Analysis of risk factors for default and failure treatment among patients with pulmonary tuberculosis under DOTS strategy

Abstract

Background: The biggest incidence of tuberculosis (114.3/100.000) in the Republic of Moldova correlates with the lowest success treatment rate (52.3%), the biggest default rate (10.9%) and failure rate (3.5%) in new pulmonary TB cases among European region countries. Material and methods: We studied social, economical, epidemiological risk factors and case-management features of a total amount of 457 pulmonary tuberculosis cases, distribuited in 1-st study group, consisting of 201 cases who failed the anti-tuberculosis treatment, 2-nd study group, consisting of 142 cases, who defaulted the treatment, and a control group of 105 successfully treated patients under Directly Observed Treatment Short Course Chemotherapy. Statistic evaluation was performed using T Student criteria and Odds Ratio, calculated through the two by two table. Results: According to the predictible value, high risc factors for failure were: chronic alcohol consumption, detention releasing and for default were: male sex, economic disadvantage, single civil state, chronic alcohol consumption, detention releasing. Conclusions: Default and failure antituberculosis treatment refers to the patients belonging to economicaly and social disadvantaged groups, with harmful habits (alcoholosm, drug injection using, active smoking), low living conditions, belonging high risk epidemiological groups. Migrations, homelessness and detention releasing imperil the continuing of antituberculosis treatment, predisposisng to failure and default of the antituberculosis treatment. Social, educational support and withdrawl techniques for harmful habits must be implemented to high risk groups to minimise the risk of non-adherence to the disease.