Prevalence and predictors of default from tuberculosis treatment in Hong Kong.
OBJECTIVE
To determine the prevalence and risk factors of default from tuberculosis treatment in Hong Kong.


METHODS
Retrospective study.


METHODS
Data were obtained from programme forms completed by physicians in the Hong Kong Government Tuberculosis and Chest Service and from medical records from Hong Kong chest clinics.


METHODS
In all, 5917 patients registered for antituberculous drug therapy in 1996; medical records of 5757 patients were reviewed.


METHODS
Patients who defaulted treatment were defined as those who had failed to collect medication for more than 2 consecutive months after the date of the last attendance during the course of treatment. Demographic and clinical characteristics, including history, treatment, and outcome, were compared between defaulters and non-defaulters, both among the whole group and among those with pulmonary disease.


RESULTS
There were 442 (8%) patients who defaulted from treatment. Forty-five percent of those who defaulted did so in the first 2 months of treatment. Key risk factors associated with non-compliance were a history of default, male sex, and a history of concomitant liver disease or lung cancer. Among patients with pulmonary tuberculosis (381 defaulters and 1537 non-defaulters), multiple drug resistance was also associated with default from treatment. Among defaulters with pulmonary disease, 39% were still bacteriologically positive at the time of default.


CONCLUSIONS
Default from treatment may be partially responsible for the persistent high rates of tuberculosis in Hong Kong in the past decade. Health professionals should ensure that all barriers to treatment be removed and that incentives be used to encourage treatment compliance.
Chan-Yeung
M
M
Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong. mmwchan@hkucc.hku.hk
Noertjojo
K
K
Leung
C C
CC
Chan
S L
SL
Tam
C M
CM
D000995:Antitubercular Agents / Q000627:therapeutic use*; D015897:Comorbidity; D005544:Forecasting; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008107:Liver Diseases / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000453:epidemiology; D010352:Patient Dropouts / Q000706:statistics & numerical data; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology
D000995:Antitubercular Agents