title: Risk factors for treatment default among adult tuberculosis patients in Indonesia.
abstract: METHODS
  Defaulting from anti-tuberculosis treatment hinders tuberculosis (TB) control.
  
  
  OBJECTIVE
  To identify potential defaulters.
  
  
  METHODS
  We conducted a cohort study in newly diagnosed Indonesian TB patients. We administered a questionnaire, prospectively identified defaulters (discontinued treatment ≥ 2 weeks) and assessed risk factors using Cox's regression.
  
  
  RESULTS
  Of 249 patients, 39 (16%) defaulted, 61% in the first 2 months. Default was associated with liver disease (HR 3.40, 95%CI 1.02-11.78), chest pain (HR 2.25, 95%CI 1.06-4.77), night sweats (HR 1.98, 95%CI 1.03-3.79), characteristics of the head of the household (self-employed, HR 2.47, 95%CI 1.15-5.34; patient's mother, HR 7.72, 95%CI 1.66-35.88), household wealth (HR 4.24, 95%CI 1.12-16.09), walking to clinic (HR 4.53, 95%CI 1.39-14.71), being unaccompanied at diagnosis (HR 30.49, 95%CI 7.55-123.07) or when collecting medication (HR 3.34, 95%CI 1.24-8.98) and low level of satisfaction with the clinic (HR 3.85, 95%CI 1.17-12.62) or doctors (HR 2.45, 95%CI 1.18-5.10). Health insurance (HR 0.24, 95%CI 0.07-0.74) and paying for diagnosis (HR 0.14, 95%CI 0.04-0.48) were protective.
  
  
  CONCLUSIONS
  Defaulting is common and occurs early. Interventions that improve clinic services, strengthen patient support and increase insurance coverage may reduce default in Indonesia.
authors.affiliation: Centre for International Health, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand; Health Research Unit, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.
authors.forename: M E
authors.initials: ME
authors.lastname: Rutherford
authors.forename: P C
authors.initials: PC
authors.lastname: Hill
authors.forename: W
authors.initials: W
authors.lastname: Maharani
authors.forename: H
authors.initials: H
authors.lastname: Sampurno
authors.forename: R
authors.initials: R
authors.lastname: Ruslami
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007214:Indonesia; D019458:Insurance Coverage / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014376:Tuberculosis / Q000188:drug therapy*; D016903:Drug Monitoring
chemical_list: D000995:Antitubercular Agents