title: Differences between Risk Factors Associated with Tuberculosis Treatment Abandonment and Mortality.
abstract: OBJECTIVE
  To identify the risk factors that were associated with abandonment of treatment and mortality in tuberculosis (TB) patients.
  
  
  METHODS
  This study was a retrospective longitudinal cohort study involving tuberculosis patients treated between 2002 and 2008 in a TB reference center.
  
  
  RESULTS
  A total of 1,257 patients were evaluated, with 69.1% men, 54.4% under 40 years of age, 18.9% with extrapulmonary disease, and 9.3% coinfected with HIV. The risk factors that were associated with abandonment of treatment included male gender (OR=2.05; 95% CI=1.15-3.65) and nonadherence to previous treatment (OR=3.14; 95% CI=1.96-5.96). In addition, the presence of extrapulmonary TB was a protective factor (OR=0.33, 95% CI=0.14-0.76). The following risk factors were associated with mortality: age over 40 years (OR=2.61, 95% CI=1.76-3.85), coinfection with HIV (OR=6.01, 95% CI=3.78-9.56), illiteracy (OR=1.88, 95% CI=1.27-2.75), the presence of severe extrapulmonary TB (OR=2.33, 95% CI=1.24-4.38), and retreatment after relapse (OR=1.95, 95% CI=1.01-3.75).
  
  
  CONCLUSIONS
  Male gender and retreatment after abandonment were independent risk factors for nonadherence to TB treatment. Furthermore, age over 40 years, coinfection with HIV, illiteracy, severe extrapulmonary TB, and retreatment after relapse were associated with higher TB mortality. Therefore, we suggest the implementation of direct measures that will control the identified risk factors to reduce the rates of treatment failure and TB-associated mortality.
authors.affiliation: Faculdade de Medicina de Campos (FMC), 28035-581 Campos dos Goytacazes, RJ, Brazil.
authors.forename: Nathália Mota
authors.initials: NM
authors.lastname: de Faria Gomes
authors.affiliation: Faculdade de Medicina de Campos (FMC), 28035-581 Campos dos Goytacazes, RJ, Brazil.
authors.forename: Meire Cardoso
authors.initials: MC
authors.lastname: da Mota Bastos
authors.affiliation: Faculdade de Medicina de Campos (FMC), 28035-581 Campos dos Goytacazes, RJ, Brazil.
authors.forename: Renata Magliano
authors.initials: RM
authors.lastname: Marins
authors.affiliation: Faculdade de Medicina de Campos (FMC), 28035-581 Campos dos Goytacazes, RJ, Brazil.
authors.forename: Aline Alves
authors.initials: AA
authors.lastname: Barbosa
authors.affiliation: Faculdade de Medicina de Campos (FMC), 28035-581 Campos dos Goytacazes, RJ, Brazil ; Programa de Controle da Tuberculose, Centro de Referência Augusto Guimarães, 28085-500 Campos dos Goytacazes, RJ, Brazil.
authors.forename: Luiz Clóvis Parente
authors.initials: LC
authors.lastname: Soares
authors.affiliation: Faculdade de Medicina de Campos (FMC), 28035-581 Campos dos Goytacazes, RJ, Brazil.
authors.forename: Annelise Maria
authors.initials: AM
authors.lastname: de Oliveira Wilken de Abreu
authors.affiliation: Faculdade de Medicina de Campos (FMC), 28035-581 Campos dos Goytacazes, RJ, Brazil ; Instituto Federal de Educação, Ciência e Tecnologia Fluminense (IFF), 28060-010 Campos dos Goytacazes, RJ, Brazil.
authors.forename: João Tadeu Damian
authors.initials: JT
authors.lastname: Souto Filho
mesh_terms: D000367:Age Factors; D000995:Antitubercular Agents / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D000067010:Literacy / Q000706:statistics & numerical data; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality*
chemical_list: D000995:Antitubercular Agents