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Patient Characteristics Associated with Tuberculosis Treatment Default: A Cohort Study in a High-Incidence Area of Lima, Peru

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dc.contributor.author Lackey, Brian
dc.contributor.author Seas Ramos, Carlos Rafael
dc.contributor.author Van der Stuyft, Patrick
dc.contributor.author Otero Vegas, Larissa
dc.date.accessioned 2019-02-06T14:53:10Z
dc.date.available 2019-02-06T14:53:10Z
dc.date.issued 2015
dc.identifier.uri https://hdl.handle.net/20.500.12866/5396
dc.description.abstract BACKGROUND: Although tuberculosis (TB) is usually curable with antibiotics, poor adherence to medication can lead to increased transmission, drug resistance, and death. Prior research has shown several factors to be associated with poor adherence, but this problem remains a substantial barrier to global TB control. We studied patients in a high-incidence district of Lima, Peru to identify factors associated with premature termination of treatment (treatment default). METHODS: We conducted a prospective cohort study of adult smear-positive TB patients enrolled between January 2010 and December 2011 with no history of TB disease. Descriptive statistics and multivariable logistic regression analyses were performed to determine risk factors associated with treatment default. RESULTS: Of the 1233 patients studied, 127 (10%) defaulted from treatment. Patients who defaulted were more likely to have used illegal drugs (OR = 4.78, 95% CI: 3.05-7.49), have multidrug-resistant TB (OR = 3.04, 95% CI: 1.58-5.85), not have been tested for HIV (OR = 2.30, 95% CI: 1.50-3.54), drink alcohol at least weekly (OR = 2.22, 95% CI: 1.40-3.52), be underweight (OR = 2.08, 95% CI: 1.21-3.56), or not have completed secondary education (OR = 1.55, 95% CI: 1.03-2.33). CONCLUSIONS: Our study identified several factors associated with defaulting from treatment, suggesting a complex set of causes that might lead to default. Addressing these factors individually would be difficult, but they might help to identify certain high-risk patients for supplemental intervention prior to treatment interruption. Treatment adherence remains a barrier to successful TB care and reducing the frequency of default is important for both the patients' health and the health of the community. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS ONE
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Young Adult en_US
dc.subject Odds Ratio en_US
dc.subject Cohort Studies en_US
dc.subject Middle Aged en_US
dc.subject Peru/epidemiology en_US
dc.subject Prospective Studies en_US
dc.subject Treatment Outcome en_US
dc.subject Risk Factors en_US
dc.subject Incidence en_US
dc.subject Antitubercular Agents/therapeutic use en_US
dc.subject Body Weight en_US
dc.subject Alcohol Drinking en_US
dc.subject Substance-Related Disorders/complications/diagnosis en_US
dc.subject Tuberculosis, Multidrug-Resistant/diagnosis/drug therapy en_US
dc.subject Tuberculosis/complications/drug therapy/epidemiology en_US
dc.title Patient Characteristics Associated with Tuberculosis Treatment Default: A Cohort Study in a High-Incidence Area of Lima, Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pone.0128541
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.07
dc.relation.issn 1932-6203


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