title: Reasons for Non-Enrollment in Treatment among Multi-Drug Resistant Tuberculosis Patients in Hunan Province, China.
abstract: In 2015, only 49% of notified multi-drug resistant tuberculosis (MDR-TB) patients in China were estimated to have initiated treatment, compared with 90% of those worldwide. A case-control study was conducted to identify the reasons for non-enrollment in treatment among MDR-TB patients in Hunan province, China. All detected MDR-TB patients registered in designated MDR-TB hospitals in Hunan province from 2011 to 2014 were included and followed until June 2015 to determine their treatment status. Approximately 33.8% (482/1425) of patients were not enrolled in standardized treatment. Factors associated with lower enrollment rate were: age greater than 60 years, living in rural area, unemployed or occupation unreported. Of those who were not enrolled in MDR-TB treatment, the primary reasons for non-enrollment included economic hardship (23.0%), out-migration for work (18.0%), concerns about work and studies (13.7%), and the belief that they were cured after undergoing drug-sensitive TB treatment (12.4%). Therefore, comprehensive strategies targeting priority populations, especially those enhancing treatment affordability and availability, need to be implemented to improve MDR-TB control.
authors.affiliation: Department of tuberculosis control, Tuberculosis Control Institute of Hunan Province, Changsha city, Hunan province, China.
authors.forename: Zuhui
authors.identifier: http://orcid.org/0000-0003-0757-2768
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of tuberculosis control, Tuberculosis Control Institute of Hunan Province, Changsha city, Hunan province, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Xiao
authors.affiliation: Department of tuberculosis control, Tuberculosis Control Institute of Hunan Province, Changsha city, Hunan province, China.
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of MDR-TB internal medicine, Hunan Chest hospital, Changsha city, Hunan province, China.
authors.forename: Kunyun
authors.initials: K
authors.lastname: Yang
authors.affiliation: Department of tuberculosis control, Tuberculosis Control Institute of Hunan Province, Changsha city, Hunan province, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Tang
authors.affiliation: Department of director's office, Tuberculosis Control Institute of Hunan Province, Changsha city, Hunan province, China.
authors.forename: Liqiong
authors.initials: L
authors.lastname: Bai
mesh_terms: D000328:Adult; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*; D055815:Young Adult