47, 95%CI 0.31-0.71) were independently associated with default from treatment. In the qualitative study, poor treatment tolerance, a perception that treatment was inefficient, lack of information, incorrect perception of being cured, working factors and behavioural problems were factors related to treatment default.CONCLUSION:
In addition to economic reasons, poor tolerance of and poor response to treatment were the main factors associated with treatment default.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tuberculose Pulmonar
/
Tuberculose Resistente a Múltiplos Medicamentos
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Farmacorresistência Bacteriana
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Adesão à Medicação
/
Antituberculosos
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Int J Tuberc Lung Dis
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
França