Predictors of failure to complete tuberculosis treatment in London, 2003-2006

Int J Tuberc Lung Dis. 2010 Nov;14(11):1411-7.

Abstract

Setting: London, 2003-2006.

Objectives: To investigate tuberculosis (TB) treatment completion failure in London and associated risk factors during 2003-2006.

Design: Cross-sectional analysis of treatment outcome and other explanatory variables in a cohort of TB patients reported to the London TB Register from 2003 to 2006.

Methods: An innovative definition of TB treatment outcome more suitable for low-incidence industrialised countries, such as the United Kingdom, was adopted. A multivariable logistic approach was used to assess predictors of unsuccessful outcome.

Results: A total of 12,929 TB cases were notified from 2003 to 2006, of which 12% (n = 1536) failed to complete TB treatment. The proportion of cases failing to complete treatment showed a significant decrease from 2003 to 2006 (13% in 2003 vs. 10% in 2006). Males, the elderly, hospitalised patients, short- and long-term immigrants, Whites and the least deprived were more likely to fail to complete treatment.

Conclusions: The proportion of TB treatment success in London exceeded the World Health Organization recommended threshold of 85%. Some specific categories of patients that are more likely to fail to complete treatment should be targeted by health services to enhance their engagement and adherence to the treatment regimen.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Antitubercular Agents / therapeutic use
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Logistic Models
  • London
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Registries
  • Risk Factors
  • Sex Factors
  • Treatment Outcome
  • Treatment Refusal*
  • Tuberculosis / drug therapy*
  • Young Adult

Substances

  • Antitubercular Agents