title: Tuberculosis treatment default in a large tertiary care hospital in urban Nigeria: prevalence, trend, timing and predictors.
abstract: OBJECTIVE
  Few studies have investigated tuberculosis treatment default in tertiary care settings. We aimed to determine the prevalence, trend, timing and predictors of defaulting from tuberculosis treatment in a Nigerian tertiary hospital.
  
  
  METHODS
  Data entered from 2006 to 2010 in the Federal Medical Centre, Abakaliki, tuberculosis treatment register were sorted into six treatment outcomes. Five outcomes were combined into one variable called 'non-defaulters' and were compared with "defaulters". The statistical analysis was conducted using SPSS.
  
  
  RESULTS
  Of 671 tuberculosis patients, 192 (28.6%) defaulted. Of these, 126 (66%) were ≥30 years old, and 115 (60%) had pulmonary tuberculosis. Furthermore, 106 (55%) were males, and 125 (65%) lived in a rural area. The annual proportion of defaulters dropped from 34.8% to 20.6%, but the decreasing trend was not statistically significant (P=0.132 for trend). Of the defaulters, 148 (77.1%) defaulted during their intensive phase of treatment. The median default time was 7 (IQR 5-8) weeks. The independent predictors of treatment default were older age (aOR 1.5), rural residence (aOR 2.3), and HIV seropositivity (aOR, 2.8).
  
  
  CONCLUSIONS
  TB treatment default is high and must be reduced. This may be achieved through improved rural DOT, further patient education, and enhanced coordination of TB/HIV care.
authors.affiliation: Department of Medicine, Federal Medical Centre (FMC), Abakaliki, Ebonyi State, Nigeria.
authors.forename: Ngozi A
authors.initials: NA
authors.lastname: Ifebunandu
authors.forename: Kingsley N
authors.initials: KN
authors.lastname: Ukwaja
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy*; D016903:Drug Monitoring
chemical_list: D000995:Antitubercular Agents