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Patient characteristics associated with tuberculosis treatment default: a cohort study in a high-incidence area of Lima, Peru

Brian Lackey, Carlos Seas, Patrick Van Der Stuyft (UGent) and Larissa Otero
(2015) PLOS ONE. 10(6).
Author
Organization
Abstract
Background : Although tuberculosis (TB) is usually curable with antibiotics, poor adherence to medication can lead to increased transmission, drug resistance, and death. Prior research has shown several factors to be associated with poor adherence, but this problem remains a substantial barrier to global TB control. We studied patients in a high-incidence district of Lima, Peru to identify factors associated with premature termination of treatment (treatment default). Methods : We conducted a prospective cohort study of adult smear-positive TB patients enrolled between January 2010 and December 2011 with no history of TB disease. Descriptive statistics and multivariable logistic regression analyses were performed to determine risk factors associated with treatment default. Results : Of the 1233 patients studied, 127 (10%) defaulted from treatment. Patients who defaulted were more likely to have used illegal drugs (OR = 4.78, 95% CI: 3.05-7.49), have multidrug-resistant TB (OR = 3.04, 95% CI: 1.58-5.85), not have been tested for HIV (OR = 2.30, 95% CI: 1.50-3.54), drink alcohol at least weekly (OR = 2.22, 95% CI: 1.40-3.52), be underweight (OR = 2.08, 95% CI: 1.21-3.56), or not have completed secondary education (OR = 1.55, 95% CI: 1.03-2.33). Conclusions : Our study identified several factors associated with defaulting from treatment, suggesting a complex set of causes that might lead to default. Addressing these factors individually would be difficult, but they might help to identify certain high-risk patients for supplemental
Keywords
MULTIDRUG-RESISTANT TUBERCULOSIS, RISK-FACTORS, ADHERENCE, PREDICTORS, STRATEGIES, 5-YEAR

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Chicago
Lackey, Brian, Carlos Seas, Patrick Van Der Stuyft, and Larissa Otero. 2015. “Patient Characteristics Associated with Tuberculosis Treatment Default: a Cohort Study in a High-incidence Area of Lima, Peru.” Plos One 10 (6).
APA
Lackey, B., Seas, C., Van Der Stuyft, P., & Otero, L. (2015). Patient characteristics associated with tuberculosis treatment default: a cohort study in a high-incidence area of Lima, Peru. PLOS ONE, 10(6).
Vancouver
1.
Lackey B, Seas C, Van Der Stuyft P, Otero L. Patient characteristics associated with tuberculosis treatment default: a cohort study in a high-incidence area of Lima, Peru. PLOS ONE. 2015;10(6).
MLA
Lackey, Brian, Carlos Seas, Patrick Van Der Stuyft, et al. “Patient Characteristics Associated with Tuberculosis Treatment Default: a Cohort Study in a High-incidence Area of Lima, Peru.” PLOS ONE 10.6 (2015): n. pag. Print.
@article{6997574,
  abstract     = {Background : Although tuberculosis (TB) is usually curable with antibiotics, poor adherence to medication can lead to increased transmission, drug resistance, and death. Prior research has shown several factors to be associated with poor adherence, but this problem remains a substantial barrier to global TB control. We studied patients in a high-incidence district of Lima, Peru to identify factors associated with premature termination of treatment (treatment default). 
Methods : We conducted a prospective cohort study of adult smear-positive TB patients enrolled between January 2010 and December 2011 with no history of TB disease. Descriptive statistics and multivariable logistic regression analyses were performed to determine risk factors associated with treatment default. 
Results : Of the 1233 patients studied, 127 (10\%) defaulted from treatment. Patients who defaulted were more likely to have used illegal drugs (OR = 4.78, 95\% CI: 3.05-7.49), have multidrug-resistant TB (OR = 3.04, 95\% CI: 1.58-5.85), not have been tested for HIV (OR = 2.30, 95\% CI: 1.50-3.54), drink alcohol at least weekly (OR = 2.22, 95\% CI: 1.40-3.52), be underweight (OR = 2.08, 95\% CI: 1.21-3.56), or not have completed secondary education (OR = 1.55, 95\% CI: 1.03-2.33). 
Conclusions : Our study identified several factors associated with defaulting from treatment, suggesting a complex set of causes that might lead to default. Addressing these factors individually would be difficult, but they might help to identify certain high-risk patients for supplemental},
  articleno    = {e0128541},
  author       = {Lackey, Brian and Seas, Carlos and Van Der Stuyft, Patrick and Otero, Larissa},
  issn         = {1932-6203},
  journal      = {PLOS ONE},
  keyword      = {MULTIDRUG-RESISTANT TUBERCULOSIS,RISK-FACTORS,ADHERENCE,PREDICTORS,STRATEGIES,5-YEAR},
  language     = {eng},
  number       = {6},
  pages        = {11},
  title        = {Patient characteristics associated with tuberculosis treatment default: a cohort study in a high-incidence area of Lima, Peru},
  url          = {http://dx.doi.org/10.1371/journal.pone.0128541},
  volume       = {10},
  year         = {2015},
}
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