Risk factors of treatment default and death among tuberculosis patients in a resource-limited setting

作     者：Isaac Alobu Sarah N.Oshi Daniel C.Oshi Kingsley N.Ukwaja 

作者机构：National Tuberculosis and Leprosy Control ProgrammeMinistry of HealthAbakalikiEbonyi StateNigeria Centre for Development and Reproductive HealthEnugu.Enugu StateNigeria Department of Internal MedicineFederal Teaching HospitalAbakalikiEbonyi StateNigeria 

出 版 物：《Asian Pacific Journal of Tropical Medicine》 (亚太热带医药杂志（英文版）)

年 卷 期：2014年第7卷第12期

页      面：977-984页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：supported through an operational research writing grant.which is a componcnt of the Wave 3 TBREACH grant from the WHO/Stop TB Partnership with funals from the Canadian International Development Agency(CIDA) 

主　　题：Tuberculosis Epidemiology Treatment default Mortality Treatment outcome Health services Nigeria 

摘      要：Objective:To evaluate the rates,timing and determinants of default and death among adult tuberculosis patients in ***:Routine surveillance data were used.A retrospective cohort study of adult tuberculosis patients treated during 2011 and 2012 in two large health facilities in Ebonyi *** was *** logistic regression analyses were used to tdentify independent predictors for treatment default and ***:Of 1668 treated patients,the default rate was 157(9.4%),whilst 165(9.9%) ***,35.7%(56) of the treatment defaults and 151(91.5%) of deaths occurred during the intensive phase of *** of default increased with increasing age(adjusted odds ratio(aOR) 1.2;95%confidence interval(CI)1.1-1.9).smear-negative TB case(aOR 2.3:CI 1.5-3.6).extrapulmonary TB case(aOR 2.7:CI 1.3-5.2).and patients who received the longer treatment regimen(aOR 1,6;1.1-2.2).Risk of death was highest in extrapulmonary TB(aOR 3.0:CI 1.4-6.1) and smear-negative TB cases(aOR 2.4:*** residents(aOR 1.7:CI 1.2-2.6),HIV co-infected(aOR 2.5:CI 1.7-3.6),not receiving antiretroviral therapy(aOR 1.6:CI 1.1-2.9),and not receiving cotrimoxazole prophylaxis(aOR 1.7:CI 1.2—2.6).Conclusions:Targeted interventions to improve treatment adherence for patients with the highest risk of default or death are urgently *** needs to he urgently addressed by the National Tuberculosis Programme.