Noncompliance with tuberculosis treatment by patients at a tuberculosis and AIDS reference hospital in midwestern Brazil

Braz J Infect Dis. 2002 Apr;6(2):63-73. doi: 10.1590/s1413-86702002000200002.

Abstract

Introduction: In developing countries, there is little information about the risk factors that predict noncompliance with tuberculosis (TB) treatment in hospitals.

Objective: This study analyzes possible factors associated with noncompliance with TB treatment among patients treated at HAA.

Design: A retrospective cohort study was made including all patients who initiated TB treatment at HAA, from January to December 1998. A standard form was used to review medical records and to collect data on each patient. This data was evaluated in comparison with data from the state TB control program.

Results: Of the 341 patients included in the study, 186 (61.2%) were considered cured and 67 (22%) were non-compliant. The factors associated with noncompliance were: previous anti-TB treatment (RR = 1.95, 95% CI 1.29 to 2.93), prescription of drugs other than the standard first-line regimen proposed by the Brazilian Health Ministry (Rifampin + Isoniazide + Pyrazinamide) (RR = 0.54, 95% CI 0.35 to 0.83), the need for hospitalization (RR = 2.19, 95% CI 1.46 to 3.29) and non-inclusion in the hospital s TB Control Program for treatment follow up (RR = 0.54, 95% CI 0.35 to 0.82).

Setting: Anuar Auad Hospital (HAA) Goiânia, Goiás, Brazil.

Conclusion: Our results indicate the importance of establishing Tuberculosis Control Programs in hospitals, while paying special attention to patients with risk factors for noncompliance with TB treatment.

MeSH terms

  • Acquired Immunodeficiency Syndrome* / complications
  • Adolescent
  • Adult
  • Aged
  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / therapeutic use
  • Brazil / epidemiology
  • Child
  • Child, Preschool
  • Female
  • Hospitals*
  • Humans
  • Infant
  • Infant, Newborn
  • Isoniazid / therapeutic use
  • Male
  • Medical Records
  • Middle Aged
  • Patients / psychology
  • Patients / statistics & numerical data*
  • Pyrazinamide / therapeutic use
  • Rifampin / therapeutic use
  • Risk Factors
  • Treatment Refusal / statistics & numerical data*
  • Tuberculosis / complications
  • Tuberculosis / drug therapy*
  • Tuberculosis / epidemiology

Substances

  • Antitubercular Agents
  • Pyrazinamide
  • Isoniazid
  • Rifampin