Noncompliance with tuberculosis treatment by patients at a tuberculosis and AIDS reference hospital in midwestern Brazil.
BACKGROUND
In developing countries, there is little information about the risk factors that predict noncompliance with tuberculosis (TB) treatment in hospitals.


OBJECTIVE
This study analyzes possible factors associated with noncompliance with TB treatment among patients treated at HAA.


METHODS
A retrospective cohort study was made including all patients who initiated TB treatment at HAA, from January to December 1998. A standard form was used to review medical records and to collect data on each patient. This data was evaluated in comparison with data from the state TB control program.


RESULTS
Of the 341 patients included in the study, 186 (61.2%) were considered cured and 67 (22%) were non-compliant. The factors associated with noncompliance were: previous anti-TB treatment (RR = 1.95, 95% CI 1.29 to 2.93), prescription of drugs other than the standard first-line regimen proposed by the Brazilian Health Ministry (Rifampin + Isoniazide + Pyrazinamide) (RR = 0.54, 95% CI 0.35 to 0.83), the need for hospitalization (RR = 2.19, 95% CI 1.46 to 3.29) and non-inclusion in the hospital s TB Control Program for treatment follow up (RR = 0.54, 95% CI 0.35 to 0.82).


METHODS
Anuar Auad Hospital (HAA) Goiânia, Goiás, Brazil.


CONCLUSIONS
Our results indicate the importance of establishing Tuberculosis Control Programs in hospitals, while paying special attention to patients with risk factors for noncompliance with TB treatment.
Rabahi
Marcelo Fouad
MF
Anuar Auad Hospital for Tropical Diseases (HDTAA) / SES Goiânia, Goiás, Brazil. mfrabahi@terra.com.br
Rodrigues
Adriana Batista
AB
Queiroz de Mello
Fernanda
F
de Almeida Netto
Joaquim Caetano
JC
Kritski
Afrânio Lineu
AL
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010361:Patients / Q000523:psychology / Q000706:statistics & numerical data*; D011718:Pyrazinamide / Q000627:therapeutic use; D012293:Rifampin / Q000627:therapeutic use; D012307:Risk Factors; D016312:Treatment Refusal / Q000706:statistics & numerical data*; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology
D000995:Antitubercular Agents; D011718:Pyrazinamide; D007538:Isoniazid; D012293:Rifampin