Abandonment of therapy in multidrug-resistant tuberculosis: Associated factors in a region with a high burden of the disease in Perú
Rivera O, Benites S, Mendigure J, Bonilla CA
Biomedica : revista del Instituto Nacional de Salud · 2019-08
Abstract
Introduction: In the context of multidrug-resistant tuberculosis, abandonment of therapy represents a serious public health problem that affects the quality of life of patients, families, and communities. Managing this phenomenon places a burden on health systems since it causes free sources of transmission in the community, thereby increasing prevalence and mortality. Thus, there is a need to study factors associated with this problem. Objective: This study sought to identify risk factors associated with the abandonment of therapy by patients with multidrug-resistant tuberculosis in the Peruvian region of Callao. Materials and methods: We conducted an analytical case-control study (cases=80; controls=180) in patients under treatment from January 1st, 2010, to December 31, 2012. Risk factors were identified using logistic regression; odds ratios (OR) and 95% confidence intervals (CI) were calculated. Results: The multivariate analysis identified the following risk factors: Being unaware of the disease (OR=23.10; 95% CI 3.6-36.79; p=0.002); not believing in healing (OR=117.34; 95% CI 13.57-124.6; p=0.000); not having social support (OR=19.16; 95% CI 1.32-27.77; p=0.030); considering the hours of attention to be inadequate (OR=78.13; 95% CI 4.84-125.97; p=0.002), and not receiving laboratory reports (OR=46.13; 95% CI 2.85-74.77; p=0.007). Conclusion: Health services must focus on the early detection of conditions that may represent risk factors to proactively implement effective, rapid and high-impact interventions.
MeSH terms
- Humans
- Mycobacterium tuberculosis
- Tuberculosis, Multidrug-Resistant
- Antitubercular Agents
- Drug Monitoring
- Microbial Sensitivity Tests
- Risk Factors
- Case-Control Studies
- Attitude to Health
- Motivation
- Professional-Patient Relations
- Life Style
- Culture
- Quality of Life
- Social Support
- Socioeconomic Factors
- Adolescent
- Adult
- Aged
- Middle Aged
- Patient Dropouts
- Educational Status
- Health Services Accessibility
- Female
- Male
- Medication Adherence
- Young Adult
- Precision Medicine