Data from: Patient characteristics associated with tuberculosis treatment default: a cohort study in a high-incidence area of Lima, Peru

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.