Evaluation of the treatment after default rates in a Tuberculosis Dispensary in 10 years period and the effect of directly observed treatment

Abstract

Background: We aimed to evaluate that defaulting from tuberculosis (TB) treatment rates and patient characteristics in our dispensary in 10 years period.

Methods: The files of patients with treatment after default between 1997 and 2006 were retrospectively analysed. Statistical analyses were made using SPSS package programme.

Results: Between 1997 and 2006 a total of 3142 patients undergoing treatment, 67 (2.13%) had defaulting from treatment. Treatment after default rates with respect to years were 3.2% in 1997, 2.8% in 1998, 3.0% in 1999, 3.0% in 2000, 2.9% in 2001, 3.4% in 2002, 1.4% in 2003, 1.0% in 2004, 0.5% in 2005 and 1.3% in 2006. The mean period for treatment after default was 2.4±1.6 months. When patients were grouped into two with respect to treatment periods (1997-2001 and 2002-2006); age, gender, marrital status, education status, the number of household contacts, the mean treatment after default months, the type of the disease, demonstrated no statistically significant difference.

Conclusion: It was found out that treatment after default rates in our dispensary in 10 years period is less than 5% which is targetted by World Health Organization (WHO). No differences about social and clinical characteristics of cases were detected.

Keywords

• Tuberculosis, treatment, patient compliance

References

1. Global tuberculosis control: surveillance, planning, financing: WHO report 2008. WHO Press, Geneva, 2008, p. 1-3.
2. Management of Tuberculosis Training for Health Facility Staff. Importance of TB as a public health problem. World Health Organization Geneva, 2003, p. 1Vree M, Huong NT, Duong BD, et al. Mortality and failure among tuberculosis patients who did not complete treatment in Vietnam: a cohort study. BMC Public Health 2007; 7: 134.
3. Jittimanee SX, Madigan EA, Jittimanee S, Nontasood C. Treatment default among urban tuberculosis patients, Thailand. Int J Nurs Pract 2007; 13: 354-362.
4. Jakubowiak W, Korzeniewska M, Kus J, et al. TB Manual National Tuberculosis Programme Guidelines. Case definitions and treatment categories. Warsaw 2001; 3-15.
5. Pinidiyapathirage J, Senaratne W, Wickremasinghe R. Prevalence and predictors of default with tuberculosis treatment in Sri Lanka [abstract]. Southeast Asian J Trop Med Public Health Nov; 2008; 39: 1076-1082.
6. Kittikrasiak W, Burapat C, Kaewsa-ard S, et al. Factors associated with tuberculosis treatment default among HIV-infected tuberculosis patients in Thailand. Trans R Soc Trop Med Hyg 2009; 103: 59-66.
7. Thiam S, Le Fevre AM, Hane F, et al. Effectiveness of a strategy to improve adherence to tuberculosis treatment in a resource- poor setting: a cluster randomized controlled trial. JAMA 2007; 297: 3803
8. Munro SA, Lewin SA, Smith HJ, et al. Patient adherence to tuberculosis treatment: a systematic review of qualitative research. Plos Medicine 2007; 4: e2

9. Shargie EB, Lindtjorn B. Determinants of treatment adherence among smear-positive pulmonary tuberculosis patients in Southern Ethiopia. Plos Medicine 2007; 4: 280-286.
10. Kruk ME, Schwalbe NR, Aguiar CA. Timing of default from tuberculosis treatment: a systematic review. Tropical Medicine and International Health 2008; 13: 703-712.
11. Jakubowiak W, Bogorodskaya E, Borisov S, Danilova I, Kourbatova E. Treatment interruptions and duration associated with default among new patients with tuberculosis in six regions of Russia. Int J Infect Dis 2009; 13: 362-368.
12. Jakubowiak W, Bogorodskaya E, Borisov S, Danilova DI, Kourbatova EK. Risk factors associated with default among new pulmonary TB patients and social support in six Russian regions. Int J Tuberc Lung Dis 2007; 11: 46-53.
13. Brasil PE, Braga JU. Meta-analysis of factors related to health services that predict treatment default by tuberculosis patients. Cad Saude Publica 2008; 24 Suppl 4: 485-502.
14. Kapela BK, Anuwatnonthakate A, Komsakorn S, et al. Directly observed treatment is associated with reduced default among foreign tuberculosis patients in Thailand. Int J Tuberc Lung Dis 2009; 13: 232-237.
15. Tekle B, Mariam DH, Ali A. Defaulting from DOTS and its determinants in three districts of Arsi Zone in Ethiopia. Int J Tuberc Lung Dis 2002; 6: 573-579.
16. Daniel OJ, Oladapo OT, Alausa OK. Default from tuberculosis treatment programme in Sagamu, Nigeria. Niger J Med 2006; 15: 63-67.
17. Santha T, Garg R, Frieden TR, et al. Risk factors associated with default, failure and death among tuberculosis patients treated in a DOTS programme in Tiruvallur District, South India, 2000. Int J Tuberc Lung Dis 2002; 6: 780-788.
18. Driver CR, Matus SP, Bayuga S, Winters AI, Munsiff SS. Factors associated with tuberculosis treatment interruption in New York City. J Public Health Manag Pract 2005; 11: 361-368.
19. Chan- Yeung M, Noertjojo K, Leung CC, Cham SI, Tam CMet. Prevalence and predictors of default from tuberculosis treatment in Hong Kong. Hong Kong Med J 2003; 9: 263-268.
20. Cayla JA, Caminero JA, Rey R, et al. Current status of treatment completion and fatality among tuberculosis patients in Spain. Int J Tuberc Lung Dis 2004; 8: 4584
21. Kaona FA, Tuba M, Siziya S, Sikaona L. An assessment of factors contributing to treatment adherence and knowledge of TB transmission among patients on TB treatment. BMC Public Health 2004 29; 4: 68.
22. Sevim T, Aksoy E, Ataç G, et al. Tretament adherence of 717 patients with tuberculosis in a social security system hospital in Istanbul, Turkey. Int J Tuberc Lung Dis 2002; 6: 25-31.
23. Al- Hajjaj MS, Al-Khatim IM. High rate of noncompliance with anti-tuberculosis treatment despite a retrieval system: a call for implementation of directly observed therapy in Saudi Arabia. Int J Tuberc Lung Dis 2000; 4: 345-349.
24. Lertmaharit S, Kamol-Ratankul P, Sawert H, Jittimanee S, Wangmanee S. Factors associated with compliance among tuberculosis patients in Thailand. J Med Assoc Thai 2005; 4: 149-156.
25. Rakotonirina el-CJ, Ravaoarisa L, Randriatsarafara FM, Rakotomanga J de D, Robert A. Factors associated with tuberculosis treatment non-compliance in Antananarivo city, Madagaskar. Sante Publique 2009; 21: 139-146.
26. Nuwaha F. Factors influencing completion of treatment among tuberculosis patients in Mbarara District, Uganda. East Afr Med J 1997; 74: 690-693.
27. Mesfin MM, Newell JN, Walley JD, et al. Quality of tuberculosis care and its association with patient adherence to treatment in eight Ethiopian districts. Health Policy Plan 2009; 24: 457-466.
28. Chee CB, Boudville IC, Chan SP, Zee YK, Wang YT. Patient and disease characteristics, and outcome of treatment defaulters from the Singapore TB control unit-a one year retrospective survey. Int J Tuberc Lung Dis 2000; 4: 496-503.
29. Wares DF, Singh S, Acharya AK, Dangi R. Nonadherence to tuberculosis treatment in the eastern Tarai of Nepal. Int J Tuberc Lung Dis 2003; 7: 3273
30. Management of tuberculosis training for district TB coordinators. WHO/HTM/TB/2005.347g. Module G.
31. Monitor and evaluate TB control. World Health Organization, Geneva, 2005, p. 25.