Predictors of Default from Treatment for Tuberculosis: a Single Center Case-Control Study in Korea.
10.3346/jkms.2016.31.2.254
- Author:
Cheol Kyu PARK
1
;
Hong Joon SHIN
;
Yu Il KIM
;
Sung Chul LIM
;
Jeong Sun YOON
;
Young Su KIM
;
Jung Chul KIM
;
Yong Soo KWON
Author Information
1. Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea. ykwon@jnu.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Lost to Follow up;
Tuberculosis;
Chemotherapy;
Risk Factors
- MeSH:
Adult;
Aged;
Antitubercular Agents/*therapeutic use;
Case-Control Studies;
Female;
Humans;
Male;
Medication Adherence;
Middle Aged;
Multivariate Analysis;
Odds Ratio;
Republic of Korea;
Risk Factors;
Socioeconomic Factors;
Tuberculosis/*drug therapy/pathology
- From:Journal of Korean Medical Science
2016;31(2):254-260
- CountryRepublic of Korea
- Language:English
-
Abstract:
Default from tuberculosis (TB) treatment could exacerbate the disease and result in the emergence of drug resistance. This study identified the risk factors for default from TB treatment in Korea. This single-center case-control study analyzed 46 default cases and 100 controls. Default was defined as interrupting treatment for 2 or more consecutive months. The reasons for default were mainly incorrect perception or information about TB (41.3%) and experience of adverse events due to TB drugs (41.3%). In univariate analysis, low income (< 2,000 US dollars/month, 88.1% vs. 68.4%, P = 0.015), absence of TB stigma (4.3% vs. 61.3%, P < 0.001), treatment by a non-pulmonologist (74.1% vs. 25.9%, P < 0.001), history of previous treatment (37.0% vs. 19.0%, P = 0.019), former defaulter (15.2% vs. 2.0%, P = 0.005), and combined extrapulmonary TB (54.3% vs. 34.0%, P = 0.020) were significant risk factors for default. In multivariate analysis, the absence of TB stigma (adjusted odd ratio [aOR]: 46.299, 95% confidence interval [CI]: 8.078-265.365, P < 0.001), treatment by a non-pulmonologist (aOR: 14.567, 95% CI: 3.260-65.089, P < 0.001), former defaulters (aOR: 33.226, 95% CI: 2.658-415.309, P = 0.007), and low income (aOR: 5.246, 95% CI: 1.249-22.029, P = 0.024) were independent predictors of default from TB treatment. In conclusion, patients with absence of disease stigma, treated by a non-pulmonologist, who were former defaulters, and with low income should be carefully monitored during TB treatment in Korea to avoid treatment default.
