Defaulting from anti-tuberculosis treatment in a teaching hospital in Rio de Janeiro, Brazil.
METHODS
Few studies have investigated factors associated with defaulting from anti-tuberculosis (TB) therapy in hospital settings.


OBJECTIVE
To identify the factors associated with defaulting from treatment among TB in-patients in Rio de Janeiro city, Brazil.


METHODS
Case-control study.


METHODS
All study participants initiated anti-tuberculosis treatment in a teaching hospital. A defaulting case was defined as a person who did not return for anti-tuberculosis medications after 60 days. Cases and controls were interviewed by a trained health care worker using a standardized form.


RESULTS
From 1 January to 31 December 1997, 228 TB cases were registered. After a review of the medical records, 39 were excluded. Household visits were performed in 189 patients; 46 subjects were identified as cases and 117 as controls. Defaulting from anti-tuberculosis treatment was observed in 66 cases (28.9%) before and in 46 (20.2%) after a home visit. After multivariate analysis, the strongest predictors of defaulting from treatment were: 1) returning card not provided (OR 0.099; 95%CI 0.008-1.2; P = 0.07), 2) not feeling comfortable with a doctor (OR 0.16; 95%CI 0.33-0.015; P = 0.001), and 3) blood pressure not measured (OR 0.072; 95%CI 0.036-0.79; P = 0.024).


CONCLUSIONS
In this hospital, the factors associated with defaulting from anti-tuberculosis treatment highlight the necessity for a structured TB Control Program. It is expected that the implementation of such a program, pursuing specific approaches, should enhance completion of anti-tuberculosis treatment and cure.
Salles
C L G
CL
Unidade de Pesquisa em Tuberculose, Serviço de Pneumologia, Departamento de Clínica Médica, Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. csalles13@hotmail.com
Conde
M B
MB
Hofer
C
C
Cunha
A J L A
AJ
Calçada
A L
AL
Menezes
D F
DF
Sá
L
L
Kritski
A L
AL
D001938:Brazil; D016022:Case-Control Studies; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D010044:Outpatient Clinics, Hospital; D017064:Process Assessment, Health Care; D012307:Risk Factors; D012959:Socioeconomic Factors; D016312:Treatment Refusal; D014376:Tuberculosis / Q000188:drug therapy*