title: Risk factors for treatment default among re-treatment tuberculosis patients in India, 2006.
abstract: METHODS
  Under India's Revised National Tuberculosis Control Programme (RNTCP), >15% of previously-treated patients in the reported 2006 patient cohort defaulted from anti-tuberculosis treatment.
  
  
  OBJECTIVE
  To assess the timing, characteristics, and risk factors for default amongst re-treatment TB patients.
  
  
  METHODS
  For this case-control study, in 90 randomly-selected programme units treatment records were abstracted from all 2006 defaulters from the RNTCP re-treatment regimen (cases), with one consecutively-selected non-defaulter per case. Patients who interrupted anti-tuberculosis treatment for >2 months were classified as defaulters.
  
  
  RESULTS
  1,141 defaulters and 1,189 non-defaulters were included. The median duration of treatment prior to default was 81 days (25%-75% interquartile range 44-117 days) and documented retrieval efforts after treatment interruption were inadequate. Defaulters were more likely to have been male (adjusted odds ratio [aOR] 1.4, 95% confidence interval [CI] 1.2-1.7), have previously defaulted anti-tuberculosis treatment (aOR 1.3 95%CI 1.1-1.6], have previous treatment from non-RNTCP providers (AOR 1.3, 95%CI 1.0-1.6], or have public health facility-based treatment observation (aOR 1.3, 95%CI 1.1-1.6).
  
  
  CONCLUSIONS
  Amongst the large number of re-treatment patients in India, default occurs early and often. Improved pre-treatment counseling and community-based treatment provision may reduce default rates. Efforts to retrieve treatment interrupters prior to default require strengthening.
authors.affiliation: Central Tuberculosis Division, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, New Delhi, India.
authors.forename: Ugra Mohan
authors.initials: UM
authors.lastname: Jha
authors.forename: Srinath
authors.initials: S
authors.lastname: Satyanarayana
authors.forename: Puneet K
authors.initials: PK
authors.lastname: Dewan
authors.forename: Sarabjit
authors.initials: S
authors.lastname: Chadha
authors.forename: Fraser
authors.initials: F
authors.lastname: Wares
authors.forename: Suvanand
authors.initials: S
authors.lastname: Sahu
authors.forename: Devesh
authors.initials: D
authors.lastname: Gupta
authors.forename: L S
authors.initials: LS
authors.lastname: Chauhan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D012307:Risk Factors; D014376:Tuberculosis / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents