Patient and disease characteristics, and outcome of treatment defaulters from the Singapore TB control unit--a one-year retrospective survey.
METHODS
The Singapore Tuberculosis Control Unit.


OBJECTIVE
1) To identify any demographic, social, disease or treatment-related characteristics which may be predictive of patients defaulting from treatment; 2) to assess the effectiveness of home visits as a means of defaulter recall; 3) to ascertain outcome in these patients.


METHODS
A retrospective, case-controlled study of TB treatment defaulters, defined as patients who missed their scheduled appointments and required a home visit to recall for treatment. Controls were randomly selected, non-defaulting patients who started treatment on the same dates as the defaulters.


RESULTS
Forty-four patients required home visits in 1996. Compared to controls, defaulters were more likely to be non-Chinese, and to live on their own or with friends. There was no significant association of defaulting with age, sex, marital or employment status, disease characteristics, or treatment-related factors. Seventy per cent defaulted during the continuation phase of treatment. Home visits did not result in contact with the patient (or any other person) 41% of the time. Although 48% of the defaulters remained lost to follow-up at the time of the survey, all but one of the sputum-positive patients had bacteriologically converted by the time of default.


CONCLUSIONS
Non-Chinese ethnicity and lack of family support were found to be factors strongly predictive of default. Age, sex, marital and employment status, treatment-related factors and disease characteristics were not significant in distinguishing those at risk for defaulting.
Chee
C B
CB
Department of Respiratory Medicine, Tan Tock Seng Hospital, Singapore.
Boudville
I C
IC
Chan
S P
SP
Zee
Y K
YK
Wang
Y T
YT
D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts; D012189:Retrospective Studies; D012846:Singapore; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*