Delay and completion of tuberculosis treatment: a cross-sectional study in the West Midlands, UK.
BACKGROUND
TB remains a significant problem in the UK with the West Midlands having the highest incidence after London. Treatment is usually for a minimum of 6 months and requires a high level of compliance. We investigated potential determinants of delays and completion of treatment for tuberculosis (TB) in the West Midlands, UK.


METHODS
We used data on 4840 patients with TB in the West Midlands from the Enhanced Tuberculosis Surveillance database from 1 January 2005 to 1 October 2010. We used regression models to investigate the cross-sectional association between sociodemographic and clinical risk factors and the timeliness and completion of TB treatment.


RESULTS
Patients with TB waited 82 days on average from symptom onset to treatment initiation. Female patients spent 6% longer time than males before receiving treatment [95% confidence interval (CI): 1.2-11.6%, P = 0.015]. Asian/Asian British patients were 11 times more likely to complete treatment than White patients (adjusted odds ratio: 11.4, 95% CI: 1.31-100.3, P = 0.028).


CONCLUSIONS
Females in the West Midlands took longer time to receive TB treatment than males, representing a health inequality that could be addressed through gender-sensitive awareness raising programmes. White patients were less likely to complete treatment than Asian/Asian British patients; additional support is needed in this group.
School of Health and Population Sciences, University of Birmingham, Room 240, Edgbaston, Birmingham B15 2TT, UK. hamira.sultan@nhs.net
Hamira
H
Sultan
Shamil
S
Haroon
Naveed
N
Syed
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use*; D044466:Asian People; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006287:Health Planning Guidelines; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D055118:Medication Adherence / Q000208:ethnology; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013997:Time Factors; D014376:Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology; D044465:White People; D055815:Young Adult; D016903:Drug Monitoring
D000995:Antitubercular Agents